With the first qualified nursing associates entering the workforce this month, Professor Geraldine Walters, director of education and standards at the Nursing and Midwifery Council, has answered some key questions about the new role.
What is a nursing associate?
A nursing associate is a new member of the nursing team who will provide care and treatment in a wide range of health and care settings. The role is being used and regulated in England and it’s intended to address a skills gap between unregulated health and care assistants and registered nurses. As well as being a role in its own right, some nursing associates will progress on to graduate level nursing. The introduction of the role will enable registered nurses to focus on more complex clinical duties.
When will the first nursing associates join the workforce?
Nursing associates will join a new part of our register which opens on 28 January. Over the first couple of months Health Education England have said we can expect around 1,800 nursing associates to qualify, with more in training as we speak. Whether they join the register immediately may depend on their next career steps.
Why has this new role been introduced?
HEE published the Shape of Caring review in 2015, which identified a role for a potential new type of worker with skills and knowledge between that of a healthcare assistant and a registered nurse. The government announced the creation of the nursing associate role and confirmed that it would be regulated. We were asked by the secretary of state for health and social care to regulate the role and we agreed to this in January 2017.
What pay band is a nursing associate?
We believe that the majority of nursing associates will be paid at Band 4, but this is a decision for employers.
Haven’t there already been some nursing associates working in the NHS?
Trainee nursing associates have been on placement over the last two years as part of their training, so nurses and midwives in England may have already met some trainees. But the first regulated nursing associates will join our register from 28 January.
How can you become a nursing associate?
Until July, you can still begin training as a nursing associate via one of the HEE approved pilot sites. Details can be found on HEE’s website.
We’re about to start approving nursing associate training programmes this month, and from July 2019, all new students starting to train as a nursing associate must do so on an NMC-approved programme. People will be able to find details of approved courses on our website. If people are interested in becoming a nursing associate and are currently employed as a health or care professional, they can ask their employer for advice on the options available or search online via NHS Careers.
Do you have to pay for training?
The government wants to see the apprenticeship route used for nursing associate education, but there are also likely to be conventional routes where students take out loans to pay their fees. Apprentices learn while they earn and employers cover their fees using money drawn down from the apprenticeship levy.
Will nursing associates have to revalidate?
Revalidation is an important aspect of the way we regulate professionals. It helps them to reflect on their work, seek feedback, and show us that their keeping up to date in their professional practice. It also gives confidence to those receiving care that people on our register continue to be capable of safe and effective practice. Nursing associates will revalidate in the same way as nurses and midwives.
Will nursing associates have to follow the same code of conduct as registered nurses?
Absolutely. The code of conduct essentially sets standards of conduct and behaviour of those on our register, and we would not expect the conduct and behaviour of a nursing associate to be any different from that of a nurse or a midwife. We made minor tweaks to the code to reflect the introduction of nursing associates in England at the end of last year.
What happens if something goes wrong with the care delivered by a nursing associate?
Where something goes wrong with the care being delivered, we would expect the employer to look carefully at this, just like with a nurse or midwife. Where the issue can’t be sorted out locally or it’s very serious, we will look at the issue in the same way as we do with nurses and midwives – the same fitness to practise processes will apply.
How many nursing associates are you expecting to register?
Health Education England have said around 1,800 are expected to qualify in the first few months. This will depend on the career intentions of the nursing associates themselves. More are in training and will join the register in the coming years. The government sought 5,000 new trainees in 2018 and is seeking a further 7,500 in 2019.
What tasks will they be able to perform?
Our standards for nursing associates set out the skills and knowledge they will need to demonstrate proficiency in, in order to join our register. We have made sure that there are clear differences between the standards for nursing associates and those for registered nurses. But, like nurses and midwives, nursing associates may develop new knowledge and skills throughout their career. Nursing associates will work as part of the wider health and care team and will contribute to the core work of nursing, carrying out a range of activities from administering medication, and dressing wounds to promoting healthy lifestyle choices and wellbeing.
How will nursing associates fit into the workforce? Can they be deployed instead of a registered nurse?
Nursing associates will work as part of the wider health and care team. They should support but not substitute registered nurses. As with any new role, employers will need to look at the skill mix they need to deliver the best and safest care for people. NHS Improvement have published supporting material for employers about deploying the role while NHS Employers have also produced guidance for employers.
Will nursing associates require supervision?
As qualified and registered professionals, nursing associates will be individually accountable for their own conduct and practice, however they are deployed. But we would expect that, especially while the role is new, most nursing associates will be working in teams that may include nurses or other registered professionals with an appropriate level of oversight of their work. The NHSI guidance is designed to help providers think about how they deploy the role safely and effectively.
How will patients be able to identify nursing associates from registered nursing staff?
It is for providers to determine the most effective way of distinguishing between different members of the team to ensuring that people are aware of who is involved in their care, and what their role in the care is.
Will the new role be evaluated?
The department of health and social care are commissioning research to evaluate the new role.
Once you are a nursing associate, how can you become a registered nurse?
Nursing associates will be able to take a shortened nursing degree programme. The maximum amount of recognition of prior learning going into nursing programmes is 50 per cent, so these programmes must be at least 18 months in length. This will allow nursing associates to develop a specialism as well as achieving a degree level qualification.