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'Time for some honesty on the nursing associate role'


In its Council meeting tomorrow the Nursing and Midwifery Council will debate whether it will accept the invitation to regulate the new nursing associate role.

It’s a pretty important day. Although most people think it’s a done deal, it will be the first time for many of us to hear the views of the Council members, and understand just why this role should – or should not – be overseen by the regulator, which has previously just been responsible for keeping the register of nurses and midwives.

Whatever happens tomorrow, it is a pretty historic day for the profession. Its regulator is almost certainly about to formally introduce a new member to the nursing family, and must work out new rules for its accountability and responsibility in practice. This new role could change the type of care offered by nurses, their scope of practice and the relationship they have with other professionals and patients or service users.

“The change has been stimulated by a dire shortage of nurses”

Of course the change has been stimulated by a dire shortage of nurses. It isn’t better for patients or even better for nurses – this role is inspired by a need for people to provide care, and as traditional routes have failed, something different has to be tried.

“We are where we are” has pretty much become the mantra of the profession. The government cut back on training places, and restricted salaries and cut benefits so that many of the nurses who secured training places decided not to stay in the profession.

“The nursing associate seems to be the only solution on the table”

So now we’ve got this problem we might as well fix it. And the nursing associate seems to be the only solution on the table. But if we are going to have this role, then it’s vital to ensure the public is protected. Introducing the role, formalising what it will do, and then regulating it to ensure standards of good practice are set and poor practitioners are rooted out is the only way to protect the public if this role is implemented.

And while there have been many negative comments about the new role’s effect on patient care, there are some positives about its introduction. It will offer a route into nursing for those who lack the academic skills, or often simply the confidence in those skills, to cope with degree-level training; many of these will provide excellent patient care and may progress to become nurses. It will also mean another swathe of the workforce providing direct patient care will be regulated.

Ultimately, whether the role is a positive or negative development, in the light of the UK losing nurses from overseas and fewer students graduating into the profession, according to the chief nurses I have been speaking to there really doesn’t seem to be any other way to plug the workforce gap.

“It will be interesting to see how people react to the news”

My money, of course, is on the NMC accepting the invitation to regulate the nursing associate role. And it will be interesting to see how people react to the news. Chief nurses, I guess, will mainly be happy. Their academic colleagues not so much.

But whatever happens, all I ask for is a bit of honesty about why we need it and how we can ensure that it doesn’t risk patient care.


Readers' comments (12)

  • If nursing associate are as well trained and as reliable as the SENs then I am certainly happy to see them in that role.
    However the danger is that they are trained ad hoc to NVQ level 3 care home standard and considered to be nurses, taking the responsibility and registration. If this happens its anyone's guess as to haw many will be referred yearly.
    he NMC could well just be looking at income as government will not bail them out when they overspend

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  • It is a sad state of affairs that we do not have enough qualified nurses. There is too much pressure these days, looking after patients to the best of our ability is what we are trained to do and what nurses love about their job. However these days there is too much beauracy, the paperwork is endless, now revalidation, caseloads are far too high. It has become more than just a very stressful job. The sad thing is that there are so many nurses that would have carried on working but have taken early retirement or found alternative employment because they have had enough. Nurses at the moment are very demoralised and the only thing that keeps us going is the people we look after. So now they are having to fill the gap with associate practioners and should they do this then they should be well trained as previously mentioned as the SEN's.

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  • I have been following this story with great interest. I have worked as a health care support worker in both adult nursing and mental health for the past 23 years. I twice turned down the offer to do my nurse training as a secondment due to family commitments. I am now about to start my Nursing Associate training on the 30th January. The course is 2 years and is a level 5 foundation degree. My hope is that, if I successfully qualify at the end of the course, I can then progress on to become a staff nurse which is currently being banded around as possibly being a further 18 months training. The Nursing Associate training I am about to commence is a pilot scheme and whether it continues beyond the current intake appears dependant on whether the NMC agree today to take on the registration and regulation of the role.

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  • Why do we need to introduce another nursing role? In earlier years we had Enrolled nurse and Registered nurse. Are we going backwards and do the same thing again?
    By introducing any role in Nursing creactes a two tier system. Is this what we are looking for?

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  • Again the assistant practitioner/ associate nurse role has been left on the shelf 2 years of intense foundation degree and higher apprenticeship study whilst working in nursing full time.....for what?

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  • I have asked this question numerous times since our senior nurses began promoting the associate role so enthusiastically.

    "How is the role going to be accomodated on a busy ward that already has properly qualified RGN's and HCA support staff.

    Describe a scenario that can justify the role"

    Alternatively they could support the role of the RGN so much more, fight for the return of the bursary and get rid of the ridiculous current revalidation procedure.

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  • what happens to the assistant practioner(foundation degree) who studied in their own time? Why should dedicated student nurses suffer by training- when people can get paid and study for slightly longer and get the same qualification?

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  • Nursing Associates is a positive way forward considering the old SEN roles were abolished without alternative replacements; this inadvertently created more pressure upon RGNs. So this is a good and positive way forward.

    The new "Nursing Associate Role (NA)" contains 8 domains on the below link: Framework Nursing Associate.pdf

    HOWEVER, I have identified 2 problems already such as...... (a) there is no anatomy and physiology and clinical observations in-depth training that should be a fundamental core component in all 3 areas that the "NA" is expected to work in. Not all 3 areas of work placements will have the same job descriptions, so there should be structured core elements in this arena that is universal for every employer who employs an "NA"..

    (b) the 3 areas of work experience for "NA`s" fails to include "Domiciliary Care Agencies" or "Residential Care Homes" that is ultimately responsible for a lot of NHS Hospital admissions for patients over the age of 65 years, but the Government allege that they want to integrate the "Health & Social Care" that could potentially save millions but more importantly save lives that are unnecessarily admitted to Hospitals..............The introduction of "Nursing Associate (NA) role" & "Assistant Practitioner’s (AP) role" fails to improve areas of care within the social domain that proves to be the weakest link that creates horrendously high NHS expenditure due to delivery of poor care caused by lack of training in social care.

    My other concern is that the DoH (Jeremy Hunt) has appointed the "Nursing Midwifery Council (NMC)" to regulate The new "Nursing Associate Role (NA)" but NMC seem to overspend up to 75% of the registrants` income on FtP cases when this should only be 45%........ The NMC fails to acknowledge any whistleblowers irrespective of the Robert Francis Report (290 recommendations, 6 x C`s and the 20 principles)............. NO ONE can investigate the NMC if they are unfair, perverse, unfounded, bias or wrong...............

    (a) - PSA can only investigate the NMC if they are too lenient but cannot investigate if they are the opposite.......... In fact, the PSA informed me I was the only complainant but question this
    (b) - the Privy Council will not investigate the NMC regardless of individual or collective cases........
    (c) - the Department of Health allege it would not be appropriate for them to become involved in individual cases.
    (d) - The NMC can NOW serve a WARNING against a nurse or midwife without them having a right to a fair hearing under Article 6 ECHR and will publish this for 12 months - even though this breaches Article 6. .....ONLY 32 NMC REGISTRANTS` responded to the DoH consultation document..WHY?
    (e) - NO ONE HAS THE POWERS OR THE INTENT ON INVESTIGATING THE NMC...... Any complaints about the NMC must be raised to the NMC ........ BUT once one has exhausted NMC complaints route at stage 3, they can the refuse to ignore answering core components of registrants` complaints...........That is the end of the matter............ So we are advised by: (a) PSA....... (b) Privy Council..... (c) DoH complain to the perpetrator (NMC) to investigate themselves, who will always deny and refuse accountability.............. Many NMC registrants` have lost their livelihoods, careers, reputation, committed suicide, financial losses and friends BUT it seems to be accepted by the majority............

    HOWEVER, DoH are now appointing the NMC to regulate the new "Nursing Associate Role (NA)" which CONCERNS me A LOT .... what will it take for the average of 700,000 odd NMC registrants in the UK to react and protect their innocent colleagues who have been unfairly treated, especially after whistleblowing against their employers (equates to 45% of NMC referrals)...... NO wonder majority of Nursing Times responses are anonymous............. I understand this now

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  • Well the NMC will have another £4 million to squander as it likes now.

    It is so sad what is happening to nursing.

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  • So give a bad 3 a new name and we have an NA. This isn't tackling the problem. Yes it would get more 'qualified' staff on the floor but are they needed if the Goverment would tacle the issues outside of the hospital? They would be better to invest in care outside of hospital and perhaps enhance the role of care homes staff. Reduce bed blocking, faster admission/discharge flow, appropriate venue/staff in the ommunity. Wouldn't that leave RGN to care for the patients in hospital who need to be there with appropriate care for those patients in the community? Give an RGN, AN, HCA ... adecent wage and they might be willing to train and stay where needed !!!

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