The minimum standards that nursing associates will need to achieve have been revealed in draft plans by the Nursing and Midwifery Council, but do not confirm the extent to which those in the new role will be able to administer medication or how far they will be accountable for delegated activities.
The professional regulator said it had decided to release an early working version of the document so that universities had the opportunity to adjust two-year training programmes that began for 2,000 trainees at the start of 2017.
“We are releasing these proficiencies to the test sites”
However, the body stressed that the standards were subject to change – noting that a public consultation on the full draft version would take place in spring 2018.
In the early version released yesterday, the NMC said issues of delegation and accountability were “key” to the working relationship between nurses and nursing associates.
In the introduction to the document, the NMC explained that nurses would need to decide what can be delegated to associates and the amount of oversight and supervision that was required.
They would need to assess the strengths and capabilities of nursing associates and also the level of complexity of the intervention, it noted.
But it went on to state that the standards of proficiency were “not the vehicle through which these will be addressed” and that this would be dealt with “elsewhere”.
“What we are saying is, is this is what you need to work with. It may change”
Meanwhile, the draft standards state that associates should be able to administer drugs in a safe and effective way, and must be able to recognise signs of allergy, drug sensitivity and adverse reaction.
They must also be able to “demonstrate the ability to safely administer specified medications by a variety of different routes, for example inhalation, topical, oral, subcutaneous, per rectum”.
But the NMC did not include any further details and, instead, said it was still working with the national workforce planning body, Health Education England, to define “an appropriate level of proficiency” for medicines administration.
HEE, which initially led the introduction of the new role, previously wanted nursing associates to be able to administer controlled drugs.
The revelation was uncovered through leaked internal documents a year ago. But following criticism and patient safety concerns, it removed the requirement in later versions and instead said associates would be trained to administer drugs according to local employer policies.
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HEE went on to say it would look at producing guidance on the possibility of nursing associates giving controlled drugs.
The NMC’s draft document, released on Tuesday, includes six sections outlining the proficiencies. These are accountability of practice, promoting health, providing and monitoring care, working in teams, improving safety and quality of care, and contributing to integrated care.
In addition, a “number of approaches” were being explored to ensure the NMC’s code of practice was suitable for nursing associates, said the regulator.
A list of specific skills that nursing associates will need to be taught during training was also still being developed, it added.
The NMC stressed the proficiencies were designed to be the threshold standard for associates and that those in the role would be able to undertake further training for other tasks.
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At an NMC council meeting at the end of last month, its director of education Geraldine Walters said: “We are releasing these proficiencies to the test sites so they can look at what we are expecting and to make sure they can course-correct if their programmes don’t currently adhere to those standards.”
Speaking to Nursing Times after the meeting, NMC chief executive and registrar Jackie Smith said there “may well be” alterations to the draft proficiencies between now and the spring consultation, as well as following that period.
Nursing Times asked whether the NMC believed employers looking to train further groups of associates through apprenticeships should wait until the proficiencies had been finalised. In response, Ms Smith said: “What we are saying is, is this is what you need to work with. It may change.”
A number of employers across England began training 2,000 nursing associates at 35 test site in January and April this year, before the NMC agreed to the government’s request to regulate the role.
At its September council meeting, the regulator also agreed to allow associates who were already in training to join the register, even though the NMC has not yet approved any courses for the new role.
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Under the plans, the pilot site trainees will be able to register with the regulator from January 2019, if they have gained a “comparable” qualification to one from an NMC-approved course.
The regulator said it was currently too early to assess whether associates trained through apprenticeships would be able to do the same and said it would look at the issue again in early 2018.
Last week, health secretary Jeremy Hunt announced 5,000 nursing associates would begin training through apprenticeships in 2018, and 7,500 every year from 2019 onwards.