In her report released yesterday [10 July] Camilla Cavendish found that HCAs, who provide basic care such as feeding and washing patients, were given no "compulsory or consistent" training, and said some were doing tasks usually performed by doctors or nurses, such as taking blood.
She called for HCAs to earn a "Certificate of Fundamental Care" and complete at least two weeks' training to prepare them for providing basic care in hospitals, care homes and at home in England.
Regulation would further protect the public
Commenting on the suggestions QNI chief executive Crystal Oldman said: "A certificate of fundamental care would provide a minimum agreed level of education and training and would arguably be beneficial in raising care standards generally, but we need to go further to protect the public and introduce a system of national regulation. This is particularly the case in the community, where care takes place behind closed doors, without the direct supervision of the qualified nurse who is ultimately responsible for the work of the healthcare support worker.
"The QNI agrees with the position of the Council of Deans of Health that a national education framework is needed before regulation could be successfully introduced. We know that healthcare support workers and patients would welcome such a national framework of education and national regulation. The QNI will continue to lobby for this to be implemented as part of our continuing Right Nurse Right Skills campaign."
The government will provide a formal response to the review, along with its response to the Francis Report into the Mid Staffordshire public inquiry, in the autumn.
It has promised to establish "minimum training standards" for HCAs by spring 2014 but Health Secretary Jeremy Hunt refused to initiate full-blown regulation, saying it could lead to a "bureaucratic quagmire".
A public inquiry into Stafford Hospital found hundreds of patients had died following neglect and abuse between 2005 and 2008.
There are more than 1.3 million frontline staff who are not registered nurses, according to the Cavendish Review.
Quality of training for HCAs varies greatly
The review says the quality of training and support that care workers receive in the NHS and social care system varies between organisations and, in some cases, is lacking.
As well as suggesting the new training certificate, it suggests calling HCAs Nursing Assistants in recognition of the important work they do.
Ms Cavendish concluded: "Patient safety in the NHS and social care depends on recognising the contribution of support workers, valuing and training them as part of a team.
"For people to get the best care, there must be less complexity and duplication and a greater focus on ensuring that support staff are treated with the seriousness they deserve - for some of them are the most caring of all."