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'Strong support' for regulation of new nursing associate role

  • 25 Comments

A national consultation on plans to create a new “nursing associate” role has shown “strong support” for its regulation, it has been revealed.

The director of nursing at Health Education England, the national workforce planning body leading the consultation, also said respondents wanted those in the role to be able to administer medication, undertake dressings and care for people with catheters.

“They are going to have to be trained robustly and that then leads you to regulation”

Lisa Bayliss-Pratt 

At an HEE lecture last week on shaping the future nursing and care workforce, Lisa Bayliss-Pratt revealed to an audience of leading nurses and academics some of the knowledge and skills respondents had said the role should have.

Referring to the consultation results, Ms Bayliss-Pratt said: “They told us this, in headlines, that the role should be regulated, that it should be able to administer medication, that it should undertake dressings, it should be able to deliver a care plan, it must be focussed on prevention and promotion and people’s health and wellbeing, that it’s got to be able to care for patients that are ventilated, that have got catheters.”

She said the consultation had been “far-reaching” and reiterated an earlier comment made to Nursing Times that it had attracted more than 1,000 responses.

However, she said she was unable to provide any more details until the full findings from the consultation were presented to HEE’s board, which is expected to happen at its meeting next week.

She asked the audience to consider what the introduction of the role – which has been designed to bridge the gap between healthcare assistants and nurses – could mean for the registered nurse workforce.

Ms Bayliss-Pratt suggested it could help improve retention of nurses and asked whether the “advanced practice of today [could become] the standard practice of tomorrow?”.

When later asked by Nursing Times how many consultation respondents wanted the role to be regulated, HEE said there was “strong support” for this.

Ms Bayliss-Pratt also later told Nursing Times that this was the case due to being in a “post-Francis era”, in reference to the public inquiry into the former Mid Staffordshire NHS Foundation Trust.

In addition, she said, for the role to be effective there was a “question mark about direct and indirect supervision”.

“If they are to work in social care and primary care, then actually they are going to have to do more than our support workers of today do. And they are going to have to work, quite probably, independently,” she said.

“They are going to have to be trained robustly and that then leads you to regulation,” she added.

“The other benefit [of regulation], of course, is to be able to create national standards. To be able to create a workforce that feels valued and has got some clear delineations around what’s its name, what its education is, where it sits within the nursing family,” said Ms Bayliss-Pratt.

  • 25 Comments

Readers' comments (25)

  • "The director of nursing at Health Education England, the national workforce planning body leading the consultation, also said respondents wanted those in the role to be able to administer medication, undertake dressings and care for people with catheters."

    Then what will staff nurses and community nurses be doing then? I was very neutral in regards to this role as my trust has massive issues with nursing employment and retention, and I've seen AP's in action and they are excellent, but if nurse associates are able to give meds, do dressings and carry out other clinical skills then all staff nurses will be doing is supervising and writing paperwork. How will nursing students be expected to learn if there are only 1 or 2 staff nurses on the ward and instead they have to train under nurse associates. Sometimes the only 'nurse' aspect of a shift might be giving meds or doing dressings, it may be the only instance you get to interact with patients. This is just a cheaper introduction of a SEN and it seriously undermines the nursing profession.

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  • michael stone

    'The director of nursing at Health Education England, the national workforce planning body leading the consultation, also said respondents wanted those in the role to be able to administer medication, undertake dressings and care for people with catheters.'

    It seems to me to be largely pointless, unless these 'HCA+' people (whatever they end up being called) can do those things. But PIPPI is 100% right, in that I feel sure the public would not want RGNs to be 'just doing paperwork' - or, indeed, to 'not interact with patients'.

    There is quite a lot of debate to be had (although it largely has already been held) over this, but it simply doesn't make much sense if HCAs are to be hugely inferior to RGNs in terms of 'skill sets' - lower-skilled yes, but improving the capabilities of senior HCAs makes sense to me.

    There is also discussion/analysis to be had, over:

    'In addition, she said, for the role to be effective there was a “question mark about direct and indirect supervision”.'

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  • Thank you for explaining what a nurse does and incorporating into a new named role, thank you for also undermining any new nurses coming into the workforce, who have tirelessly studied 3 years for to be a nurse - an absolute privilege I must say. So what are nurses going to be- paper pushers. Please also look up the meaning of nurse. I disagree with this article wholeheartedly

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  • As a community AP I am confused about the new role and where I and my colleagues will fit in? Will we have to retrain or just move over into the new role? As an autonomous practitioner in the community I am unable to administer medication, the rest of the role outlined is what we already do which frees up the registered nurses to focus more on palliative care.

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  • The issue here is about deprofessionalising nursing so that eventually you can reduce or remove the registered nurse role. Has everyone forgotten the impact of skill mixing in the 1990s - obviously not. Registered nurses will be replaced by Nursing Associates and Associate Practitioners. I do not that the consultation is not actually about whether anyone supports the introduction of this new unnecessary role, it is about filling in recruitment gaps with cheaper labour - government will save money as they will not be paying these staff bursaries, student loans, and they will not be required to commission education from universities. Due to this government driven, ill advised and unnecessary intiative we will see the day very soon when shifts will only be required to have 1 registered nurse on duty and the rest will be non-registered. Nursing has just gone back over 100 years and has learnt absolutely nothing from all the nurse education reviews from the time of Florence Nightingale to now - unbelievable

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  • Look at what is already happening ! Unqualified care workers are trained to the specifics in order to work with a client in their own home - either with a care company or an agency. The NHS pays for the service. The care workers deal with meds, ventilators, tracheostomies, catheters etc. They are not regulated and have no registration. If they cause problems / harm then they leave that client and are, for the most part, moved on to a different client by their agency / care company. There is no protection for the clients / patients. Many of them work alone so it is a case of the client's word against their's when things go wrong.

    The things going wrong are endless and dangerous. Sleeping on a 1:1 waking night shift, whikst supposedly caring for a patient needing constant attention. Care companies / agencies sending out people they know are not sufficiently trained for the client / patient.

    Yes this new role should be regulated and have a registration system but this should also be extended to care workers.

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  • Nursing on the cheap.
    I imagine the only people who want nursing associates to "administer medication" are management types who want to cut back on band 5/6 staff so they can pay associates less.

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  • I am an assistant practitioner for a district nursing team. I welcome the role as it is the only way I can progress to become a nurse. I like many other mature competent and caring APs are unable to afford to complete my nurse training. I am in my second year of the foundation degree and enjoying it so much. I agree we and the nurse associate should be regulated for the patient safety and our protection. And I completely understand where everyone is coming from wondering what will it mean for already band 5 nurses. I do feel sorry for them and understand nurses must be anxious but this will help so many like me to become a band 5 and progress. I just hope some compromise can be met so everyone is happy.

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  • I have worked very hard to get to the band 4 role from band 2. At the moment all of the negative discussion regarding Aps and the nurse associate role makes me feel like Aps are not being taken seriously. I feel low and demoralised in my role. It should not be like this. Band 4s should be proud! I hate the term un trained like I'm in competent and stupid. I am highly trained in what I do just maby not as trained as a band 5. Everyone is asking nurses what they think but there is no support and interest asking young Aps what they want and think about all this change. Who at the end of the day are the future and new generation of nursing.

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  • Emma what is the point of you doing the AP course and possibly the nurse associate course if you want to be a RN? You would most likely have to study nursing just like everybody does now if you want to be registered and if they do fill wards with nurse associates then they will train less and less RNs making it almost pointless to become a nurse. I agree with Stone that there should be progression for HCAs, they work too hard for such little pay - but it shouldnt come at the cost of undermining nurses because thats what it feels like.

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