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Skill mix—HCAs and their role in quality healthcare

McIntosh, Bryan; Smith, Stephen


Bryan McIntosh


The NHS must increase productivity by 6% every year if it is to make projected efficiency savings of £21 billion by 2014. At the same time, it is expected to maintain or improve the quality of care. We know staff costs make up 60% of the NHS budget, so it is likely that both the number and composition of the 1.7 million-strong workforces will need to change in order to meet these targets. We argue that while substituting registered nurses with healthcare assistants (HCAs) is desirable in terms of financial benefits, there is not enough research evidence to identify the impact of changes or maximisation in skill mix upon efficiency (represented by the number of NHS cases treated) and the quality of care experienced by service users.


McIntosh, B., & Smith, S. (2012). Skill mix—HCAs and their role in quality healthcare. British journal of healthcare assistants : for HCAs and assistant practitioners, 6(8), 396-399.

Journal Article Type Article
Online Publication Date Aug 16, 2013
Publication Date 2012-08
Deposit Date Nov 14, 2012
Electronic ISSN 1753-1586
Publisher Mark Allen Healthcare
Peer Reviewed Peer Reviewed
Volume 6
Issue 8
Pages 396-399
Keywords Care quality; economics; healthcare assistants (HCAs);
skill maximisation; nursing management; hospital administration
Public URL