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New nursing associate role developed too quickly, warn profession's leaders

  • 6 Comments

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”

Helga Pile

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”

Jill Maben

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”

Lisa Bayliss-Pratt

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.

  • 6 Comments

Readers' comments (6)

  • michael stone

    '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'

    Yes - there seems to be an element of politics in the speed with which this has been progressed, and logically there should have been much more 'analytical groundwork' carried out than has happened.

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  • @Michael Stone, I can't agree with you more ☝? Speeding crucial decisions always lands in serious consequences and endanger lives. More consultation is as important.

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  • The Nursing crisis has been coming upon us for at least 30 years and I do not believe this attempt to begin to solve this problem is premature, in fact it should have thought of earlier.
    The response for training places clearly shows that there are thousands of frustrated Nurses out there wishing to go into Nursing in a new way.

    The academics clearly have not a clue as all their attempts have failed miserably to enroll sufficient numbers in their over academic solutions.

    Any new system will need monitoring and adapting so that it is "fit for purpose" and it is absolutely paramount that we define clearly what the main purpose is.

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  • You quote Professor Maben as saying 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. At the time I realised that so responded saying forcefully that that not providing the option of saying whether or not one thought the role should be introduced meant the responses were distorted from the stasrt.

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  • hi I yes this post has not been thought throu .Thou out the nhs the has been a number of fantastic,caring staff that knew there post as band three,thay helped the nurse to the full then due to nhs cut backs thay was dismissed that was a waste of time and money now the is a nother post that would be a band 4 the n h s is in break down why are you doing this? p.s lots of the band 3s were asked if thay wanted to be aps but we refused and the trusts decided to knock it on the head.?????

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  • What we need to know as a matter of urgency is will nursing associates be fully accountable for their actions, I know the NMC are considering regulating them but if this doesn't go through what will happen? I don't see why I should be accountable for the actions of a nursing associate if they incorrectly give a controlled drug or any medication for that matter. If they feel competent and want to administer medications then they should be 100% accountable for their actions. I don't want this to sound petty but I have no intention of "Baby sitting" nursing associates. We also have the problem of mentorship- how is this going to work when student nurses are on the ward? Honestly I would give priority to the Student Nurses because they are training to become Registered Nurses and need to learn with us, I don't want a scenario where I am having to mentor a student and a nursing associate on the same shift. When am I going to have time to do my own job? I am also feeling as if nursing associates are going to be stepping on my toes, I know my job role and I don't particularly need anyone running behind me. I am very skeptical about this role

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