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Francis inquiry: compulsory work as healthcare assistants won’t make better nurses

BMJ 2013; 346 doi: (Published 25 April 2013) Cite this as: BMJ 2013;346:f2480
  1. Elaine Maxwell, assistant director, Health Foundation, London WC2E 9RA
  1. Elaine.Maxwell{at}

The government’s recent response to Mid Staffs included a policy that potential nurses should first spend a year working as healthcare assistants. Elaine Maxwell thinks this may do more damage to the profession

Many health professionals already spend time as paid healthcare assistants before and during their studies, and many enjoy their experience. But there is no reason to think that this makes them better practitioners or that it should be made compulsory.

This response by the government to the report of the Public Inquiry into Mid Staffordshire NHS Foundation Trust is concerning for three reasons. Firstly, it plays to the popular conception that nursing is about caring, without recognising the level of cognitive skills required. Secondly, far from increasing the number of good nurses, it might decrease it. And finally, the policy has the potential to reduce quality by destabilising the current healthcare assistant workforce.

Providing personal care is a fundamental part of nursing, but well educated nurses do more than complete a task in a caring way. They thoroughly assess a patient, for example, examining …

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