Hospitals increasingly turning to healthcare assistants to plug care gap

NHS hospitals are “plugging the care gap” with healthcare assistants where they are struggling to recruit nurses, a new report suggests.

The document, by BPP University School of Nursing, states that while nursing positions rose by 0.5% between December 2015 to December 2017, the number of healthcare assistants rose by 6.5%.

The authors of the report said that for every additional nurse hired over those two years, almost four extra healthcare assistants were appointed.

They said 29% of care roles in NHS trusts in England are now being carried out by healthcare assistants.

The report, based on responses to Freedom on Information requests to NHS trusts in England – of which 67% of acute trusts responded – states that the number of nurses working in the responding trusts remained “virtually unchanged” over a two-year period, increasing slightly from 270,725 in December 2015 to 272,476 in December 2017.

Meanwhile, the number of healthcare assistant roles in these trusts rose from 103,797 in 2015 to 110,450 in 2017.

But the authors cautioned that the nurse vacancy rates in the same period paint a more “alarming picture”.

Across all English trusts, the nursing and midwifery vacancy rate rose from 28,713 in December 2015 to 34,682 in December 2017 – a rise of 21%, they wrote.

“Although nursing numbers appear to be holding up, the sharp increase in vacancies tells a different story. They have soared by over a fifth in two years,” they wrote.

“To plug that care gap, trusts are increasingly turning to healthcare assistants, whose numbers have grown substantially.”

Professor Lynne Gell, dean of BPP University School of Nursing, said: “As demands for care rise inexorably and the supply of nurses struggles to keep pace with that demand, it’s inevitable that hospital trusts will look to other sources for their staffing requirements.

“We won’t solve our care staffing needs by standing still. We have to think more imaginatively about routes into health care and attracting and training more people.”

Commenting on the report, Dr Anne Corrin, head of professional learning development at the Royal College of Nursing, said: “Healthcare assistants offer vital support to registered nurses and other clinical staff, and perform an important role as part of a multi-disciplinary team.

“But it is a very different role to a registered nurse and cannot and should not be used as a substitute.

“This is not fair on healthcare assistants, who may feel under pressure to perform tasks they are not trained for, and it is not fair on patients, who will rightly be concerned if healthcare assistants are replacing registered nurses.

“This trend highlights yet again that across England we are desperately short of registered nurses.

“The Government must pass legislation that guarantees the right number of staff with the necessary skills to keep patients safe. This should be underpinned by a workforce strategy that responds to population need and prioritises nurse recruitment and retention.”

A Department of Health and Social Care spokeswoman said: “Healthcare assistants are a vital part of the NHS and work incredibly hard to make sure patients get excellent care.

“As the demands on the NHS continue to grow it’s right that more are recruited alongside the 12,200 more nurses we have on our wards since 2010 and the 52,000 nurses in training – and more to come thanks to our historic commitment to a 25% increase in training places.

“We have also opened up new routes into nursing, such as the nurse degree apprenticeship, to encourage healthcare assistants to reach their potential as fully trained nurses and ensure the NHS has the staff it needs for the future.”

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