'Regulation of Health Care Support Staff and Social Care Support
Staff in Scotland'
The UNISON Scotland Response.
- UNISON Scotland agrees with the broad thrust of the consultation.
We recognise that the highest possible levels of public protection
must remain a priority and that staff, increasingly taking on
new roles and responsibilities, must be properly trained within
an appropriate career pathway
- We fully support the Executive's view that all health and
social care staff whose work impacts on the care of patients
should be subject to proper regulatory arrangements. However,
we believe that the proposed regulatory framework needs to be
drawn more broadly than is outlined in the consultation document.
- UNISON Scotland is conscious that some ancillary staff groups,
e.g. porters and domestic/house-keeping staff, frequently have
direct patient contact. As such, we believe that there may well
be a case for extending regulation to these groups. We believe
that such a move should be given serious consideration.
- UNISON Scotland acknowledges that the public has a right to
expect high standards of competence and care from health and
social care support staff. However, we also believe that in
order to provide these high standards the Executive must be
committed to fully fund the necessary training programmes for
relevant staff to achieve any new set standards.
- UNISON Scotland believes that if support staff have to undergo
more intensive training and achieve better qualifications the
Executive must also be prepared to fully fund appropriate increases
in remuneration for these groups of healthcare and social care
- In addition, we believe that before a new regulatory system
is established it is essential that the Executive ensure a comprehensive
review of the training needs of the various groups has been
carried out. In addition, we believe that the Executive must
also ensure that all necessary training programmes are fully
developed and rolled out in time to meet the requirements of
any new legislation.
- A major concern for our members - and one not addressed by
this consultation - is the key question of who bears the cost
of regulation. Experience has shown that this is likely to fall
upon those being regulated. We believe that such requirements
should not be imposed on these staff, many of who are low paid,
working part time and employed on temporary contracts.
- A related concern is, (once instigated) the arbitrary way
registration fees are increased. Healthcare assistants and support
staff are the lowest paid groups in this sector. We would oppose
those being regulated having to bear this additional cost.
UNISON Scotland welcomes this opportunity to
comment on the Scottish Executive's proposals for the regulation
of health care and social care support staff.
UNISON is Scotland's largest trade union representing 150,000
members working at the front line delivering public services.
Over 85,000 of these members work for local authorities in Scotland,
just under 50,000 are employed in the NHS in Scotland and 2,500
of our members are employed in the voluntary sector.
We represent NHS nursing, ancillary and clerical staff and a
wide range of local authority and voluntary sector social care
staff. They are all involved in building communities, supporting
families, protecting vulnerable people and caring for children.
This paper constitutes UNISON Scotland's response to the Scottish
Executive consultation document ‘Regulation of Health Care
Support Staff and Social Care Support Staff in Scotland'.
Q1 Should regulatory requirements be extended to the groups
of staff identified above? If not, which groups of staff should
be included and on what criteria?
UNISON Scotland supports the statutory regulation of those groups
of staff outlined in the consultation document. In addition, we
believe that all staff who are involved in carrying out tasks
which can substantially impact on patient health or welfare should
also be regulated to ensure protection of the public and the continued
maintenance of high standards of care.
UNISON Scotland believes that greater consideration
should be given to extending regulation to ancillary staff groups
like porters and domestic/house-keeping staff. These groups of
staff frequently come into direct contact with patients and in
discharging their duties they can impact directly on the health
and welfare of patients. They are part of the care team and as
such we believe that extending regulation to these groups should
be given serious consideration.
In addition, UNISON Scotland is keen that these staff, not as
yet regulated, have access to training opportunities for progress.
The fact that they are not regulated should not mean that they
are ignored for training and development, or considered less important
to the overall patient journey than other groups who are regulated.
Q2 Should assistants and support staff be accountable for
their own practice?
UNISON Scotland is disappointed at the assumptions made in the
document that support staff, unlike other professional groups,
are somehow incapable of self-regulation or delivering standards
of competency. This ignores the fact that this group of staff
are NOT unqualified NOR are they unprofessional in discharging
their current roles.
UNISON Scotland believes that just because Health and Social
Care Support workers have a more limited scope of practice compared
to that of Health and Social Care professionals, this does not
mean that they cannot be responsible for deciding when they do
not have the skills to undertake a delegated task.
UNISON Scotland believes that assistants and support staff should
be accountable for their own practice up to individual levels
of skills, knowledge and experience in the role that they are
currently employed to perform. We believe that the limits and
limitations of what work is carried out must be clearly defined
and within that defined area of practice, the limitations of work
must be explicit to all members of the team.
Q3 Should assistants and support staff set their own standards
OR should those with overall responsibility for the work of these
staff share in, or take, the lead in setting these standards?
UNISON Scotland believes that the task of setting standards should
be approached in a spirit of partnership. We would support a system
in which support staff are given the lead role in setting the
standards and in which they are afforded the fullest opportunity
to develop the extent and range of these standards, in close co-operation
with other relevant groups.
In addition, UNISON Scotland believes that it is incumbent on
those with overall responsibility to provide good leadership and
encourage active participation from assistants and support staff
during the process of developing these standards.
Q4 How can multi-disciplinary and multi-agency issues best
be addressed? Should the regulators set common standards and/or
recognise each others so that workers can move between different
health and social care settings without the need for multiple
registration? OR could all assistants and support staff be regulated
as a single group within a single framework including some shared
standards and some discipline-specific standards?
UNISON Scotland recognises that there needs to be a system supporting
the development of flexible, multi-skilled staff working across
traditional professional boundaries and across specific care settings.
UNISON would welcome shared standards of competency, fitness
and conduct and would support the development of a collaborative
framework between regulators in both health and social care in
order to extend the protection of regulation without setting unnecessary
barriers to staff movement.
Q5 Is statutory regulation appropriate or should other approaches
UNISON Scotland fully supports the principle of statutory registration
in relation to healthcare and social care support staff.
Q6 Should Scotland follow any decision that might be reached
in England in order to make sure transferability of staff and
public protection by having one system for the UK?
UNISON Scotland believes it would be desirable for a common regulatory
approach to be adopted within the UK. We believe that the regulatory
structure must be consistent to enable free movement throughout
the UK and combined with flexibility, which permits mobility into
and across occupational groupings.
However, we believe that simply complying with any English-based
regulatory judgement or decisions would constitute considerably
more than just ensuring a ‘common approach' to regulation.
The fact that this issue is a devolved matter and that the Scottish
Executive has undertaken a separate consultation exercise on this
issue from that of the DoE in England and Wales highlights the
need for a distinctive Scottish dimension to this issue.
UNSION Scotland believes that any regulatory system, which is
established, must be flexible enough to give regard to the differences
between Scottish and English delivery of health and social care
Q7 Should the Nursing and Midwifery Council (NMC) regulate
those groups of assistants and support staff who currently work
with the professions they regulate? Should the Health Professions
Council (HPC) regulate those groups of assistants and support
staff who currently work with the professions they regulate?
Q8 Should the SSSC be the regulatory body for all health and
social care support staff or for social care support staff only?
Q9 If the HPC is the most appropriate body, should regulation
be by way of a statutory Health Occupations Committee or would
other options be preferable?
UNISON Scotland recognises that currently there
are differences in employee cultures between health and local
government, which present an impediment to joint working and the
progression of the Joint Future agenda.
As such, we believe that additional work is needed
to identify and define the scope of the proposed regulatory arrangements.
Importantly, we believe that further clarification is required
to establish which staff are considered to be social care staff
and the way in which they differ from the definition of social
service workers as outlined in the Regulation of Care (Scotland)
In these circumstances UNISON Scotland feels
that in order to progress this matter a more extensive scoping
exercise of the social care workforce is required. We believe
this exercise would identify the need for a number of regulatory
bodies, rather than a single co-ordinating regulating body, taking
responsibility for regulating support staff across the agencies.
Q10 Would regulation of assistants and support staff by the
bodies responsible for regulating those whom they support lead
to other problems such as "second class workers"?
UNISON Scotland believes that this perception must be avoided
at all cost. We believe that having a shared understanding of
the key issues which matter most to those supporting as well as
being supported is crucial to better quality services.