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I have written previously about the importance of the professional regulation of healthcare assistants (HCAs). The government has made it clear that while educational standards for HCAs will be developed and implemented, there will be no professional regu

I have written previously about the importance of the professional regulation of healthcare assistants (HCAs). The government has made it clear that while educational standards for HCAs will be developed and implemented, there will be no professional regulation.

This is a missed opportunity with consequences which will be revisited many times in the years to come. HCAs will continue to practice in an unregulated way and the protection of the public will rest with the supervising professional. The accountable professional is normally a registered nurse. In the community, I have always been concerned about this, from the HCA's and the nurse's perspective.

My concerns were validated this week by a example from practice. An HCA working in a GP surgery was asked to administer infant immunisations. The HCA had no training to undertake this work but would be operating under the direction of the registered practice nurse who is trained to do this work. I am concerned the GP considered this acceptable practice, regardless of whether or not the nurse agreed to supervise the work.

Would the GP ask the HCA to do the immunisations if they were directly accountable for the work of the HCA? If it were their professional registration at risk, when babies in their practice were being immunised by someone who had no formal training or assessment of competence in understanding immunology and the administration of immunisations? As regulated professionals, we know we must operate within the boundaries of our competence. If competence is decided by another professional and they accept accountability for your work, it may engender a reliance on the knowledge of others when providing critical care.

If HCAs are to be provided with an educational structure to support professional practice, development and career progression, why not ensure they can be fully, independently accountable for their work by introducing regulation?

Crystal Oldman, chief executive,Queen's Nursing Institute