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Best practice involves quality improvement

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HCAs must be regulated HCAs must be regulated

Whenever there is a question mark over health or social care quality, ministers react with proposals to increase scrutiny and strengthen regulation. This may well be required, but as nurses point out in our news focus there should be equal emphasis on encouraging and supporting staff to achieve excellence.

A spectrum exists, ranging from 'quality assurance' (stopping people from doing their worst) to 'quality improvement' (helping people to do their best) and the current focus is squarely on the former.

I would argue that a balance is required in order to facilitate a culture in which compassion thrives, and practice remains safe but in which nurses are able to embrace innovation and develop services to meet patients' needs. This balance must be addressed and where regulation is needed, it must be put in place, not simply discussed, costed, then dismissed. While wishing to increase health care scrutiny, ministers are loathe to put their hands in their pockets.

The call for compulsory healthcare assistant (HCA) registration and regulation is loud and clear and comes not only from other health professionals and patients but from support workers themselves. In a recent survey by IN's sister publication the British Journal of Healthcare Assistants, 93% of 385 HCA respondents agreed there should be a compulsory registration for healthcare support workers. A total of 76% agreed support workers should be regulated.

Despite this, the government continues, stubbornly, to support its policy of voluntary registration for HCAs belying the rhetoric that it will do whatever it takes to stamp out serious care failings. Ministers are keen to impose a statutory duty of candour on those working in health; perhaps they should be reminded of their own duty of candour and requested to adhere to it.

Sarah Wild, editor, Independent Nurse


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