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Support from nurse leaders for senior HCA role to bridge skills gap


Nurse leaders say they support the creation of a senior care assistant role to bridge the gap between support staff and registered nurses, insisting the move would not “dumb down” the profession.

The nursing directors, who were speaking as part of a panel session on workforce challenges at Nursing Times’ Directors’ Congress in Brighton last week, said it represented a “professional response” to the current workforce challenge.

“The reality is we have got to do something different”

Janice Stevens

Janice Stevens, interim chief nurse at Barts Health NHS Trust in London, said: “The reality is we have got to do something different. The gap between band 2 – who are trained with the care certificate and doing lots of the care – to graduates, feels to me, when you’ve to 1,000 vacancies, too big.”

She added: “I don’t know why we can’t have a well-trained person who is supporting care that is regulated and trained to a higher standard.

“That is not dumbing down our profession, it is about recognising care is complex and spans lots of needs…. We’ve got to get off our professional high horse for the sake of quality,” said Ms Stevens.

Ruth May, nurse director at regulator Monitor, said she also supported the proposal for the new role, referred to by some as the associate nurse.

“It’s not a financial issue, it’s about a professional response to a challenge we are seeing. I do support the associate nurse and I do support them being regulated,” she said.

“I think it would give them a career pathway. We’ve got some great people out there who would love to do the associate nurse role,” she added.

“We’ve got some great people out there who would love to do the associate nurse role”

Ruth May

Maggie Davies, deputy director of nursing at Western Sussex Hospitals NHS Foundation Trust, who was also on the panel, backed the introduction of the role as well. She said: “We have to do something different. We have toy tackle it now because it’s not safe for our patients.”

As exclusively revealed by Nursing Times last week, national workforce planning body Health Education England will be piloting the role at 30 sites across the country in 2016.

The idea for the new position was first put forward in the Shape of Caring Review earlier this year, which looked at education and training for both nurses and healthcare support workers.

However, the Royal College of Nursing said in a briefing paper earlier this month that it did not support the creation of a new role “to plug a perceived gap between healthcare support workers and registered nurses”.


Readers' comments (17)

  • Dangerous move in my opinion. A nurse associate? really? any title with the word 'nurse' in it should be based on a university qualification..... a nurse degree!! I went to uni to get the title of nurse and so should others in our profession. This is a cheap way of replacing nurses, instead of creating stop gap sub standard roles, we should be shouting from the rafters to raise the professional profile of nurses, increase pay, and value the nurses we do have before we all leave this profession that we love. It concerns me greatly that I see senior nurses and chief nurses endorsing this ridiculous idea. Stop thinking of targets and finance and start thinking about the patients and your staff!!

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  • What a great idea. We could call them Enrolled Nurses.

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  • Can hospitals try to use non-ward based admin staff to assist as auxilliaries on wards from around 8am to 10am and around 20 mins at lunchtime too. Along with senior + non medical / nursing managers to help out with improving patients experience and care.

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  • Well said anonymous 12:16 I for one don't want unqualified people looking after me or my loved ones...

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  • anonymous 26-oct-2015 10:11pm

    Ill put you on a list?
    I have a uni Qualification for all my training and skills as well as basic care.
    It is the opinion of nurses like you that help to put the mochery on N H S. I wonder if the pin dutys go up for the likes? as for car ins, house ins etc I think you you would be fantastic in the present government?

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  • This senior care worker…. is accountable to which body?

    I am aware of a recent death in a care home where the elderly person with complex needs had, amongst other problems, several pressure sores. There had been moving and handling issues over 2 years. There had been an earlier pressure ulcer quite possibly not reported it seems to the GP by the staff. The CQC and Local Authority were involved. The home continues to operate with a registered nursing manager just a "responsible individual."

    The Senior Carer who was/is a very intelligent person and improved her English language to a completely acceptable level in an admirably short space of time, apologised for not reporting the ulcer to the GP but excused herself because she thought it was up to the nurse to do that. The nurse was likely a bank nurse and obedient to management.

    Still, the Senior Carer continued to do the bidding of the owners, there being no permanent registered manager, and disregarded proper moving and handling techniques, also teaching other staff to do likewise. On a personal level she would have preferred to use proper moving and handling techniques but what good is that to the service user?

    So who, in the absence of a proper and timely response from the local authority and the home's supervisory body should deal with that? The CQC is acting in a fragmented way, the NHS body appeared to be instigating the neglect at the home and the police and local authority were useless. All activity but no outcomes.

    And as far as I know the nice but misguidedly obedient Senior Carer continues to do, permit and teach harm...

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  • wow! glad its not me? But should you be voiceing your delemia on the net you say the CQC are involved have you voiced to them on this matter yourself ?
    Me I can be nice,but not misguided, and I know my job and where the full stops are and dam good at it.........................................................................................................................end

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  • Do you fail to prevent avoidable pressure sores then fail to report them to the GP? No? Then it's not you.

    Plenty of reporting to CQC, LA and DoLS and NHS Trust.

    The website for the care home is absolutely fantastic-must have cost loads.

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  • So who would the Senior HCA be accountable to?

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  • If a nurse or carer feels intimidated into obeying his/her employer when it is harming the patient/service user then they can anonymously report it to the CQC.

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