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Nursing associate deployment must be 'constantly reviewed', says CQC


Health and social care providers will have to prove to the Care Quality Commission that they understand how to safely deploy nursing associates before they receive registration from now on. 

The watchdog will be also checking during its routine inspections that organisations have taken a “systematic approach” to their use of nursing associates and have mitigated risks to patients.

“Staffing levels and skill mix need to be constantly reviewed”


The CQC will take enforcement action against providers if they are found to have breached regulations in relation to nursing associates.

The regulator laid out its rules on nursing associates today in a new briefing for health and social care providers.

The release of the document comes as the Nursing and Midwifery Council register opens to nursing associates for the first time today. 

The briefing noted: “CQC recognises the current challenges facing the health and care sector: an ageing population, increased demand for services, financial constraints, and challenges to workforce supply, recruitment and retention. This requires innovative approaches and planning to ensure an adequate workforce for the future.

“The new role of nursing associate is intended to bridge a gap between health care support workers (and social care equivalent) and registered nurses. It has the potential to shape the workforce in the future and to demonstrate positive outcomes and experiences for people who use services across health and social care, their families and their carers.”

However, the watchdog warned that nursing associates could not be used to replace registered nurses and providers were expected to consider this when deploying them.

“As with the introduction of any other new role, we are not prescriptive about how you deploy nursing associates, but we need assurance that using them is safe and supports you to deliver high-quality care,” the CQC document noted. 

“We will look to ensure that nursing associates are being employed safely”

Ted Baker 

The briefing also highlighted the importance of “constantly” reviewing their staffing arrangements to meet the needs of those using that service at that time.

It stated: “Staffing levels and skill mix need to be constantly reviewed, and all providers should adapt and respond to the changing needs and circumstances of people using the service, particularly when introducing nursing associates to a workforce.

“We expect you to clearly articulate how you have counted nursing associates into the staffing establishment and to carry out regular staffing reviews after deployment, ensuring that nurse-sensitive quality indicators are taken into account to improve quality and safety for people who use services,” it said.

The document set out key areas of law under the Health and Social Care Act that employers need to take into consideration when deploying nursing associates. These include regulations around staffing, good governance and safe care and treatment.

The CQC has urged trusts to adopt a “systematic approach” to nursing associates, and to use “evidence-based decision tools and professional judgement” to inform deployment decisions.

Employers should also make sure their existing staff understood the rationale for deploying nursing associates, the benefits of the role and how to escalate concerns, the document added.

In addition, it stated that organisations that employ nursing associates should be able to demonstrate that they were suitably qualified, competent, skilled and experienced to keep patients safe.

Meanwhile, the CQC has refreshed its “memorandum of understanding and joint working protocol” with the NMC to involve nursing associates.

Care Quality Commission

Ted Baker

Professor Ted Baker, CQC’s chief inspector of hospitals, said: “The introduction of the nursing associate role has the potential to shape the NHS and social care workforce in the future and to lead to better experiences for people using services and their families. 

“Through our inspections and ongoing monitoring, we will look to ensure that nursing associates are being employed safely,” said Professor Baker..

“This will include checking that health and care providers are using evidence-based decision tools and professional judgement to determine the number of nursing associates and range of skills required to meet people’s needs and keep them safe at all times,” he said.

“We have developed a briefing for providers setting out the key areas of consideration in meeting the regulations when deploying nursing associates and have reviewed our formal working agreement with the NMC which details how we work together and share information,” he added. 


Readers' comments (2)

  • I havn't spoke to one person who is able to explain how the NA role will be integrated into ward staffing numbers.

    The role undermines the RN and the HCA.

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  • spoke should say spoken

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