Plans to develop the forthcoming nursing associate role have been drawn up at a “helter skelter” pace and have been “rushed”, leaving insufficient time for the profession to scrutinise what the new role will be able to do and how it will be trained, it has been claimed.
The warning follows last week’s revelation that nursing associates will be expected to calculate drug doses and independently administer controlled medications, after a draft document detailing the curriculum for training the role was leaked.
The first wave of 1,000 trainee nursing associates are due to start two-year on-the-job programmes at pilot sites in January, closely followed by a further 1,000 in April.
But the final version of the curriculum for the trainee role and its job description have still yet to be finalised, while a government decision on whether nursing associates should be regulated is also still due to be announced.
Nurses and professional bodies have warned there has not been enough time for the plans to be fully consulted on due to the desire to bring in the role quickly to help deal with staffing shortages.
Helga Pile, national officer for health at Unison, said the timescale to introduce nursing associates was “really challenging”.
“It feels as though it is at a helter skelter pace,” she said. “I think that means that the kind of planning and engagement that it’s been possible to do has suffered as a result of the timetable.”
“It feels as though it is at a helter skelter pace”
Commenting on the recently revealed plans for nursing associates to work without direct supervision and at times independently, she said it still unclear when and in what setting they would be expected to do so.
She also noted there remained a lack of detail about how the role’s responsibilities would be different to those of nurses.
Dr Crystal Oldman, the chief executive of the Queen’s Nursing Institute, also warned there had been a “rush” to introduce nursing associates, hinting it was driven by the current national nurse shortage.
If ministers decided the role should be regulated by the Nursing and Midwifery Council, there would not be enough time for training programmes to be signed off by the NMC before nursing associates began their courses at the pilot sites in January, she said.
“In the rush to get nursing associates – and probably substitute registered nurses – we haven’t got our processes sorted,” said Dr Oldman.
“If we all agree that these roles need to be regulated, then the curriculum needs to be an approved curriculum and the system needs to be in place to approve the universities to deliver that curriculum,” she told Nursing Times.
“We need much greater discussion across the profession”
Meanwhile, Jill Maben, professor of nursing research at King’s College London, said she had “serious concerns” about the timeframe for developing the role, which she said felt like a “quick fix”.
“This needs to be tested, better thought through and we need much greater discussion across the profession,” she said.
Professor Maben noted that Health Education England, which is developing the role, had not actually asked whether nursing associates were even wanted in its consultation earlier in the year.
“It basically said this is the role and what do you think they should do,” she said. “I am concerned. I don’t feel there has been enough engagement with the profession. It feels like quite a quick fix with potentially very big unintended consequences.”
She added that the draft curriculum itself had been drawn up without wide consultation.
“We are pushing at open doors in terms of people wanting to develop it”
In response, HEE’s director of nursing Professor Lisa Bayliss-Pratt told Nursing Times it was “absolutely true” that “we are moving at pace” because the “situation is urgent”.
“We know we’ve got vacancy rates, we’ve got agency spend controls and we do need to get more people with caring knowledge and skills into the service to improve the care we are delivering,” she said.
She said there had been “huge engagement” from the profession, noting the large number of organisations involved in the pilot sites, including social care, NHS, higher and further education providers.
“We are pushing at open doors in terms of people wanting to develop it. There is a need to get testing this role and seeing how it can help the nursing challenges we face,” she said.