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Draft list of over 90 skills nursing associates should be trained in released by NMC


The Nursing and Midwifery Council has unveiled a list of over 90 procedures and communication skills that nursing associates should be trained in, as part of draft proposals published yesterday.

The regulator stressed it was still developing the list and that a final draft version would be published for consultation in April. However, the NMC said it wanted to release the initial list earlier than then in order “to allow people to see how the skills annexe is developing and what it contains”.

“This working draft of the skills annexe is being released to allow people to see how the skills annexe is developing”

NMC draft skills annexe

Around 2,000 people are half-way through two-year training programmes to become nursing associates and will need to meet the NMC’s standards to get onto its register before they can practise.

The controversial new role is intended to act as a bridge between healthcare assistants and registered staff, with the government also proposing it as a potential new route into nursing for some associates at a time when the country is facing a major shortage of nurses.

The NMC’s plans contain more than 30 communication skills and over 60 procedures, including those for respiratory support, managing medicines and end-of-life care.

Nursing associates must be able to “manage the administration of oxygen using a range of routes and approaches”, use appropriate nasal and oral suctioning techniques, and manage inhalation, humidifier and nebuliser devices in line with prescription, according to the plans.

They should be able to carry out drug calculations “for a range of medications”, administer drugs via oral, topical and inhalation routes, and administer injections using subcutaneous and intradermal routes, state the proposals.

In addition, nursing associates should “exercise professional accountability” when administering medicines to patients, add the plans.

Specific skills for monitoring a patient’s condition – such as recording and interpreting vital signs and undertaking venepuncture, cannulation, blood sampling, and routine electrocardiogram recording – are laid out in the draft skills annexe.

Associates should also be able to observe and reassess patients’ skin and hygiene status and “determine the need for ongoing intervention” and provide wound care using aseptic techniques.


Any number of ECGs, blood tests and scans, but not a sniff of any results

Undertaking routine ECG recordings will form part of nursing associate training, according to draft plans

Other skills for bladder and bowel care are also detailed, such as managing catheters, assistance with self-catheterisation, and providing stoma care.

Infection prevention and management, end of life care, supporting the management of common symptoms – such as pain, nausea and anxiety – managing falls, supporting nutrition and hydration and sleep, are all covered in the list.

Meanwhile, communication skills to prevent ill health, for therapeutic intervention – such as de-escalation strategies – and techniques in supervision and coaching, such as for delegating care to others, are also set out.

The NMC noted that some people had proposed that nursing associates should also be trained in insertion and removal of oral and nasal gastric tubes, insertion and removal of catheters, intramuscular administration of drugs, and use of infusion pumps.

The regulator said it was considering adding these skills to the draft proposals when it launched the consultation in April.

The list of skills will form part of the NMC’s overall competency standards for nursing associates.

It published an early version of the draft competency standards in October 2017 to allow universities that have already started training associates to adjust their courses.

Around 2,000 trainee nursing associates began two-year programmes in January 2017.

The NMC agreed to the government’s request to regulate associates later that month but it will not officially become the regulator of the role until changes are made to legislation, expected by autumn 2018.

It expects to open its register when the first set of nursing associates complete training programmes in January 2019.


Readers' comments (13)

  • This is a message to all Matrons in the NHS get out of the office and join in the work the days of slavery are over. Treat your nurses and HCA’s with respect and support them and if there are HCA’s who are overseas nurses waiting to sit the IELTS support them don’t ridicule them. This is happening and If you lazy matrons think your better try the IELTS yourself and watch your failure to pass this corrupt system.

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  • I agree. In the office/ management roles talk about forgetting what nurses roles are. Power, oh yes, power certainly goes to their heads. Checking computer systems. Remember, no patients no documentation. Check your people and public are ok. RGN.

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  • Would the NMC like to set out how they see the role of the properly registered , properly trained registered general band 5 nurses when faced with an influx of nurse associates who seem to be becoming nurses on the cheap.

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  • Reinventing the SEN is not the answer, just as they were used and abused before being killed off in the 80s! I would like to see these skills embedded in Student Nurses first. Far too many of my Staff Nurses were unable to complete many of these tasks on arrival on the ward, unlike my generation who had to demonstrate these in practice before we sat our finals.

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  • So why on Earth would Trusts pay for a nurse when they can have a nursing associate doing more or less the same role for less money.
    What is going to be the point of band 5 nurses? Or is this some underhand plan to get nurses on the cheap?

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  • Can someone please tell me why I am putting myself and family through so much hardship to get a nursing degree!? After reading this there seems little point, just makes me feel more undervalued and demotivated than I already do.

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  • The associate nurse would be in theory a great support for the nursing team, but I fear they are introduced for the wrong reasons, to substitute the lack of nurses, paid less, with same responsibilities and stress. This is a way of saving money, but not saving lives.

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  • Welcome back to the Enrolled Nurse at a much cheaper rate.
    With associates, apprentices, HCA's of differing levels et al I wonder how much time the RN will have to spend at the start of each shift delegating these roles? What a glorified mish mash, so many Indians and no Chiefs.

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  • Training going full circle.Nurse associates or just SEN nurses. Wake up and smell the coffee!!!!!!

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  • It is indeed going full circle, yet again. Basically, the SEN role re-introduced. I fully support this comment above, "The associate nurse would be in theory a great support for the nursing team, but I fear they are introduced for the wrong reasons, to substitute the lack of nurses, paid less, with same responsibilities and stress. This is a way of saving money, but not saving lives."

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  • Don't worry I'm sure the Duchess of Cambridge will be able to sort it all out for us.

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  • I am doing my nurses training now and would just like to say why would a trust employ me when they can appoint a nurse associate who has already been trained in skills such as venipuncture cannulation infusion pumps, as a student nurse these are not skills that I am allowed to undertake! So why would the NMC make the nurse associate more skilled than a degree nurse ?

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  • Why not get rid of all nurses, and let junior doctors do the basic care. At least then, nursing care will be moderately well paid.

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