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”
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.
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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”
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.”
Vocational workforce expert defends nursing associates
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.”