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Plans for nursing associates risk 'confusing' patients

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Government plans to introduce a new nursing associate role could cause confusion with current assistant practitioner posts, increase accountability for nurses and risk creating “cheap labour” in place of registered staff, it has been warned.

Healthcare support workers and nurses raised the concerns as part of a debate to discuss the impact of nursing associates at the Royal College of Nursing’s annual congress on Tuesday.

“Why create a new role when assistant practitioners are already in existence?”

Lindsay Cardwell

However, some said the new role – aimed at bridging the gap between HCAs and registered nurses in England – could help to ensure better training and career progression, but this should be for all healthcare support workers.

Others also said they wanted the regulation of all support workers if nursing associates were to be regulated, which has still yet to be decided.

Lindsay Cardwell, from the RCN’s health practitioner committee, said: “Why create a new role when assistant practitioners are already in existence? Assistant practitioners have been in healthcare and working very well since 2002.”

She noted many APs – usually employed at band 4 on the Agenda for Change pay scale – held a foundation degree qualification and worked in acute, GP surgeries and community and district teams, which were all suggested features of the new associate role.

“Why create a new title which will add to confusion? According to the Cavendish report there are up to 60 different title for healthcare support workers,” she added.

“This is an initiative that is pushing the number of registered nursing staff down and increasing the number of support staff”

Michelle Quested

Another member, Michelle Quested, said she believed the role would lead to fewer nurses and more support workers, which would increase accountability for registered staff.

“This is an initiative that is pushing the number of registered nursing staff down and increasing the number of support staff,” she said.

“What we need to remember is registered nurses maintain accountability for those supernumerary team members – who are extremely well skilled but are not allowed to make clinical decisions around making changes in patient care,” she added.

She urged caution over the number of nursing associates working in complex care settings in the future which could lead to a “diluted” workforce.

One RCN member also warned of a lack of mentors to train nursing associates, while another said they could be used as “cheap labour”.

RCN member Margaret Devlin, from Northern Ireland, said: “Registered nurses need to be very careful in definitions of their role. Equally, if my HCA colleagues are going to do the work they should be recognised for it and not be used as cheap labour.”

Matter for Discussion

That this meeting of Congress discusses the impact of the nursing associate role

  • 3 Comments

Readers' comments (3)

  • michael stone

    '“Why create a new title which will add to confusion? According to the Cavendish report there are up to 60 different title for healthcare support workers,” she added.'

    'The NHS' [and the DH/goverment] seems to love 'creating new titles', re-badging old ideas/organisations without much fundamental change beyond the new name, 're-structuring' so frequently that 'nothing ever properly settles down and runs smoothly', and changing responsibility for ongoing long-term projects mid-stream. It isn't entirely clear, that these things are unambiguously helpful.

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  • What I don't understand is, if the Government are so keen to create these nursing associate roles, why are they simultaneously cutting training and CPD budgets and scrapping the bursary? And now we're out of the EU how are we going to recruit overseas nurses that will inevitably be needed in 5-10 years time?

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  • Sadly at my trust the band 3 courses of csw stopped years ago, stopping development from the band 2 wanting to progress,. I like the idea of the associate role band 4, but it's been silly stopping the band 3 csw courses, which many staff at my trust would of jumped the chance to do. Especially the ones who have so many years experience clinically on the ward.

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