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Willis says nursing associates must not be nurse substitutes


The peer who originally proposed the nursing associate role as a way to improve the career pathway for healthcare assistants has said his intention was never about substituting nurses.

Plans to create the new nursing associate role were confirmed by the government in December and it is currently the focus of a consultation exercise due to finish this Friday.

“You can’t just simply create a role and say it will produce better and safer care”

Lord Willis

The role, expected to be based at band 3 or 4 and sit between existing healthcare assistants and nurses, will be able to provide direct patient care under the supervision of registered staff.

However, concerns have been raised by some that the move to introduce nursing associates across the NHS will lead to a dilution of the existing graduate-based nursing workforce.

Lord Phil Wills, author of the Shape of Caring report, which last year recommended the role be created, said there needed to be a “clear understanding that this is a post to support the nursing workforce”.

Under his idea for the role, he said it should not be viewed as a replacement for nurses but as a “complimentary service to deliver the best workforce we can”.

He added that possible regulation by the Nursing and Midwifery Council would mean nursing associates would have clear standards “to assure that they are doing what they are supposed to be doing”.

“Saying it will automatically lead to substitute for nurses is making a huge leap2

Lisa Bayliss-Pratt

He suggested there was a “general acceptance” of a need for a bridging role that created a “career path for HCAs and a springboard for those that want to go into nursing”.

But he added: “You can’t just simply create a role and say by creating that role it will produce better and safer care. What you have to do is define what we are wanting from that role.”

The role formed part of “the most far reaching change in the way nursing and care workforce is educated and trained we have probably seen since the days of Florence Nightingale”, the Liberal Democrat peer told Nursing Times’ sister title Health Service Journal.

In response, Health Education England director of nursing Lisa Bayliss-Pratt agreed that the nursing associate role should not be used by NHS trusts as a substitute for registered nurses.

Reiterating a point made in a previous interview with Nursing Times, she said the new role would be in addition to existing nursing staff and would have consistent standards of education designed to increase patient safety.

She rejected claims that the role would increase risks to patients saying research evidence on this was not as clear as people believed.

She said: “Saying it will automatically lead to substitute for nurses is making a huge leap. Nobody wants patients to be less safe than they already are.

Health Education England

Senior HCA ‘bridging’ role will be piloted next year

Lisa Bayliss-Pratt

“Safety will be absolutely central to any role and the message from regulators will be loud and clear that this role must not diminish patient safety,” said Ms Bayliss-Pratt, whose organisation is running the consultation.

She added: “Assistant practitioners already exist in some places but it isn’t consistent and it doesn’t have national standards and there are questions about the career pathway.”


Readers' comments (3)

  • But they are going to be substitutes. No bursary and a hard 3 year course working full time for slave labour rates and a pittance at the end of it, who's daft enough for that!! Oh wait here's a cheap option let's make a cheap workforce and problem solved. They must think we are stupid.

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  • i have seen some of the training books for level 2 medication administration and I would be very worried as there is very little in-depth reference to contraindications and side effects. Training is at the heart of excellent health car so we ned to think on

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  • I'm in my final year of Nursing and have seen unbelievable changes since I started.This move to create a nursing associate role undermines the fundamental of what I've been studying for the last 3 years. I myself am disappointed that coming into a profession I love and am excited to be registered with soon, am faced with the fact that we will pushed further and further away from patient care and more into a paper pushing role/supervisory role.

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