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Exclusive: New band 4 ‘associate nurse’ role set to be created


Government plans to introduce a new nursing role designed to bridge the gap between registered nurses and senior healthcare assistants are to be launched in the coming weeks, Nursing Times has learnt.

An announcement on the creation of the new role is expected to be followed by a consultation shortly afterwards.

Nursing Times understands the role will be assigned to band 4 and is expected to be given the title “associate nurse”.

“There is a shortfall of nurses on the ground, and we can’t continue working the way we are”

Eileen Sills

However, question marks are thought to remain on whether those employed in the new post will be regulated by the Nursing and Midwifery Council.

There has been increasing support among directors of nursing for the role’s introduction in recent months, but the Royal College of Nursing warned the move could mark a “retrograde” step.

First recommended in a major review of education and training standards for nurses in England earlier this year, the role is already due to be piloted at 30 sites next year, as revealed by Nursing Times last month.

However, it is understood that plans to introduce the role will now go ahead before the pilots begin. National training and workforce planning body Health Education England is working on the plans alongside the Department of Health to develop a role that “gives patients the best possible safe and effective care”.

HEE has previously said it was looking into how to make it easier for people with care experience to complete a fast-track nurse degree.

Dame Eileen Sills, chief nurse at Guys’ and St Thomas’ Foundation Trust, told Nursing Times she wanted to see the introduction of a regulated associate nurse.

“It’s like we fall into the same trap we have done before, after fighting so hard for a graduate profession”

Janet Davies

She said she would want those in the role to be able administer medicines under the supervision of registered nurses. The position would require a “clear title and boundaries” as any member of the care team does, said Ms Sills.

“There is a shortfall of nurses on the ground, and we can’t continue working the way we are. Whatever happens with students, we have three years to wait so we have to do something different to protect the patient,” Ms Sills told Nursing Times.

She added: “I have no problem supporting the associate nurse role. It needs to be regulated and the scope of practice must be broad enough to add value to the nursing team.”

There was also support for the introduction of the role among other trust chief nurses at Nursing Times’ Directors’ Congress last month.

Janice Stevens, interim chief nurse at Barts Health Trust in London, said “something different” was required to tackle workforce vacancies, claiming the new role would not “dumb down” the profession.

“It is about recognising care is complex and spans lots of needs… We’ve got to get off our professional high horse for the sake of quality,” she said. Ruth May, nurse director at regulator Monitor, also voiced her support for the role and that it should be regulated.

“We’ve got to get off our professional high horse for the sake of quality”

Janice Stevens

However, the RCN’s chief executive and general secretary Janet Davies told Nursing Times that the introduction of such a role would be a “retrograde step”.

She said the profession risked recreating a “second level nurse” – also known as state enrolled nurses that were phased out during the 1990s, who required less training than nurses.

“We are moving towards a second level nurse and we know the outcomes. It’s like we fall into the same trap we have done before, after fighting so hard for a graduate profession,” she said.

“I understand – and have every sympathy with – directors of nursing who want this role. But it is a short-term solution to a problem created by the cutting of posts and [training] places,” she said.

Ms Davies noted it was important for HCAs to be able to advance in practice, but any creation of a senior assistant care worker should be “supplementary [to] and not a substitute” for nurses.

A spokeswoman for HEE said it was looking at a new role as a way of “building capacity to care” and “capability to treat” and said it would be a “new team member for health and social care”.

“A key part of this work is to continue engaging with our stakeholders and listening to their views on how best take this work forward to ensure we have the right people with the right values, skills and behaviours in this profession,” she said.

A Department of Health spokeswoman told Nursing Times it was working with HEE on plans for the new role. She said a joint decision on a public consultation would be made once this work was completed.




Readers' comments (43)

  • I think it might be better giving all HCAs better training so that they can be a better support for us register nurses. In Sweden there are no HCA's working in hospital who haven't got 1 or 2 years care training and you can really feel the difference when you are working. They can do the wound dressings and bloods, things that take a long time. But they do get paid quite a lot and the gap in pay between nurses and HCAs is not very big there.

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  • I did my S.E.N. training in 1964 and still enjoy working for our committed under funded NHS. I dont believe that patients are interested at all in what level or grade of nurse is dealing with their care as long as they are caring passionate and committed too delivering the highest standards of care possible. My experience has shown me that in some cases our Registered Nurses could learn alot about compassion and dedication to patient care by observing alot of our HCAs and so called untrained nurses who all to often demonstrate a true Vocation in caring for others. I totally support training many more "Hands on Nurses"

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  • I am a Band 4 Assistant Practitioner. I'm very confused as to what the difference in my role and an Associate Nurse will be. Can anyone answer this???

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