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Employers urged to dispel 'myths' about nursing associates


Health leaders should endeavour to dispel “myths” about the nursing associate role before introducing it into their workplace, according to new guidance.

NHS Employers, which acts on behalf of trusts in the health service, has produced an online advice document to help employers develop and deploy the new role within their organisations.

“The nursing associate role needs national support and leadership to succeed”

Danny Mortimer

A pilot programme launched in 2017 has since seen thousands of trainee nursing associates rolled out across various test sites.

From 28 January, those who have successfully completed their training programmes will able to join the Nursing and Midwifery Council register for the first time and will become newly-qualified nursing associates.

Danny Mortimer, chief executive of NHS Employers, said: “The nursing associate role needs national support and leadership to succeed.

“Future workforce plans outlined in the NHS Long Term Plan include new roles, such as the nursing associate role, as part of our teams,” he said. 

“The guide will help organisations think how to develop and deploy the role across the NHS and wider,” Mr Mortimer added. 

The main route to become a nursing associate will be an apprenticeship, in which students split their time between on-the-job training and academic study.

However, NHS Employers noted that education providers might also provide “conventional or fee-paying routes” into the nursing associate profession “if the demand is there” in the future.

The document offered employers guidance on introducing trainee nursing associate programmes and also on the employment and deployment of qualified nursing associates.

It stated: “The development of trainee nursing associate programmes and implementation of the new role will need to be supported by everyone in the organisation, from board members and senior leaders through to line managers, multi-disciplinary teams, patients and service users.”

In addition, the guide set out some of the challenges faced by employers during the trainee nursing associate pilot scheme.

These included lack of acceptance or awareness of the new role among the wider care team, and other professionals such as registered nurses seeing the nursing associate as a “threat”.

“Employers tell us they require an increasingly flexible workforce”

NHS Employers 

NHS Employers recommended that organisations introducing a nursing associate training programme should put a “strong support network” in place for the students.

It added: “Support trainee nursing associates by promoting their role and its benefits widely among the workforce, including communications about myths relating to the role.”

The NMC has developed and published standards of proficiency for nursing associates, which set out the knowledge, competencies, professional values and behaviours expected of them at the point of registration.

The six main proficiencies are:

  • Being an accountable professional
  • Promoting health and preventing ill health
  • Provide and monitor care
  • Working in teams
  • Improving safety and quality of care
  • Contributing to integrated care

NHS Employers noted that these could be used to help employers make decisions about whether and how to use the role within their organisation for the benefit of patient care.

The nursing associate role was developed to bridge the skills gap between healthcare assistants and registered nurses and also to offer a new pathway to become a registered nurse.

In a survey carried out by NHS Employers in April 2017, employers said nursing associates would offer a host of benefits including improving patient experience and safety, and offering development opportunities for support staff.

They also said the introduction of the new role would give registered nurses more time to concentrated on complex care, and would tackle nurse shortage by offering a new route into the profession.

“Employers tell us they require an increasingly flexible workforce to keep pace with developments in patient care treatments and interventions,” the guide said.

“The nursing associate role is designed to provide employers with a range of skills within multidisciplinary teams, and to help teams make best use of the skills within the registered nursing workforce, which have been developed further through the new Future Nurse standards,” it added. 

The release of the document followed the publication of a guide by the National Quality Board on how to deploy nursing associates into secondary care.


Readers' comments (21)

  • I have lost count of the number of times I have asked senior nurses how they see the associate being integrated into a busy ward with registered nurses and health care assistants. Nobody can tell me, If there is anybody reading this who can, please enlighten me.

    As for feeling threatened as a Band 5 by the Associate, nothing could be further from the truth, but I will refuse to be accountable for them if I have to work alongside one. I see the role as an utter waste of money when we need RGNs, who it has been documented improve the safety and care of patients, yet the bursary is taken away from them . Far better to reinstate the bursary, give better training to Health care Assistants who do actually deserve more and stop wasting money on the associate role.

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  • Nursing Associates are NMC registered healthcare professionals, therefore accountable for their own practise. Most of them were also healthcare assistants prior to the course who deserved more and so were given better training. They have spent two years in University and passed at academic level 5 despite many of them only possessing Level 2 numeracy and literacy. They have the same medicine management training and also have to achieve 100% in a drug calculation test just as student nurses do.
    Take a look at how many nurses are leaving the register each year, would it make that much difference to staffing levels if they did bring back the bursary?

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  • I think bringing back the bursary would make a difference to those applying and be safer.

    I see you didn't comment on how an associate would be integrated into the ward.

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  • Why would it be safer to bring back the bursary? Why would it make a difference to those applying? And as for Nursing Associates integrating into the ward, that is down to the individual trust and type of setting. For example on a clinical assessment unit the Nursing Associate is able to care for a bay of patients, undertaking most of the tasks that a RN can do except for IV medications and the initial care plan. This change reflects what is to be expected from the new nursing standards where the Future Nurse will have the time to care for more complex patients, while Nursing Associates will provide safe. high quality care to others.
    There's a Q and A on here about Nursing Associates which was recently published also.

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  • So who exactly will do the IV's and care plans for the the nurse associate ?
    Oh don't tell me... the band 5 nurse on top of the work she/he already has to do caring for more complex patients plus the rest of her bay . Great idea.

    Bringing back the bursary would encourage more people to apply to be proper registered nurses. Why should associates get free training anyway?

    This also undermines the role of the HCA wouldn't it have been more sensible to give them better training?

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  • Do all HCA's want better training? Some of them want to stay in the same role and may not want any more training. The point is being missed entirely here, every HCA is encouraged to apply for TNA, therefore the ones who want to increase their skills can do so. There are also more places each year so every HCA has the opportunity.
    The RN will do the IVs and the initial care planning. The Nursing Associate can take charge of the bay as already stated, they have had sufficient training to know when to refer on. They are registered health professionals. Perhaps you perceive this new role as undermining the RN role not the HCA?

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  • Of course, it undermines both the HCA and the RN. There is nothing wrong with giving good basic training to Health Care Assistants. I hope all who choose that role would want it. I have worked with some who are thrown into the deep end after 2 weeks initiation and struggle.

    You are effectively saying that the associate runs the bay with the help of the HCA and potentially one RGN oversees the ward writing care plans for all and doing the all the IV's?
    Are you an HCA RN or Associate.

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  • Try reading some of the documents from Health Education England and increase your understanding and knowledge about the Nursing Associate role. All HCA's receive the appropriate training prior to starting, we know that. Some of them want to stay in that role and do not wish to undertake any further training. They are all offered the opportunity to do so, therefore why does the Nursing Associate role undermine them?
    I am a Trainee Nursing Associate due to register with the NMC on the 28th of this month. Most wards where I trained have really welcomed the role, some have been negative like you. It's change after all which always equals resistance. Nursing Associates are here to stay!!!

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  • I have read and it is as clear as mud. I thought you might be an associate.

    What roles would you undertake in a ward/bay situation then and what would you expect the HCA to do, you already have the RN doing your IVs and care plans doesn't leave a lot for you really, please enlighten me.

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  • It can't be as clear as mud because you wouldn't be asking so many questions about the roles.
    HCA's do what they are paid to do. I don't know what ward/ department you work on but from what I've seen the workload is increasing and its too much for one RN to do everything. Nursing Associates can document properly in notes, know when to make a referral and do it, clinical skills including IM injection and catheterization, patient admissions, medication rounds.....and IV's may follow. We come across this sort of negativity all the time until the RN is absolutely run off her feet and has no choice but to ask us for help.

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