New nursing associates must be regulated, health education body told

A consensus that nursing associates should be regulated has emerged from the recent consultation on the new role, the nurse director of Health Education England (HEE) has revealed.

Lisa Bayliss-Pratt indicated that she would support such arrangements during a question and answer session at the sixth International Nurse Education Conference.

‘The feedback from our consultation is telling us that most people think this role must be regulated,’ she said. ‘Hopefully we shall get to that place.’

Professor Bayliss-Pratt, addressing a packed session at the conference in Brisbane, Australia, pointed out that the Shape of Caring review led by Lord Willis in 2014/15 had identified a gap between registered nursing staff with degrees and support staff.

The nursing associate role was designed to act as a bridge between the two.

‘If we don’t upskill our support workforce – the team that works with the graduates – then it is difficult for the graduates to lead, manage and think critically because they keep getting dragged down doing fundamental care,’ she said.

Professor Bayliss-Pratt acknowledged that the move to create nursing associates was ‘quite controversial’ and admitted that some of the responses to the consultation had surprised her.

‘One of the questions was what kind of activities, and what knowledge and skills, these people need to do or have. When I looked at the list, I thought “crikey, that’s what I was doing as a nurse”.’

She shared the platform with Anne Marie Rafferty, professor of nursing and dean of the Florence Nightingale school of nursing in London, who declared her opposition to the introduction of nursing associates.

Comparing the role to that of enrolled nurses, Professor Rafferty said: ‘The folklore is that they were used and abused. People were locked into career cul-de-sacs with nowhere to go. 

‘My fear is that, given where we are with the economy, which is not going to fast-forward out of austerity, this will become a default, preferred grade for the registered nurse. It’s great to think that there will be a kind of “golden ladder” and that it will be an uplifting story of social mobility for the profession, but that is a feat of engineering that we have never been able to accomplish.’

Professor Bayliss-Pratt said she was aware that a shortage of resources and pressures on health services mean everyone is seeking quick fixes, but added: ‘I am an optimist. It’s my job to make sure that the “golden ladder” is in place for people because HEE is responsible for the education and training of the workforce.’

Professor Rafferty replied: ‘We have had many policy recommendations that say we should work with what we have got and do it better. Rather than introducing yet another grade of worker, let’s supercharge the healthcare support workers, let’s regulate them, give them a proper 18-month certificate so that they can move up the ladder and progress.

‘We are making it unnecessarily complicated and I am not an advocate of the associate nurse role for that reason.’