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'Green light' given for nursing associates, says HEE, as consultation results revealed


A new nursing associate role that bridges the gap between healthcare assistants and registered nurses has been confirmed, after the consultation findings were published today.

Health Education England, which led the six-week consultation, reiterated there was a real “appetite” for the role among the profession but that it would not be a substitute for increasing the supply of nurses.

“This new role has the potential to transform the nursing and care workforce”

Lisa Bayliss-Pratt 

Five workshops will now take place in England in July for HEE to develop its scope of practice. Test sites will recruit 1,000 students to start training in 2017.

Respondents said nursing associates would benefit patients, provided safety was prioritised in developing the role, according to the report on the consultation findings, called Building Capacity to Care and Capability to Treat: A new team member for Health and Social Care in England.

However, the consultation - which recevied 1,384 responses overall including more than 1,100 individuals - noted there were “some concerns” the role would undermine or substitute nurses, potentially leave them with less contact time with patients.

According to the report, an “overwhelming majority” – of 761 respondents – said they wanted to see statutory regulation of nursing associates, while around 240 said it should just be registered.

“I am hugely encouraged that after a thorough examination of the new nursing associate role, the green light to go ahead has been given”

Lord Willis

Of those who wanted full regulation, 581 said the Nursing and Midwifery Council should be the responsible body.

“Those advocating regulation identified a number of benefits, including patient safety, public reassurance, accountability, professional credibility and protection of the new professionals.

“The administration of medicines – seen as a key aspect of the role by many - was given as a further reason,” said the report.

It added that the decision on whether to regulate the role would be made once the knowledge, skills and competencies of nursing associates had been confirmed.

“If once this is defined, NHS Improvement, NHS England, HEE and the NMC assess there are risks to patient safety, they will consider the appropriate level of regulation (if any) and HEE will work with the Department of Health to take this forward,” it said.

Meanwhile, the majority of respondents said nursing associates should sit at band 4 within the Agenda for Change pay scale.

However, some said current financial restraints meant funding for the role would not be available, while others described the proposed new role as a cost-saving exercise.

The report said a number of respondents wanted lessons to be learnt from the former State Enrolled Nurse (SEN) role in developing nursing associates, noting SENs were often left without equal access to career opportunities.

There was support for the role’s training to lead to a nationally recognised qualification, with a defined scope of practice “mapped to the pre-registration nursing standards”.

Training was generally recommended to be to “level five” – which is the same level as a foundation degree, and there was in general support for this to be provided through an apprenticeship.

The consultation findings were announced by Lisa Bayliss-Pratt, HEE’s director of nursing and deputy director of education and quality, who had previously indicated there were positive views on the role. 

In a statement today, she said: “Our consultation has shown that there is a real appetite for this role, which we firmly believe can provide a real benefit to the nursing and care workforce across a range of settings and play a key role in the delivery of patient care with safety at its heart.”

“This new role has the potential to transform the nursing and care workforce – making sure the role has a clear entry and progression point will be crucial in its development,” she added.

“We do need to protect what we value across the nursing and care profession but we also need to collectively agree that we can’t always hold on to what we have done in the past – change is inevitable,” she said.

Lord Willis

‘We aim to ensure nurses get the best education and training’

Lord Willis

Health minister Ben Gummer said: “This new role will enhance patient care and open up a career in nursing for thousands of people, as well as providing opportunities for existing staff who want to progress to become registered nurses. “

Lord Willis of Knaresborough, who first recommended the new role in his Shape of Caring review of nursing training and education last year, said: “I am hugely encouraged that after a thorough examination of the new nursing associate role the green light to go ahead has been given.

“There is a crucial need to create a seamless nursing and care staffing structure which will enhance patient safety and patient outcomes across both health and care structures,” he said. “We must now move swiftly to make this role a reality and a success.”


Readers' comments (9)

  • While I think it is desirable to be able to regulate the health care assistants I thought it was decided that the "SEN" role was obsolete. This has the ring of deja vu whatever name you give them.
    There are no associate doctors on their register, why are we diluting and devaluing nursing even more. Nurses are already paid about 1/5 of what doctors get.and are increasingly being asked to take on more of their work. Nurses are ALOT cheaper of course and love to play doctors. Why is our representation so weak.

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  • I'll be honest, there could be studies showing APs as not competent (not something I believe), under - cutting the role of nurses, causing nurses to leave their positions etc but the HEE would still OK the role. I now see where all the funding for nursing students is going.

    I'm also disappointed they are considering making this role band 3 when majority of APs will already have been band 4. Essentially just having APs carrying out the role of nurses on the cheap, while deskilling the nurses. It's a shame people like Lord Willis, who have not ever worked in the nursing field, make huge decisions for nurses while we can do nothing but watch.

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  • The consultation would appear to be a fix, the NMC would appear unfit to regulate nurses and why should the associate role be tied to any specific profession. Therapy assistants have become widespread and why could not this not be an extension?
    The aim is quite clearly "nursing" on the cheap with all the associated risks, although it is fair to say that some people in these roles show more CARE than professionals

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  • we have nursing assistants pilot scheme one nurse on now instead off two. so the one nurse has overall responsibility of up to 60 residents all the staff, visitors and the building. I hate it and am currently looking for a new post in or out off nursing. As this role has replaced the nurse in my opinion. I have no support or another nurse to help me when things are not right. feel totally let down and feel patient care and well being could be compromised.

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  • This is unbelievable. Over 300k nurses and about the same or more HCA and a study of under 1500 show there is an appetite for band four. Other countries train nurses better treat nurses better and don't constantly undermine them like we do. The Francis report said we need to get back to basic nursing. Why are training others to do the role of nurses when we barely have nurses due to the above. This is a simple thing of cost cutting.

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  • Where is our voice in 'nursing'? After nearly 40 years in the profession and having 'been there' when the Enrolled Nurses were booted out because the RCN et al wanted a '1-Tier' Nursing System, it leaves me despairing at the weakness of those who supposedly 'lead' our great profession, suggesting anything other than strengthening the contribution of Registered Nurses. Be warned: IT WILL MEAN LESS RN's at the coalface.

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  • michael stone

    PIPPI, who is 'considering' making the role band 3 - as it points out above:

    'Meanwhile, the majority of respondents said nursing associates should sit at band 4 within the Agenda for Change pay scale.'

    My view is that if it intended to 'fill-in the capability gap' this new 'super-HCA' should sit immediately below a newly-registered nurse, and as I understand it (I'm happy to be corrected - NHS banding isn't a real interest of mine) those nurses are band 5 ?

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  • The nursing profession has been tinkering with these ideas for years. I thought we already had the Assistant/Associate Practitioner role in place (albeit only patchily implemented). I would go for the greater flexibility of a generic 'associate' which has already implemented successfully in pockets. The nursing profession still seems beset by tentative and muddled leadership. Whatever you wish for you will need the full backing of the Trust CEOs without which nothing useful will happen! I'll call back to this page in 5 years time when I expect to see the latest 'consultation and recommendations' on a 'new' support role for nurses!

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  • michael stone

    Terry Smyth1 June, 2016 9:59 pm

    There does seem to be an awful lot of 're-inventing the wheel' inside the NHS. I suspect that some of this is because a perfectly sane idea, such as 'let's put wheels on the cart', subsequently gets screwed up by a moron who attaches square wheels, instead of round ones.

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