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New nursing associate role developed in ‘wrong order’


Concerns have been raised that nursing associates who have been trained at pilot sites will not be qualified to the level required by the Nursing and Midwifery Council and could present a risk to patient safety.

At the end of January, the NMC agreed to a request from the government in England to regulate the new role, which is expected to sit between a healthcare assistant and registered nurse.

At the NMC council’s latest meeting where it agreed to the request, the body’s chief executive said the development of the new role had been done in the “wrong order” because pilot programmes had already begun before the NMC had set the training standards.

It was claimed by a member of the council that this could lead to a “dangerous” situation in which those who trained through the pilots might practise under the title of nursing associate without being regulated by the NMC.

“We are going to be in a position where some people might want to call themselves nursing associates who will be ready to apply for jobs, before we have the regulatory framework set up, and I am really anxious about this,” council member Stephen Thornton said at the meeting.

“I am anxious for them that they may end up having marginally the wrong training to be able to cope to do what we say they should do,” he added.

“I’m also concerned for patient safety. I’m also concerned for simply what patient expectations are going to be of what people in that kind of situation are going to be able to do for them – be it on a ward or in a community setting,” said Mr Thornton.

“I am anxious for them that they may end up having marginally the wrong training”

Stephen Thornton

He later stressed that it would be “catastrophic” if this “dangerous” situation occurred and the body should seek assurances from the government that only those regulated with the NMC would be able to call themselves nursing associates.

His concerns were echoed by Unison’s outgoing head of nursing Gail Adams, who said at the meeting that there was a “big risk” that pilot site trainees would not in the future be regulated by the NMC, because “we are putting the cart before the horse”.

More than 1,000 trainee nursing associates began two-year pilots at employers and universities across the country last month, under programmes developed by Health Education England, with a further 1,000 due to begin in the spring.

NMC chief executive and registrar Jackie Smith said the regulator would need to “seize” the pilot programmes off HEE and work closely with the employers and universities involved over the next couple of years.

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Stephen Thornton

She acknowledged that the development of the role had been done in the “wrong order”. “We would not be setting on this path in this way. It would be us setting the standards, and then training,” she told the council.

But she later told Nursing Times that, while there were concerns and the risks would need to be managed, “they are not showstoppers”.

HEE’s senior nursing policy manager Sam Donohue said at the meeting that the 2,000 pilot trainees needed to be “protected” and they had been made aware they might need to complete additional elements of training beyond the current programmes.

She said HEE had been working closely with regulators and employers to ensure they waited until the training standards had been set and met, before “badging” people as associates.

A Department of Health spokesman said: “The pilot programme has been developed alongside the NMC and HEE – clearly it is not in anyone’s interest to train nursing associates in the pilot programme who then won’t meet the NMC’s standards for registration.”


Readers' comments (13)

  • What a surprise ... NOT ,

    What a disgrace this has been rushed through and supported by the nursing hierarchy desperate to pacify the government at the expense of the profession.

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  • What a "pig's ear". Nursing is going to die without even a whimper. Our over paid leaders and complicit unions have sold us up river. I agree with first commentary.

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  • I share the concerns. This whole scheme flies in the face of the evidence on safe staffing. Without pre - agreed outcome standards how can the NMC do anything but say they have completed a course ? I hope at least that they have evaluated the courses already in place.

    Rather than setting up untried schemes more funding should be put inot reducung attrition both per and post registration and into getting RNs who have left nursng to return. The NMC know who is on the register adn there is data on how many RNs are in employment.

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  • Surely the NMC was aware of what they were signing up to and as usual one hand doesn't know what the other is playing with, not unusual is it? or has it been intentional I wonder ? I can't see the NMC really supporting this scheme, they have been resisting it for many years now, haven't they?

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  • Yes but now they will be paid £4 million to supposedly regulate them.
    Money talks.

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  • I have just returned from an interview for a practice nurse position, with 17 years of practice nurse experience i was basically told that they had two nursing auxiliaries who now did all treatment room duties, so i was not really any use to them! so now i am no longer required although i have been regularly undertaking clinics for cytology screening, baby immunisations, women health and all other treatment room duties I was informed that as i did not have a diploma in diabetes i was basically worthless.
    Now as my pay has not had any increments for 4 years and I worked my socks off to do my revalidation in April.
    This interview made me think i should have just remained an NA after 22 years of nursing and 3 as a student, with a background in ITU and Burns and Plastics then 17 years of being known as baby imms and smear queen, i now feel totally worthless.

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  • Mary Caddick

    As a mature third year student nurse who should be excited about the prospect of achieving my life long ambition of qualifying I am afraid I am terrified and think the profession has lost its way. The wards are fill with people under so much pressure they cant spend time to mentor and they are a number of those who have been nursing along time burnt out and feeling under valued once again with the introduction of a quick fix !!!!! The staff I have worked with have been nursing for the right reasons but how much more can they take and as a student with life experience how much more can we give!

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  • I agree totally that there needs to be a sea of change and that more nurses are the way forward to man the busy wards. But how can this be achieved when the bursaries have gone, students need to pay and the environment is so stressful? Things are going to get a whole lot worse before they get better.

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  • The removal of bursaries is recent is it not, surely this cannot be used to explain the present shortage, although I agree it will not help matters.
    Maybe we should be more aware of Social attitudes and trends of Young People towards Caring as this is were we go to for new recruits is it not? I have noticed more and more people are showing less respect for their elders .

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  • I agree with the above comment.

    For years now the government has been using scare tactics on the public to imply that the cost for elderly people is too great, which it isn't if the NHS senior managers know how to provide long term care, though how many do?

    So young people may well be thinking that our elderly people have had their day and are expendable. Fact is though that unregulated, ignorant Senior Managers and seriously ignorant Civil Servants and some MPs just are not up to their jobs and do not know how to deliver long term care, despite a considerable amount of research demonstrating that decent care is cheaper.

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