A group of nurse leaders have expressed concerns over the government’s planned introduction of the new nursing associate role, claiming the proposals “fail to recognise the functions and value of registered nurses”.
They also suggested the creation of the new role – aimed at senior healthcare support workers to bridge the gap to degree-level nurses – could lead to an increase in avoidable patient deaths.
The plans to bring in the role were revealed by Nursing Times in November and confirmed by the government last month.
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The new nursing associates will deliver hands-on care and will allow registered nurses to spend increasing time on their clinical duties, according to a statement from the Department of Health, which announced the move just before Christmas.
But in a letter signed by nurse academics, patient representatives and former NHS directors of nursing, warned against substituting registered nurses with the new role and said that it was wrong to suggest basic aspects of care did not require expertise and experience.
They noted that being with the patient and providing direct care gave registered nurses the opportunity to assess and monitor patients. They added that other staff should help nurses with technical tasks, rather than be delegated to.
“The complexity of patients’ care needs means that an apparently simple task, such as washing a patient, requires skill and knowledge for it to be done effectively,” said the nurse leaders in a letter published in The Times newspaper.
“For nurses to make informed decisions about treatment, and carry out their full range of activities, they must be there with their patients observing, monitoring and equally important, doing – not relying on reports from staff without the knowledge to think critically,” they added.
“Increasing the number of lower-skilled staff could increase the number of unnecessary deaths”
Letter signed by nurse leaders
The letter was signed by nurse leaders including Alison Leary, professor of healthcare and workforce modelling at London South Bank University, Trish Morris-Thompson, director of quality and clinical governance at private care home provider Barchester Healthcare, and Helen Thomson, former director of nursing at Calderdale and Huddersfield Foundation Trust.
They claimed the plans ignored research that showed patients achieve better outcomes and lower mortality rates when cared for by registered nurses.
“Every 10% increase in degree-educated nurses is associated with a 7% lower mortality rate after common surgery. Hence, increasing the number of lower-skilled staff could increase the number of unnecessary deaths,” they said.
In response, a Department of Health spokesman said: “The Royal College of Nursing, the Nursing and Midwifery Council and the chief nursing officer for England all support our proposals to introduce a new nursing associate role.
“We have been clear in our announcement that we will maintain nurse training places as the scheme goes forward – 23,000 more nurses should be available by the end of this parliament,” he added.