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Nursing associate role will ‘supplement, not replace’ RNs, says top HEE nurse


The new “nursing associate” role will not remove overall responsibility of care from nurses, though it will take on some of their functions, Health Education England has told Nursing Times.

The role will be fully tested and developed before being rolled out nationally, despite earlier plans to pilot the role at 30 sites having been cancelled, confirmed HEE’s director of nursing Lisa Bayliss-Pratt.

“We must never forget that the person ultimately responsible will be the registered graduate nurses”

Lisa Bayliss-Pratt

Last year, Nursing Times revealed that plans were being developed for a bridging role intended to sit between nurses and senior healthcare assistants, which would also offer a fast-track route onto the register via degree-level apprenticeships.

The creation of what are provisionally being called “nursing associates” – previously often referred to as associate nurses – was confirmed by ministers in December and a consultation on the role was launched yesterday.

In an interview with Nursing Times, Professor Bayliss-Pratt said the consultation exercise would look at what competencies would be required by those in the new role to free up nurses’ time and at the skill mix required in certain clinical areas.

It would allow more registered nurses to move into leadership and management positions and take increasing control of the quality of care provided by their teams, she said.

“There’s something around who’s doing what tasks and whether they are the best people to do them, but we must never forget that the person ultimately responsible will be the registered graduate nurses,” she said.

The consultation document states that nursing associates would not be able to independently review patient treatment plans, measure or evaluate progress to make decisions on patient care, or lead or design the care planning process.

“We absolutely have to test this and see where the role adds the most value”

Lisa Bayliss-Pratt

They would also be unable to manage or oversee care interventions, or provide clinical expertise.

The role would be “firmly grounded” in direct care provision, working across a range of settings and conditions, with greater emphasis on community and public health perspectives, it said.

However, the consultation does not put forward a proposal on the regulation of nursing associates and ask for views instead.

It notes there has been “strong support” for regulation, but asks respondents to “take into account the other measures in place to shape and specify practice”, such as enhanced qualifications and clinical governance.

Meanwhile, it reiterates training for the role will take place via an apprenticeship that leads to a foundation degree.

A “key mechanism”, said the consultation, to deliver this will be the government’s proposed apprenticeship levy on large employers from 2017.

The levy is part of a wider raft of measures the government is planning to boost apprenticeships across all industries. It includes targets for NHS organisations on their numbers of apprentices, which were outlined in a separate consultation earlier this week.

Under the nursing associate proposals, practitioners in the role would also be able to go on to become registered nurses through an apprenticeship.

“Whether we like it or not, we are in a new era”

Lisa Bayliss-Pratt

Concerns have been raised this idea would not provide the same standard of training as the university route, but Professor Bayliss-Pratt stressed it would be a degree-level apprenticeship, which already existed through places such as the Open University.

She said entry routes into nursing needed to be thought about more “creatively”, considering the future needs of the healthcare system in England.

“Whether we like it or not, we are in a new era, we’ve got the Five-Year Forward View, we’ve got financial challenges, quality gaps and increasing patient demand,” she said.

“We need to say, ‘isn’t it great there is more than one way you’ve got to become a registered nurse and that we’ve got to take advantage of that, so we get the diverse nursing workforce our patients need’,” she added.

Last year, Nursing Times revealed that HEE planned to pilot a new senior HCA role at 30 sites across England in 2016, after its creation was recommended in the Shape of Caring report – the review of nursing education and training published by Lord Willis.

However, following the subsequent Department of Health announcement about the intention to formally introduce the position, the initial pilots were called off.

But Professor Bayliss-Pratt told Nursing Times that testing would take place as part of the roll-out of the role.

HEE would be sending out “imminently” a call for expressions of interest from providers across all setting including social care to test the role, she said.

“We absolutely have to test this and see where the role adds the most value, least value and if it adds value in some places,” she added.



Readers' comments (17)

  • Opps my keypad automatically typed 'underestimates'.

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  • Interesting....Probably very soon there will also be a 'short cut' for nurses to become medical doctors so as to 'supplement' for the shortage of doctors, since nurses and doctors 'have similar functions' in patient care. I bet they will be called 'doctoring associates'.

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  • No, it just means there will be fewer nurses to take responsibility since Monitor has told trusts to reduce their staff!

    'Hospitals told to cut staff amid spiralling NHS cash crisis

    Exclusive: Nurses’ jobs threatened as regulators ditch policy brought in after Mid Staffs scandal'

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  • Also revalidation is obviously a failure and they have to make up for the shortfall. Worst government ever.

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  • The focus should be on team contribution and excellent patient care regardless of grade. We do need clear role differentiation to meet the many demands imposed on us but have also have nurses who welcome moving away from the shop floor . Maybe a time window of mandatory shop flooring and patient contact for all grades would help keep keep everyone in touch with the main purpose of our profession-looking after the most vulnerable persons within society

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  • I may be completely missing the point of the nursing associate...but it seems, again, more responsibility for the RN. And, a bit of a slap in the face for all time spent studying to become an RN.

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  • why not have Registered Nurses and qualified suppport workers.Even in the USA, the LPNs are restricted primarily to Long-term units not Hospitals

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