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Controlled drug administration removed from nursing associate curriculum


Nursing associates will be trained to administer drugs “within the confines of local employer policies”, it has been confirmed as the final version of the curriculum for those in the new role was published today – marking a change from a leaked version of the document that was heavily criticised.

They will also be able to calculate drug doses under delegation, according to the document by Health Education England. However, contrary to a leaked draft version, the final curriculum does not say nursing associates will be trained to administer controlled drugs.

In the past few weeks there has been criticism over the proposal for giving controlled medications, with nursing leaders highlighting the potential risk to patient safety, blurring of the boundary with nurses, and possibility of nurses being held accountable for drug errors if the role is unregulated.

In response to concerns, HEE said today it would meet with representatives from across the health and care system in January to produce guidance on the possibility of nursing associates giving controlled drugs.

The final version of the curriculum, also released today, emphasised the role of employers in drawing up rules around medicine management.

It stated that, by the end of the training programme, nursing associates would be able to “administer medicines safely and in a timely manner”, and that they would “only administer medicines, if suitably trained and competent, in settings where it is deemed appropriate and where this is guided by organisational medicines management policies”.

“Any independent work will be within defined parameters of practice, within their competence, and the…authority given by a registered nurse”

Lisa Bayliss-Pratt

Nursing associates must be able to explain the role of drugs in the body, the therapeutic actions of certain medicines, and also how doses are determined by dynamics and systems in the body, said the document. They will also be trained so they can discuss the risks and benefits of medication.

The curriculum also confirms those in the new role will be taught to use invasive and non-invasive procedures, and that they will be required to recognise and act upon early signs of deterioration by carrying out assessments and observations.

In addition, the curriculum states that nursing associates will deliver planned nursing interventions “under the direction of a registered nurse, without direct supervision”, and that they will deliver care “at times, independently”.

In accompanying documents, HEE said employers will be expected to deploy the new role to support registered nurses, who will delegate and assign tasks to nursing associates.

“We will train these new nursing associates to understand medicines management and to administer medicines safely”

Lisa Bayliss-Pratt

In the curriculum, it states that by assigning specific tasks to associates – within their competence – nurses are handing over both responsibilty and accountability to them.

The two-year training programme for 2,000 nursing associates will begin at 11 test sites from January.

In the accompanying documents, HEE suggested this could in the future be reduced to less than two years for trainees who have undertaken prior learning that meets the requirements of the curriculum.

A decision on whether nursing associates will be regulated has yet to be announced by the Department of Health, though senior nurses have said they support the idea.

Launching the curriculum, Professor Lisa Bayliss Pratt, HEE’s director of nursing and deputy director of education and quality, said: “We will train these new nursing associates to understand medicines management and to administer medicines safely in a timely manner, within the confines of local employer policies.”

“Nursing Associates will be trained to work independently under both the direct and indirect supervision of the registered nurse,” she said. “This will realise their full potential as valued members of the nursing team.”

Health Education England

Senior HCA ‘bridging’ role will be piloted next year

Lisa Bayliss-Pratt

“Any independent work will be within defined parameters of practice, within their competence, their training and the responsibility and authority given by a registered nurse in line with nursing practice in delegation and accountability,” she added.

“The service has asked us to move as quickly as possible to provide this new role that sits alongside care assistants and registered nurses as part of a multi-disciplinary care team,” said Professor Bayliss-Pratt.

Professor Jane Cummings, chief nursing officer for England, said: “The test sites delivering the first training programmes will allow feedback, which will inform the competencies needed and the scope of the nursing associate role.

“The views of directors of nursing, registered nurses in clinical practice and education, as well as prospective nursing associates will be vital,” she said.

“The introduction of nursing associates is a positive and welcome step forward, and I look forward to following progress made as training begins,” she added.



Readers' comments (4)

  • Glad to hear the Associates will not be administering drugs. They should have the SEN status, be excellent carers and report everything to the RGNs

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  • I am very supportive of patient safety and governance but still not quite understanding what this role is about. We have some very experienced HCA's/Assistant Practitioners who administer insulin, B12, Clexane injections who having undergone training and have been deemed competent are able to do these tasks.
    We also have support workers working with children who undertake extended roles including medication. I think this is something rushed through by the powers that be with no regard for what is already in place which is safe in lots of areas because we have already taken this seriously. Very frustrated by everything about this role which is demeaning to people who have a level 5 qualification or vast experience already

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  • I have to say after attending the forum on the 16th Nov and now reading about the new course with an emphasis on medicines management and calculations I am very skeptical. There is a actual lack of medicine management in the current nursing degree programme so what will make this course so special that they will be given better tools to do such tasks. Also after looking at past studies involving nursing students and qualified nurses undertaking calculation tests lots actually failed to gain the pass rate, highlighting a major concern in this area.

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  • If the new Nursing Associates are to be trained and allowed to administer medication, and to perform invasive procedures, not always under the direct supervision of a registered nurse, they should definitely be regulated, otherwise they would be licensed to practice more freely than Registered nurses, who are!

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