Nursing Associate role expands

Topics covered: Ridouts professional advice

Internal plans by Health Education England propose the introduction of training to allow unqualified Nursing Associates to perform duties previously preserved for only qualified nurses.

The new Nursing Associate role is to be introduced from January 2017 and is intended to sit alongside healthcare support workers and registered nurses across the health and social care sector. It will take two years for Nursing Associates to complete their period of training.  It was initially envisaged that the Nursing Associate role would be an apprenticeship route prior to eventually training to become a registered nurse. Direction from a registered nurse still seems to feature heavily within the training for the new role; however the training allows for Nursing Associates to carry out invasive procedures and administer controlled medication without direct supervision.  According to the internal documentation seen by the Health Service Journal the role appears to have evolved into one which is to be treated as an independent profession.

Some commentators have expressed concern at the apparent expansion of the Nursing Associate role which may have the unintended consequence of diluting the importance of the registered nursing profession.  The Royal College of Nursing has cautioned against using the role as a substitute for registered nurses.  Research has shown that the risk of death increases when there is a higher proportion of healthcare assistants to beds.

Anne Marie Rafferty, Professor of Nursing Policy, King’s College London said of the proposals:- “What are these people not able to do? What would be the sole preserve and scope of practice for the qualified registered nursing professional? This potentially undermines the nursing profession because of the confusion it will create.”

Decisions have not yet been made in relation to whether the Nursing Associate role will be regulated and if so by whom. If the role is to be expanded, as suggested in Health Education England’s proposed training documentation, regulation of the role appears to be necessary.  There clearly is a demand for nursing staff to support the provision of health and social care and this role is designed to fill the void between registered nurses and competent unqualified colleagues.


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