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'Patients need properly trained nursing staff'


Ever since we broke the story on the nursing associate role, people have asked what Nursing Times’ position is on the issue.

Let me clarify where we stand on the issue. This role should not be used to substitute registered nurses. All the evidence suggests that registered nurses improve patient outcomes, safety and experience. – But if the role is a substitute for anything it must be for untrained healthcare assistants.

And I disagree that nursing associates will be better than registered nurses because they care more than graduate nurses who are “too clever to care”. I loathe the argument that compassion and competence are mutually exclusive. They aren’t.

I went to a great event organised by recruitment consultancy Liquid Personnel last week, where those in charge of hiring health professionals, including nurses, for care homes, hospices and other organisations, discussed manifold challenges in this sector.

One person contended that nurses are arguably less academically trained than chartered accountants and yet accountancy hires huge numbers of non-graduate apprentices.

A registered nurse pointed out that apprentice accountants can’t kill you if they get their numbers wrong, but nursing associates doing drug calculations could. She argued that education and training for all involved in nursing is essential for safety.

I am for the new role if it leads to more and better training of healthcare assistants, and sees them acquire new skills that will help both patients and stressed-out, overworked registered nurses – and gives them some career development into the bargain.

If the government’s plan is to introduce nursing associates to get rid of registered nurses and make care provision cheaper, ministers are in for a shock and more scandals like Mid Staffs.

Nursing associates will need proper training and supervision to ensure they have the right skills – and that will cost money. There is no avoiding an investment in those providing care.

Patients need well-trained nursing staff. It is vital that those taking on the new nursing associate role not only know how to provide safe patient care but also when to ask for support from registered nurses. If the government doesn’t plan on providing appropriate training for them, nursing associates won’t be clever enough to care. And that’s far more worrying.




Readers' comments (7)

  • dtbarron

    I wish I believed the underpinning hope and belief in your article - that this would lead to better trained HCAs - but it won't - it will lead to a diminution of the registered nurse numbers across clinical areas.

    To do what you hope for does not require any new role, it simply requires investment in our current workforce, so let's ask why that isn't happening?

    Today in NHS Ayrshire & Arran I got an email which is offering five NAs to undertake their RN training. The ward they come from will need to release them for 600hrs per year - the NA will continue to earn their current salary - the ward will get £10k to backfill them.

    The OU is the HEI involved and funding comes from the Scottish Government.

    It seems to me that we will have achieved everything the HEE/DoH are proposing (apprenticeship) without the need to invent a new role with no competency framework, no standards and no regulatory framework.

    In terms of full disclosure this is five for the whole of the Health Board, so it's still challenging for us - however it is a massively positive step without undermining the registered nurses role or numbers.


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  • What's the difference between an NA and AP?

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  • michael stone

    The consultation currently open asks what the 'label' should be for these 'nursing assistants'. There will also, I think, be 3 'grades' of what are currently termed HCAs if you include NAs.

    I will be suggesting to the consultation, that the current HCAs should all be called ''Descriptor' Care Worker - so HCAs would be 'Basic Care Worker', 'Intermediate [or perhaps Standard] Care Worker' and 'Senior Care Worker' (Senior Care Worker being the title for the 'nursing associate' role).

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  • michael stone

    For ANONYMOUS6 FEBRUARY, 2016 8:48 AM

    What's the difference between an NA and AP?

    You can download a 'future of community nursing' PDF from:

    A 'nursing associate' will be the most-qualified type of Health Care Assistant, and will for practical purposes 'sit immediately below the lowest 'tier' of registered nurse'.

    An Advanced Practitioner is the highest 'tier' of nursing (unless you include Nurse Consultant, which seems to be higher still).

    There is a list of roles/titles on page 28 which goes:

    1 Pre-employment
    2 Health Care Assistant
    3 Health Care Assistant
    4 Assistant Practitioner (called Nursing Associate in the NT piece)
    5 Community Staff Nurse
    6 District Nurse/Team Leader
    7 Senior District Nurse/Team Leader
    8 Advanced Community Nurse Practitioner

    No 4 in that list - this 'nursing associate' role - will require qualifications at about foundation degree level.

    Hope that helps - not sure if it will (and they keep changing the names !).

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  • michael stone

    I've just tried the link I posted - it doesn't seem to work.

    You will find the document if you do a Google search for its title:

    District Nursing and General Practice Nursing Service: Education and Career Framework October 2015

    I just pasted that into here, then into a browser window which did load the PDF.

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  • michael stone

    I've just discovered - initially causing me confusion - that there are several different 'versions' of that 'community nursing' document, although the theme is a constant (it isn't clear that the differences are 'update' - it seems to be several versions, released at the same time). Confusing to a simple chap like me !

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  • I am a trainee Assistant Practitioner and have 30 years experience working with the elderly. HCA's are the backbone of the NHS and without them, Nurses Cannot do their job efficiently.. ask any of them! We need many different disciplines to care for patients. Instead of running down hCAS, APS and NA support them!! because without them we are stuffed!!
    NA's are different to AP's I am currently doing a foundation degree to become an AP (first year of nursing) I can then go on to do a further 2 years to become qualified...................embrace, encourage and enjoy

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