Legislation changes to allow nursing associates onto the Nursing and Midwifery Council’s register are to go ahead, following “broad support” for the plans, the government has said while publishing results to its consultation on the proposals.
In its response to the consultation, released on 30 April, the Department of Health and Social Care laid out how it would give statutory responsibility to the NMC to regulate the new role in England.
“It’s clear that there’s widespread support for the proposed approach to regulation”
The changes will extend the regulator’s current powers to allow the body to register associates, set standards for and approve training programmes, and carry out fitness-to-practise activities.
The NMC will also be able to allow people who have comparable qualifications – from Scotland, Northern Ireland, Wales, Europe and international countries – onto the nursing associate part of the register, said the document titled Regulation of nursing associates in England: government response.
In England, it will become an offence for someone to call themselves a nursing associate unless they are registered as one with the NMC.
It will also become an offence to falsely claim to be on the nursing associate part of the register, or to pretend to hold the relevant qualifications for the role.
However, 19% of the 373 respondents did not agree with the plans, with many saying this was because they believed the offences should be extended across the UK.
The government said it had rejected this suggestion because other parts of the UK “have no plans to introduce a nursing associate role at this time”, and so any breaches of the legislation outside of England would be minimal.
“Closing sub-part 2 to new applications will also ensure clarity between…a nurse and nursing associate”
DHSC response to associate regulation consultation
In addition, it noted there were existing offences that could potentially be applied in cases where someone falsely claimed to be registered as a nursing associate in another part of the UK – such as for fraud in Scotland.
Under the legislation proposals, nursing associates trained through a programme that has not been approved by the NMC – such as those taking part in the pilots or apprenticeships – will still be able to join the register.
However, this route will only be possible if they start training by 26 July 2019 - and to get onto the register they will also have to show they have gained a comparable qualification, or will need to take a test of competence.
Beyond the July cut-off point, all those starting associate training in England will be required to be on an NMC-approved course.
Inspection of courses should be carried out by either nurses or nursing associates, according to the plans.
The government said it was preferable for associates to inspect training programmes but, “until the profession is mature, it is not possible to know whether there will be suitable numbers of experienced nursing associates available for this role” and so the NMC should be able to select nurses instead.
As originally proposed by the government, the NMC will not be able to allow associates to prescribe on a temporary basis in the case of an emergency – such as a flu epidemic.
However, 21% of respondents disagreed with this plan due to many believing it could be a natural progression as the role becomes embedded and develops.
The government said its proposal had been misunderstood and that respondents may have believed an emergency situation referred to day-to-day hospital emergencies – when it in fact was talking about a national emergency that would be declared by the health sectary.
Meanwhile, the government’s consultation response laid out its plans to close the part of the NMC’s register for state-enrolled nurses to all new entrants.
SENs hold different qualifications to other nurses – who are on a part of the register known as sub part 1 – but both are able to practise to the same level.
The SEN section of the register, known as sub-part 2, has effectively been closed to UK-trained SENs since the late 1990s when nurse education was transferred from employers into universities, under Project 2000.
There are currently approximately 11,000 nurses who are only registered on sub- part 2 and “this number is diminishing each year,” said the government’s consultation response.
Under government plans, SENs will no longer be able to join the NMC register, but existing registrants will be able to remain on it.
“It’s critical that the government now push forward with these changes”
Applicants from outside of the UK will in the future either be directed to the nursing associate part of the register or the sub-part 1 of the nurse section of the register.
“It is important that the process that allows applicants from overseas to join a part of the register now unavailable for newly qualified professionals trained in the UK is closed,” said the government.
“Closing sub-part 2 to new applications will also ensure clarity is maintained between the roles of a nurse and a nursing associate,” it added.
Commenting on the government’s response, NMC chief executive and registrar Jackie Smith said: “Since our council agreed to become the regulator for nursing associates we’ve been working hard to make sure everything is ready to welcome the first nursing associates on to our register in January 2019.
“It’s clear that there’s widespread support for the proposed approach to regulation and while there’s still more work to be done, today is an important landmark,” she said.
“It’s critical that the government now push forward with these changes to enable us to open the nursing associate part of the register on time,” she added.