Use of unregulated healthcare workers: Conclusion

The challenge for many healthcare systems is to provide access to appropriate care for those who need it. An increasing trend in many countries where there are shortages of professional care givers or where the costs for such are high is to use unregulated healthcare workers to provide some of the services. This paper thus purposed to evaluate the benefits and drawbacks associated with the use of these unregulated care providers.

The main reason for use of UCPs was advanced to be the shortage of professional healthcare providers. With these shortages resulting from either inadequacy of trained personnel to meet care needs or migration of these from places where their care is needed to where the services can be afforded; UCPs have proved an alternative that has brought better outcomes for those needing care in many countries. The second probable benefit for use of UCPs has been advanced as reduction in cost since they offer their services at lower fees than the professional alternatives. This however has been contested on the basis of the training costs and other adjustment costs that arise in order to maintain the standard of care needed.

As such, the quality and safety of care are the main drawbacks associated with use of UCPs. Since the UHWs do not have a unified training, vetting and regulatory system; the care they offer may not meet the required standards. It has for instance been noted that in most cases nurses working with UCPs may spend most of their time in supervision than providing care. Despite such being the case in some instances where there are shortages of nurses or the subjects cannot afford constant care provision from professionals, UCPs could prove the only way for these to assess reasonable care. What therefore should be the focus is harmonizing the training and supervision of UCPs and strengthening the guidelines for delegation of tasks and procedures by professionals so as to better outcomes for the people needing care.


Association of Registered Nurses of Newfoundland and Labrador (ARNNL) & College of Licensed Practical Nurses of Newfoundland and Labrador – CLPNNL (2009). Professional responsibilities when working with institutionally based unregulated care providers. Retrieved April 26, 2010, from

Canadian Nurses Association – CNA (2008). Valuing health-care team members: Working with unregulated health workers. [Discussion Paper] Retrieved April 26, 2010, from

Canadian Practical Nurses Association – CPNA (2009). Facing forward: Current and future health care trends and issues and the implications for Canada’s practical nurses. Retrieved April 26, 2010, from

College of Nurses of Ontario – CNO (2009). Utilization of unregulated care providers (UCPs). Practice Guideline. Retrieved April 26, 2010, from

College of Registered Nurses of Manitoba – CRNM (2002). Decision making: A framework for delegation. Retrieved April 26, 2010, from

Gill, D. (1996). Factsheet: Health human resource planning – The unregulated care provider. Nursing Effectiveness, Utilization & Outcomes Research Unit; University of Toronto Faculty of Nursing and McMaster University School of Nursing Collaborative Project. Retrieved April 26, 2010, from

Heineman, B. W. (2007). Avoiding integrity landmines. Harvard Business Review, (April 2007); 100-108, retrieved April 25, 2010, from

Herron, S. (1996). AIDS residential care. Home Care Provider, 1(6). 291-296. DOI: 10.1016/S1084-628X(96)90187-2.

International Council of Nurses. (2006). Safe Staffing Saves Lives. Information and Action Tool Kit. Retrieved April 26, 2010, from

Janes, N., Sidani, S., Cott, C. & Rappolt, S. (2008). Figuring it out in the moment: A theory of unregulated care providers’ knowledge utilization in dementia care settings. Worldviews on Evidence-Based Nursing, (first quarter 2008), 13-24. DOI: 10.1111/j.1741-6787.2008.00114.x

Janz, K. (2004). All home care is not created equal – one view: Dramatic growth in home care industry creates unregulated workforce: More government oversight is needed. Geriatric Nursing, 26(1), 53-55. DOI: 10.1016/j.gerinurse.2004.11.011.

Ncama, B. P. (2005). Models of community/home-based care for people living with HIV/AIDS in Southern Africa. Journal of the Association of Nurses in Aids Care, 16(3), 33-40. DOI: 10.1016/j.jana.2005.03.006.

Statistics Canada (2008). Perspectives on labour and income: Employment trends in nursing. Retrieved April 26, 2010, from

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