Regulation and related issues

The RCN believes all health care assistants (HCAs) and assistant practitioners (APs) should be regulated in the interests of public safety and is committed to supporting steps towards mandatory regulation. This has been a major policy position for the RCN for many years and campaigning for regulation continues to be a priority for the organisation going forward.

The Care certificate

In England the Care Certificate will be implemented from 1 April 2015. There is an expectation that employers will support their new to post support workers to achieve the standards in the certificate within approximately twelve weeks of starting employment. For further information visit Health Education England.

Cavendish Review

The Cavendish Review is  available on the gov.uk website.

RCN work on regulation

The RCN has published various policy papers setting out its position on regulation. See the RCN work on regulation section for more information and details of member research about the perceived benefits of regulating health care assistants.

If you would like to contribute your own views on the issue please contact hca@rcn.org.uk

The regulation agenda forms an important part of the RCN’s This is Nursing initiative, along with training and education to ensure HCAs and APs are competent for their roles. Find out more about This is Nursing here.

Promoting good employment practice

In 2011 assurance codes were developed in Scotland and Wales to promote high quality care for patients and good standards of practice for all staff. These codes can be accessed as examples of good practice wherever in the UK you are employed. Many organisations have developed similar codes and guidelines.


NHS Education for Scotland have developed the health care support workers toolkit which includes the Scottish government's mandatory induction standards for health care support workers (HCSWs), a code of conduct for HCSWs and a code of practice for employers in Scotland. Mandatory induction standards have been in place since 2011.  There are separate sets of codes relating to conduct and practice in the Independent Sector produced by the Scottish Social Services Council (SSSC).  The SSSC currently require all their HCSWs to be on a register (which is paid for by the HCSWs) and they are now moving to a fitness to practice model. For more information please visit the SSSC website


A code of practice (PDF 533KB) has been developed for NHS Wales employers as well as a code of conduct for health care support workers (PDF 692KB). Principles of induction standards for health care support workers (PDF 90KB) have also been produced. An NHS Wales career and development framework for HCSW will be launched in 2015.

Northern Ireland

Northern Ireland, health and social care services are integrated. The Regulation and Quality Improvement Authority (RQIA) registers and inspects a wide range of services delivered by HSC bodies and independent sector providers. The Northern Ireland Social Care Council is now regulating all social care assistants, including those care assistants working within nursing homes. See more information.
In Northern Ireland, the RCN continues to lobby in favour of HCAs being appropriately regulated alongside their registered nurse colleagues by the Nursing and Midwifery Council. It opposes the regulation of HCAs by the Northern Ireland Social Care Council as it does not believe this to be is in the public interest.
A regional group in Northern Ireland is currently looking at an HCA code and job descriptions for those working at band 2 & 3. Further information on this work is available on Northern Ireland Practice and Education Council for Nursing and Midwifery (NIPEC).