The consultancy study on “Skill and Qualification Requirements of Residential Care Home Staff providing Health and Rehabilitation Services in Hong Kong”
Background
Currently, a majority of the residents in RCHs for the Elderly (RCHEs) and RCHs for Persons with Disabilities (RCHDs) require health and rehabilitation services from RCH staff, including nurses, Health Workers (HWs), Care Workers (CWs) and various types of therapists or visiting professionals. As RCHEs and RCHDs often encounter difficulties in recruiting or retaining staff, the 2022 Policy Address announced that a holistic review of the skill and qualification requirements of RCH staff would be conducted to establish professional standards and a career progression path for them.
In July 2023, the Social Welfare Department (SWD) commissioned a Consultant to conduct the consultancy study and established the Steering Committee on Review of Manpower for Healthcare Services in RCHs (the Committee) to offer advice and steer on the study. The Committee was chaired by Dr Lam Ching-choi and its membership comprised stakeholders from various sectors, including RCH operators/organisations, allied health professionals, trade union members and representatives of relevant policy bureaux/departments. The Committee was responsible for steering the work progress of the Consultant, providing advice on the recommendations and implementation details of the study and clearing the consultancy report.
The consultancy study mainly covers three aspects –
- reviewing the skill and qualification requirements of staff providing health and rehabilitation services at RCHs so as to establish professional standards and a career progression path for them;
- exploring the feasibility and implementation plans of establishing a new rank in RCHs, including its required qualifications, training, registration requirements, regulatory framework, as well as the division of labour and collaboration among staff providing health and rehabilitation services; and
- identifying factors conducive to the recruitment and retention of staff of RCHs.
Recommendations of the Consultant
Based on the results of the review and the views of stakeholders collected through various channels, the Consultant puts forth four key recommendations –
Recommendation (1): Establishment of the “Health&Care Practitioner” professional rank
With the increasing demand for professional care services in the RCH sector, there is a need to nurture specialised care professionals for the welfare sector to sustain its healthy development. The Consultant recommends establishing a new professional rank to specialise in providing care services in RCHEs, RCHDs and other elderly/rehabilitation welfare service units. The new rank is a brand new care professional position dedicated to the welfare sector that can both attract people who aspire to pursue a career in the welfare sector and offer promotion and career prospects for HWs, which is conducive to talent retention. Furthermore, it would provide RCHs with greater flexibility in utilising their manpower resources. To the welfare sector as a whole, the new rank would help build up dedicated care talents for the sector, reduce competition for talent with the medical sector and alleviate the tight manpower situation in RCHs.
Having regard to the views of the parties concerned, the training content and the duties of the new rank, etc., the Consultant suggests designating the new rank as “Health&Care Practitioner” (HCP), reflecting the fact that the post covers both care and health duties with due emphasis on practice. With reference to the existing regulatory mechanism for HWs, the Consultant recommends that the SWD should be responsible for such matters as registration, assessment and complaints to ensure their professional competency and ensure that they would be effectively regulated. The validity period of a registration or renewal of registration as an HCP would be not more than five years.
At the initial stage of the establishment of the HCPs, the Consultant recommends inviting serving registered HWs who have served in the position for not less than three years to undergo the training. Trainees are required to complete the recognised HCP Training Course and attain a professional diploma. The diploma concerned is pitched at QF Level 4 with a total of 760 learning hours, including 480 hours of face-to-face teaching and 280 hours of practicum. The HCP Training Course’s entry qualification requirements are identical to those of the EN (General) Training Programme, and in respect of the required health and care work in the social welfare service units, its assessment standards would also be the same as those of ENs. To ensure that HCPs are competent to perform the care duties in the future, trainees of the HCP Training Course must pass the assessment of applying relevant nursing skills, such as intramuscular injections, insertion or replacement of indwelling urinary catheters and nasogastric tubes, in order to obtain a graduation certificate.
Recommendation (2): Adjustment to the training content of the Certificate in Progression Training for CWs
The Consultant recommends maintaining the entry requirements of the Certificate Training whilst redistributing the training hours of different subjects. Currently, the total face-to-face course time of the Certificate Training is 150 hours, of which 126 hours are for “Specification of Generic (Foundation) Competencies”, including Chinese, English, Numeracy and Information Technology; and the remaining 24 hours are for “Understand Basic Knowledge of Drugs”, “Master Communication Skills with Elderlies” and “Master Communication Skills with the Families of the Elderlies”. As language proficiency can be further developed through other means while the duties of HWs are mostly practical, the Consultant proposes to reduce the number of learning hours in language subjects with a corresponding increase in those training hours on vocational-related knowledge such as prevention of elder abuse and assisting elderly persons in using assistive devices. In this regard, CWs who aspire to take up healthcare work in RCHs would be equipped with more practical experience and operational competencies.
Recommendation (3): Amendments to the Residential Care Homes (Elderly Persons) Regulation and Residential Care Homes (Persons with Disabilities) Regulation
The consultancy study indicates that according to the existing statutory staffing requirements of the Residential Care Homes (Elderly Persons) Regulation and the Residential Care Homes (Persons with Disabilities) Regulation, the staffing provision of RCHs can meet residents’ care needs. The Consultant thus recommends introducing the new HCP rank into the relevant Regulations without altering the existing statutory staffing requirements, and RCHs could employ either ENs or HCPs to meet the relevant statutory staffing requirements. In addition, the Consultant recommends that the basis of calculating statutory staffing requirement for nursing homes (NHs) be changed from the total number of beds as currently adopted to the number of residents in the future, so as to align with international practice and the statutory staffing requirements for RCHs of other levels of care in Hong Kong; and that the staffing requirement for HWs should also be clearly set out to reflect their important role in the NHs.
Recommendation (4): Staff recruitment and retention
The Consultant recommends that RCH operators should attract and retain staff through measures such as enhancing career development and promotion opportunities, applying information technology and gerontechnology, and encouraging staff to undergo training.