Nursing Associates and Registered Nurses
Professor Lisa Bayliss-Pratt, Chief Nurse, HEE
Anne Trotter, Nursing & Midwifery Council
Overview
• Nursing associates and registered nurses: the
difference between the roles and the regulation
• How can NAs be used to best support the nursing
workforce
• Regulation and future nurse standards
Draft May 2016
• a new member of the nursing team providing care and
support for patients and service users.
• key part of developing the nursing workforce.
• addresses a skills gap between health and care
assistants and registered nurses.
• stand-alone role in its own right
• a progression route into graduate level nursing - a
pathway which previously healthcare assistants could not
access.
The role
Draft May 2016
• 2,000 in Waves 1 and 2, in
2017
• First cohort qualify in January
2019
• Retention rate 85%
• 5,000 to be recruited
in 2018
• 7,500 to be recruited
in 2019
The story so far
Draft May 2016
The story so far
• Clear evidence that trainee
Nursing Associates are
moving away from a task-
based role, towards more
patient- and outcomes-
focused role
• Placements are allowing
trainee Nursing Associates to
exchange skills and practice
with colleagues across
different settings.
• Reportedly leading to
immediate improvements in
the quality of care.
Draft May 2016
The story so far
• trainee Nursing Associates are
showing increased assertiveness
and self-belief when entering
placements, and are seeking out
learning opportunities.
• As they develop their skills and
knowledge they are
bringing additional capacity to the
settings or services they are
working in.
Feedback from independent evaluation
• Shift from a task-focused to a patient-focused role:
“Trainees are starting to move away from a focus on tasks, they
are looking at the competencies of care and not just tasks.”
Employer
• Exchanging skills and knowledge between settings:
"As I work in different settings I've been able to help to reduce the
stigma of mental health – as a Trainee Nursing Associate I can
share my skills, principles, values with the staff that I work with."
Trainee Nursing Associate
• Growing confidence and assertiveness about learning
needs
Evaluation of Introduction of Nursing Associates
Phase 1 report for Health Education England
July 2018
The consultation ran for 12 weeks from 9 April to 2 July
Regulation of nursing associatesThe consultation
Category Examples
1. Areas where we
proposed applying
the existing regulatory
approach for nurses
and midwives
• The Code (as amended)
• Standards of education and training
• Revalidation
• Registration, English language and fitness to
practise requirements
2. New nursing
associate specific
resources
• Standards of proficiency for nursing associates
(including the skills annexe)
• Nursing associate Programme Standards
Regulation of nursing associatesResponse overview
• 1,149 respondents accessed the consultation
• Most popular question received 732 responses
• Majority of responses received from individuals
• 93% of individual respondents resided in England
• 56% of responses from UK-registered nurses
• 24% of responses from nursing associate students
• 113 organisational responses
Standards framework for nursing and midwifery
• 91% agreement
Standards for student supervision and assessment
• 90% agreement
Other areas
• >90% agreement for the same English language and revalidation requirements
• 69% agreement in applying the same fitness to practiseapproach to nursing associates
Regulation of nursing associatesExisting approach
Set out what nursing associates need to know and be able to do at the point of registration
Aims:
• Appropriate level of skill and knowledge to support the registered nurse
• Appropriate skills annexes
• Generic in nature
• Demonstrates the “clear blue water” between the role of the registered nurse and nursing associate
• To facilitate educational transition from nursing associate to registered nurse for those able
Nursing associates and registered nursesPurpose of NA standards ofproficiency
Nursing associates
Six platforms
1. Be an accountable professional
2. Promoting health and preventing ill health
3. Provide and monitor care
4. Working in teams
5. Improving safety and quality of care
6. Contributing to integrated care
Nurses
Seven platforms
1. Be an accountable professional
2. Promoting health and preventing ill health
3. Assessing needs and planning care
4. Providing and evaluating care
5. Leading and managing nursing care and working in teams
6. Improving safety and quality of care
7. Coordinating care
Nursing associates and registered nursesNA vs RN standards of proficiency
Nursing associates and registered nursesDifferent expectation levels
• Research knowledge and application
• Critical thinking skills
• Decision making
• Bringing about behaviour change
• Referral
• Restricted aspects of medicines administration
• Leadership
• Management
• Supervision
• Risk Management
• Evaluation of nursing care
• Discharge
• Health legislation and policy
• Health economics
Regulation of nursing associatesNext steps
Apr – Jul ‘18 Formal consultation on standards (proficiency and
programme), and the Code begins (release 2)
Sept ‘18
Jan ‘19 First cohort of nursing associate students qualify
and apply for registration
Council asked to agree final nursing associate
standards (release 3)
Oct ‘18Publication of finalised standards of proficiency, programme standards and Code
Jul – Aug ‘18 Review and analysis of consultation responses.
Further engagement and refinement of standards
Oct ‘17Early version of nursing associate standards of
proficiency available for test sites (release 1)
Oct ‘17 – Mar ‘18 Open engagement on standards