There is no minimum standard of training for healthcare assistants before they can work unsupervised, an independent report has found.
Some were doing tasks usually performed by doctors or nurses, such as taking blood.
The Cavendish Review was set up by the government to study the role of healthcare assistants (HCAs) in England after the Stafford Hospital scandal.
HCAs provide basic care in hospitals, care homes and at home.
They should go through a universal training system and gain accreditation before they can work unsupervised, the report said.
End Quote Camilla Cavendish Author of the reviewFor people to get the best care, there must be less complexity and duplication and a greater focus on ensuring that support staff are treated with the seriousness they deserve"
Currently, there is no consistent qualification or training for HCAs, with employers deciding for themselves what training is needed.
The government will provide a formal response to the review, along with its response to the Francis Report into the Mid Staffordshire public inquiry, in the autumn.
It has already promised to establish "minimum training standards" for HCAs by spring 2014.
A public inquiry into Stafford Hospital found hundreds of patients had died following neglect and abuse between 2005 and 2008.
Call for certificateThere are more than 1.3 million frontline staff who are not registered nurses, according to the Cavendish Review.
They provide some of the most personal and fundamental care such as turning people in bed so they do not get pressure sores, helping people to eat and wash and to get out of bed and get dressed.
But the review says the quality of training and support that care workers receive in the NHS and social care system varies between organisations and, in some cases, is lacking.
It calls for a new Certificate of Fundamental Care for fully-fledged HCAs - a qualification that would link HCA training to nurse training, making it easier for staff to progress up the career ladder should they wish to.
All new recruits would need to obtain the certificate and existing HCAs would need to prove they had the equivalent training.
And in recognition of the important job HCAs do, they should be called Nursing Assistants.
Journalist Camilla Cavendish, author of the review, said: "Patient safety in the NHS and social care depends on recognising the contribution of support workers, valuing and training them as part of a team.
"For people to get the best care, there must be less complexity and duplication and a greater focus on ensuring that support staff are treated with the seriousness they deserve - for some of them are the most caring of all."
Peter Carter, of the Royal College of Nursing, was concerned that without mandatory regulation there would be a danger that any staff who were found to be unsuitable could move from one employer to another unchecked.
"The priority must now be to underpin the recommendations made by Camilla Cavendish in the regulatory structure which governs care," he said.
Christina McAnea, of Unison, said that in some hospitals HCA's have been treated as "cheap labour".
"Common training standards across health and social care are long overdue and welcome."
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