Nursing associates will administer controlled medicines

Nursing associates will be able to administer controlled medicines and carry out invasive procedures, government documents suggest.

A total of 2,000 nursing associate roles will be created across England, with the first 1,000 due to start training at 11 test sites from December.

The role is intended to bridge the gap between healthcare assistants and qualified nurses. 

‘Huge interest’

Health Education England (HEE), which is overseeing training, has said there has been ‘huge interest’ in the role from hospitals and other parts of the NHS.

But Unison has warned the new role should not be used ‘as a cheap way to replace registered nurses’.

Government officials have said nursing associates will work under the direction of a registered nurse. The role is also being billed as an opportunity for healthcare assistants to progress into nursing roles.

No direct supervision

New HEE documents seen by the Health Service Journal (HSJ) say that after 2 years of training, the ‘trainee nursing associate will be able to deliver planned nursing interventions... in a range of health and/or care settings under the direction of a registered nurse without direct supervision, delivering care at times independently in line with an agreed/defined plan of care’.

The documents add that they will be able to assess, plan, deliver and evaluate care, as well as recognise deteriorating patients.

Nursing associates will ‘correctly and safely undertake medicine calculations; administer medicines safely and in a timely manner, including controlled drugs’. This will only happen where deemed appropriate and set out in organisational medicine management policies.

Nursing associates will also be expected to correctly and safely receive, store and dispose of medications, the HSJ reported.

Unfair burden

RCN general secretary Janet Davies said expecting unregistered staff to perform tasks previously carried out by registered graduate nurses risked placing an unfair burden on them, and could reduce patient confidence in the health service. 

She added: ‘The nursing associate role must not be a substitute for registered nurses, who are required to make clinical judgements using a high level of experience and knowledge to assess complex situations. 

‘Safe administration of medicines is a key patient safety issue. Drug administration is not a mechanistic task – it requires professional judgement, and if ongoing assessment of a patient is required it should be the responsibility of a registered nurse.’

Curriculum framework

HEE director of nursing Lisa Bayliss-Pratt said the curriculum framework for the nursing associate role was a guide for education providers to ensure they provide what the NHS needs.

She added: ‘We have developed this framework as a result of wide consultation across the health and education systems, listening and responding to their needs to ensure this role plays a central part in a multidisciplinary team that focuses on quality of care.

‘HEE’s response to the consultation makes clear that this new role will support registered nurses, and employers are expecting to deploy them as such.’

Dr Bayliss-Pratt added that there was strong support for regulation of nursing associates in a consultation earlier this year, and HEE is expecting a decision on the position from the Department of Health shortly.