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Too many working beyond limits of competence

The big story last week was the call for ministers to introduce standards for the growing number of unregulated healthcare assistants working in the NHS.

Firstly the Royal College of Nursing’s Peter Carter highlighted the increasing replacement of nursing roles with HAs. And then the Nursing and Midwifery Council’s Prof Dickon Weir-Hughes said the lack of compulsory regulation and training of HAs means that many are working beyond their competence levels, increasing the potential for things to go wrong. Hundreds of complaints are made against HAs each year, but with officials powerless to act, we continue in a circle where lessons aren’t learnt and changes aren’t made.

Our experience at MPS shows that working beyond the limits of competence is an issue for many other health professionals, including nurses and doctors.

Financial constraints can lead to more responsibilities being given to less expensive staff. While this may save money in the short term, it doesn’t add up to safe care and increases the risk of costly mistakes.

With savings of around 4% to be made annually over each of the next four years, the NHS faces a massive challenge in maintaining standards of healthcare. If high level tasks are pushed down the chain to staff with insufficient training, this will lead to unsafe practice and harm to patients. These short term savings could potentially lead to high cost claims and complaints in the future.

Today, our health service is staffed with people who have wide variations of knowledge, skills and experience. More and more, we see nurse practitioners and advanced nurse practitioners providing frontline care in general practice and out of hours, but there is no regulation or minimum standard for job titles. This causes confusion and a real potential for a mismatch between responsibilities and competence.

I am also concerned that doctors who have trained outside the UK can be recruited to work in the NHS without any language testing or familiarity of NHS structure. The GMC’s decision to introduce mandatory basic induction is a welcome step to address this issue, but I still think more needs to be done.

Employers have an important role to play in ensuring that they recruit the right people, with the right skills and experience, to the right role. It is unacceptable to recruit without assessing CVs, references, skills and reviewing performance. It is critical that they also invest in specific high level training to make sure all healthcare workers have the right breadth and depth of skills to ensure safe and sound assessment of patients.

The safety of patients should always be our primary concern and it is important that tighter budgets and increased responsibilities do not push an already stretched healthcare system over the edge.

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One Response to “Too many working beyond limits of competence”

  1. DarellC says:

    “I am also concerned that doctors who have trained outside the UK can be recruited to work in the NHS without any language testing or familiarity of NHS structure. The GMC’s decision to introduce mandatory basic induction is a welcome step to address this issue, but I still think more needs to be done.”
    While I really have no problem whatsoever with foreign nurses filling positions left vacant in our healthcare system, I do agree that language testing should be mandatory. A big part of nursing is based on communication, nurse-to-colleagues and nurse-to-patient, so surely language ability is a vital necessity?

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