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Super-regulator currently unable to recommend full regulation of new nursing role

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The body tasked with assessing whether nursing associates should be regulated has said it cannot yet make a decision due to the role still being in development, but has recommended it should be registered as an interim measure.

The Professional Standards Authority, which oversees the work of the Nursing and Midwifery Council and eight other statutory bodies that regulate UK health and social care professionals, was asked by the government in August to review the new role.

In its report published today, the PSA said there was not enough clarity about the scope, clinical practice and working environments envisaged for nursing associates for it to assess the risk of harm and make a recommendation about regulation.

The body said in a statement it had “insufficient information and time to come to a definitive conclusion”. Its recommendation to “register, but not yet regulate” the role is a “pragmatic” response to a role that is still being shaped and tested, it stated.

At the time of the PSA’s assessment, the curriculum for the nursing associate had not been finalised. However, the PSA said it did understand that all nursing associates would be expected to administer medicines.

In the report, the body added that at the time of its assessment there was also no agreed general descriptions distinguishing between healthcare assistants, nursing associates and registered nurses.

The curriculum for nursing associates has since been published by Health Education England, as reported by Nursing Times yesterday evening.

The curriculum document states that those in the new role will be able to calculate drug doses under delegation and also administer medication according to employer policies – but does not state they will be trained to give controlled drugs, as was previously planned.

The PSA noted that many respondents to HEE’s consultation on the role earlier this year saw regulation as a way of reassuring that employers nursing associates were accountable and traceable if they moved on to a new role following misconduct, and would also provide reassurance to nurses about implications for their own registration when delegating tasks.

Regulation was also seen as a solution to enhancing the professional status of the role, defining national education and training standards, and protecting associates from working beyond their scope of practice. But it said it was not always clear on what basis these views were formed.

“Our report summarises the additional evidence we will need to finalise our assessment [of regulation of nursing associates]”

Professional Standards Authority

In conclusion, the PSA said that due to lack of evidence about the scope of the role of nursing associates, the role should be registered on an interim basis.

Once the role had begun testing at pilot sites next year, the PSA could then provide a full assessment of whether the role should be regulated, said the body.

It suggested that a regulator such as the NMC could set up a voluntary register under its existing legislation, which would provide an easy route to regulation at a later stage if required.

“Our recommendation to register, but not yet regulate the role is a pragmatic response to a role that is not yet fully defined or tested,” said the PSA in a statement.

“Our report summarises the additional evidence we will need to finalise our assessment as well as outlining some of the methods of assurance that could be considered for the role when there is more clarity around its scope,” it added.

The report from the PSA is the latest twist in the path towards a decision on whether nursing associates should be subject to regulation like nurses.

Nursing representatives from NHS England, Health Education England and NHS Improvement have all recently confirmed that they are in theoretically favour of regulating nursing associates, and the NMC has told Nursing Times that it could undertake the task if asked to do so by the Department of Health.

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