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Vocational workforce expert defends nursing associates


The new nursing associate role is something to be “cheerful about” as it will provide both a route to become a higher-level support worker and also into nursing, according to a workforce policy expert.

Richard Griffin, a specialist on the UK’s unregistered health and social care workforce, has backed the creation of the new role, arguing that it should be viewed as an “opportunity”.

“I am not suggesting nurses should walk away from the bedside”

Richard Griffin

His comments follow the publication last week of the final version of the curriculum for the first tranche of nursing associate trainees by Health Education England.

It also follows growing concerns among academics and unions about the risk of skill mix dilution, if nurses were substituted for nursing associates, sparked in part by new study findings.

Mr Griffin’s defence of the role, which is still largely under development, come in a blog titled “in praise of the nursing associate role”, published on social media site LinkedIn.

He highlighted a recent King’s College London study showing that healthcare assistants were now a “key bedside presence” on adult wards with, on average, 60% of face-to-face care provided by them.

“The important part HCAs play in the nursing team is something I frequently observe in my dealings with the NHS personal and professional,” said the director of the Institute of Vocational Learning and Workforce Research at Buckinghamshire New University.

“Surely many of the new nursing associates will be drawn from those HCAs on wards or in care homes or GP surgeries who deliver that 60% of care, who are at the bedside allowing registered nurses to get on with the higher level tasks they have been trained for,” he said.

“Just to be clear, I am not suggesting nurses should walk away from the bedside, but this is about creating opportunities, recognising that important contribution, building the team and delivering safe and effective care,” he said.

“There are other reasons to be cheerful about the nursing associate role”

Richard Griffin

Mr Griffin, a former associate director at the Department of Health who also has a part-time project role with HEE North West London, questioned the “more extreme” criticisms made on social media that the new role “would signal the end of nursing and perhaps the NHS as we know it”.

“Nursing associates will need to complete two years of formal education delivered by a university at level 5 – that is equivalent to finishing half an undergraduate degree,” he said. “They will not be substituting the role of band 5 nurses but complementing them.”

He argued that many members of the HCA workforce would “make fantastic registered nurses but struggle to enter degree programmes”.

Mr Griffin cited a range of current barriers to HCAs entering the nursing profession, including a lack of role models and poor guidance, financial concerns and many universities not considering vocational qualifications as equivalent to A-Levels.

“Nursing associates will provide a route not only to become a higher-level support worker but also into nursing,” he said, adding that there were “other reasons to be cheerful” about the new role.

“One problem… with foundation degrees that support the development of assistant practitioner roles is that they vary so much institution by institution,” he said. “The nursing associate will be underpinned by a national curriculum, making the role standardised and transferable.”

Bucks New University

Vocational workforce expert defends nursing associates

Richard Griffin

He argued that nursing associates would not necessarily diminish the status of existing assistant practitioners, who he suggested “could become more distinctively specialist roles”.

In addition, Mr Griffin said more band 4 staff – the expected Agenda for Change banding for trained nursing associates – would help address the “shape of skills distribution” in the nursing workforce.

Its current shape was like an “hour glass”, rather than a “Christmas tree”, he said, due to the comparatively large sizes of the HCA and registered nurse workforce versus that of band 4s.

Mr Griffin said: “Support staff have crossed a lot of boundaries all of which have enhanced care. Yes, we need more registered nurses. Yes, we need to ensure all staff get appropriate training, but we also need the nursing associate.”


Readers' comments (6)

  • Big deal ! So one government-funded "expert" says we should be cheerful about the nursing associate role, whereas all the credible, good quality research evidence suggests we should be the opposite of cheerful. Who would you put your trust in, government funded spokespeople, or robust research? It is a lie to suggest that there is "widespread support" for this so called "new" role, as there hasn't been any representative national polling of the British nursing profession or care providers. Those government funded spokespeople, DoH representatives and the other HEE senior nurses who are all responsible for perpetrating this lie are guilty of committing a fatal disservice to the British nursing profession by pushing through this "new" role, when all the available research evidence shows how better patient outcomes are clearly associated with the numbers of registered nurses (RNs) in the worforce. The real reason for this situation is that the government (and near bankrupt NHS trusts) desperately want a cheaper nursing workforce, and the quickest way to get it is through establishing a workforce of 'nursing associates' (ancillary to RNs) that are cheaper to train and significantly cheaper to employ. NHS trusts and other care providers will then be able to reduce their RN workforce, whilst increasing the supervisory role of the remaining RNs who are already dangerously overburdened. As implied by the Nursing Times this week, diluting the RN expertise within the workforce in the short term can only lead to poorer patient outcomes, further national scandals and greater erosion of the terms and conditions of employment for RNs. This is a criminal act perpetrated by those employed by government, not a decision arrived by the nursing profession as a whole. It is also a wake up call for the profession which shows how badly the government regulates us, aided and abetted by those who really should know better.

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  • karen Webb

    Of course it is an opportunity. To de-professionalise nursing. To deconstruct it, to make it a series of tasks, divide them up and pay someone less to be "almost" a nurse.

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  • I couldn't agree more with the above comments,

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  • peter rolland

    There are indeed many potential benefits to the proposed 'nursing associate' role as espoused by Richard. However, the key sentence in the final paragraph is the telling one; "Yes we need more Registered Nurses ... but we also need the nursing associate". Surely the funding pot is the same one; we cannot have more Registered Nurses and also have the nursing associate, it is one or the other. Unless I have misunderstood!

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  • Well said Kevin. Nursing is being destroyed.

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  • Nurses on the wards who trained before project 2000 and haven't 'topped up' to a degree are working with a level 4 diploma....nursing associates will have a level 5 diploma! But hey I'm sure that's irrelevant right?!

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