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Lamb backs nursing assistant role 'akin' to state enrolled nurse


The re-introduction of a role similar to state enrolled nurses could help provide a career path into registered nursing for healthcare assistants, according to care minister Norman Lamb.

Mr Lamb said he was “very attracted” to bringing back a nursing role “akin” to the SEN, which would make it easier for care workers to move onto graduate nurse training.

Speaking at a symposium on residential care earlier this week, the minister pointed to the gap in career progression for HCAs once they had achieved the new care certificate of fundamental skills, which is due to be rolled out next month.

“Should we be thinking about something intermediate between the care certificate and a fully qualified graduate nurse,” he asked the audience.

“I was talking to Peter Carter last week, the head of the Royal College of Nursing, and it is his view – and I am very attracted by it – that we should re-introduce something akin to the SEN, the state enrolled nurse,” he said.

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Mr Lamb, who is Liberal Democrat MP for North Norfolk, added: “I look in my own county and there are vast numbers of vacancies for nursing positions in the care sector.

“And yet we could create something that is easier for people to progress onto – perhaps in time to progress in turn to become a graduate nurse. But surely something in between is worth thinking about,” he said.

“There are vast numbers of vacancies for nursing positions in the care sector”

Norman Lamb

His suggestion was met with a round of applause from the audience of health and social care academics, policy experts and workers.

His comments follow renewed focus on the SEN role, after the UK Independence Party said last month that it would reintroduce it in order to encourage more “home grown talent” in nursing, as part of a package of election pledges for the NHS.

SENs were introduced in the 1940s but phased out during the 1990s after the restructuring of nurse education under Project 2000.

An RCN spokesman confirmed to Nursing Times that it was not calling for the reinstatement of the actual SEN title, but that it did want to see improvements in career development for HCAs and better access to nursing.

A Department of Health spokesman said Mr Lamb had been speaking in a personal capacity and it currently had no plans to reintroduce SENs.

Likewise, the Shape of Caring Review, which is due to publish its recommendations next week on the future of nursing education and training, is not expected to call for the return of SENs.

However, it is expected to call for measures to boost the career development of HCAs.


Readers' comments (42)

  • There are vast vacancies because salaries are crap-

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  • I agree bringing an Enrolled type of nurse would be advantageous. To provide care does not require a degree, I'm sure if you asked patients they would rather nursing institutions recruited people that genuinely wanted to care for patients, not chase a degree to end up as a Specialist nurse being far removed from care.
    Offering the degree course only prevents people that truely care from applying into nursing as a degree course does not suit all, but these are the people that would make excellent nurses. i have first hand experince as the owner Manager of a children's nursing home, I have some excellent carers that would make excellent Enrolled nurses.

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  • think you will find the salaries are actually pretty good when you look at what else is out there - think we sometimes forget that however, they will soon be worse with pensions/pay freeze etc....

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  • Go back a step - can someone explain why we had to go graduate only. I was lucky enough to be able to fund my degree but other students, who are excellent nurses and just as capable, could not afford to study without the allocated bursary.

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  • I have been a first level registered nurse since 1986 and the removal/phasing out of SEN's was lamented by the majority of my peers. But did the politicians and the pompous nurse leaders listen? Of course not. Then we had P2000 qualified nurses on the wards who didn't know how to take blood pressure readings and were not willing to get the excrement of others un der their fingernails. Why is it that no one listens to those who know? Probably because listening to people who know is not something that can be put on a CV to further ones own career, irrespective of any casualties or collateral damage along the way. Isn't Lamb the one who said that allowing people to keep personal possessions when they move into a care home would preserve their dignity? What an absolute jest!

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  • I've known this for years. Perhaps I should be a Minister too?

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  • Why can't someone just stand up and admit the following;
    1. Should never had got rid of enrolled nurses in the first place.
    2. Return nurse training to hospital based training with input from universities.
    3. Please call a spade a spade, and not say ‘bringing back a nursing role “akin” to the SEN’, but reintroduce the enrolled nurse training. They could then register with the NMC and be accountable and responsible for the care they give in their own right.

    Those I come across give 1st rate care and would rather have 1 EN looking after me that 10 RN’s

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  • Hear hear to all above comments! I trained as an SRN in the 60s, before it was a degree course. I spent eight months out of my three-year training in study blocks but the rest of it working in the wards, where I learned as much from the fantastic SENs as I did from anyone else.

    I left the UK in '75 and couldn't believe my ears when former colleagues told me the SEN qualification had been abolished. I saw the results at first-hand 10 years ago, during the three terrible months my mother spent in various hospitals at the end of her life. Some of the health-care assistants admitted to me they'd never had a day's training and had literally come into an acute hospital environment from the pavement!

    The NHS needs to get over the idea that it's "the envy of the world", an attitude which fosters complacency of this kind. I'm sure it is the envy of the Third World, but here in continental Europe it's a laughing-stock. In my adopted country, health-care assistants - even those in old people's homes - have to have an educational level mid-way between the UK's GCSEs and A-levels, then do an 18-month college course, around half of which is spent in serious work experience.

    The NHS was never broke till someone started trying to "fix" it. Let's hope it's not too late to turn back the clock.

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  • I trained as an enrolled nurse in 1977 and qualified in 79 I worked as one for 5 years before moving on to RSCN training. It was the mood at that time to phase out Enrolled Nurses and most of my friends felt compelled to retrain, I dont regret it, but I do feel that we have lost that good bedside nurse who knew what she was doing, and the paperwork was left to the ward sister and staff nurses. We have in the social care sector Senior's who have had additonal training, but I do see some shortfalls in this area also as I visit care homes on a regular basis, it is all depenedent on the training, bring it back to a more formal structure and registration with the NMC the same way care staff in the social sector in scotland have to register with the SSSC

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  • perhaps a role similar to that of the Licences Practical Nurse (LPN) that supports RNs in Canada?

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