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Evolution of the health care support worker role

 Matthew MacDowall 15 May 2018

RCN Scotland are profiling and giving health care support workers (HCSWs) a voice in our We Care campaign. Matthew McDowall, Quality Improvement Assistant, at Erskine Care Home gives an insight into his role and explains why it’s important HCSWs’ views are heard.

As our National Health Service has grown and evolved since its inception nearly 70 years ago, so too has the role of health care support worker (HCSW) and the need for more skilled roles within the wider HCSW field. There have been numerous external factors involved in the growing necessity for the HCSW role, some of those factors include; continued increases in chronic disease, expansion of community care and the introduction of legislation/policies put in place to safeguard medical staff by limiting the number of working hours. 


Having worked in a Nursing Home setting caring for disabled ex-veterans and spouses for over 20 years I have witnessed and been a part of the changes to skilled HCSW roles. I began as a part-time Nursing Auxiliary at the age of 16, where the belief amongst some medical/nursing staff was that they were paid from the neck up, and we (the Auxiliaries) were paid from the neck down, and certainly that was the case as much of, if not all of our duties were task orientated and hands-on with little credence given to the experience based knowledge and opinions of the Auxiliary. 

I am fortunate the organisation I work for supported me to train and develop into the role of Senior Care Assistant. In this role I worked alongside the nursing staff, carrying out administrative, care planning and supervisory duties. I recently earned a promotion to Quality Improvement Assistant within our clinical governance department, a HCSW role where my experience and knowledge are utilised to help identify areas for improvement within the service. I continue to work alongside staff at all levels to make the necessary changes to not only the care that we deliver but to the policies and procedures that govern us. It’s really important our voices are heard in all quarters, both in the workplace and as part of wider workforce planning, and our views are taken into account.  

There is overwhelming evidence all over the country of the benefits to both the service and, more importantly, the service users when organisations, large and small, invest in skilled HCSWs’ training and development and involve staff with decision-making. What return do you get in return? You get an engaged workforce who feel supported and included in the planning/policy making process and who continue to strive for improvement and always go the extra mile.

Matthew MacDowall

Matthew MacDowall

Quality Improvement Assistant, Erskine Care Home