Nursing Associate

The Nursing Associate role will be a key part of a multi-disciplinary workforce needed to meet the needs of a changing population and set out in the 5YFV. Discussions across England have demonstrated widespread support for the introduction of this new role for health and care.

The necessity for the health and care workforce to focus on mainstreaming public health and prevention, self-care and long term condition management is without doubt. This sits alongside the requirement for a flexible workforce to develop advanced portable skills to match the ever increasing complexity of need and the pace of developments in treatment and interventions that help our patients, the public and the NHS to operate at the limits of science. The composition of the current workforce simply does not have the capacity to meet all of these needs.

Like all other services and industries, we need to build an adaptable contemporary responsive workforce. Like all public sector organisations we also have a duty to ensure that we also use resources wisely and in addition ensure that careers remain attractive and accessible.

The Nursing Associate role is part of the developing contemporary workforce and will work under the direction of a fully qualified Registered Nurse (RN). The Nursing Associate is not a registered nurse but will undertake some of the duties that a RN currently undertakes, and is expected to undertake to meet the challenges of the FYFV. The role of the Nursing Associate will enable the RN to spend more time on the assessment and care associated with both complex needs and the advances in treatments.

When undertaking a review of skill mix, consideration should be given to the role of the Nursing Associate within the multi-disciplinary team. The Nursing Associate will have the training and skills to bridge the gap between what a health care assistant can do and what a RN is now needed to do. The role is designed to enhance the quality of personalised care, strengthening the support available to nursing staff and reducing the reliance and dependency on RNs to do things that others can be trained to do.

The Nursing Associate role has additional benefits. Firstly, it widens the access to careers in nursing and potentially other health professions. It is our intention that prior learning and experience could be accredited, once the qualification, and any education and training standards, are finalised. This will involve working with education providers, employers and ultimately the regulator, to consider this as learning from the test sites starts to emerge next year. It is hoped that the education programme training will align to 50% of the learning outcomes and skill set continuum set for the graduate nurse.

Equally, for those who wish to remain as a Nursing Associate the recognised breadth of the training not only provides national recognition and meaningful career development but transferability of skills within different settings e.g. community and primary care, mental health and social care.

For employers and clinical leaders, this will afford a further option of how to safely align the right staff with the right skills to match need, dependency and the environment of care. Using the appropriate tools and frameworks that support decisions about safe staffing, employers will have options about how to manage resources appropriately in accordance with clear, professional and evidenced based guidance.

Our expectation, subject to further work on assessing the patient safety impact of the role, is that the Nursing Associate will be regulated.

Professor Jane Cummings, Chief Nursing Officer for England
Professor Lisa Bayliss-Pratt, Director of Nursing, Health Education England
Hilary Garratt, Director of Nursing, NHS England / Deputy CNO
Ruth May, Executive Director of NHS Improvement / Deputy CNO