Support staff doing tasks of nurses puts care at risk – report
RCN Wales says assistant practitioners, nursing associates or healthcare support workers should never be pressured to work beyond their competencies or scope of practice
Using support staff for tasks usually done by a registered nurse is a ‘very real risk’ and could cause harm to patients, nursing leaders have warned.
A new report by RCN Wales, Progress and Challenge in Delivering Safe and Effective Care 2023, highlights the significant risks associated with role substitution, where assistant practitioners, nursing associates or healthcare support workers are used in situations requiring a registered nurse by employers struggling to fill workforce gaps.
Support workers are ‘both invaluable and different to that of a registered nurse’
The report, which is published annually, investigates how the Welsh Government is implementing the Nurse Staffing Levels (Wales) Act 2016. The legislation places a legal duty on NHS health boards in the country to calculate for and provide adequate nursing staff for safe and sensitive care on certain wards, including adult medical, surgical and children’s wards.
This year’s report makes it clear that support workers are a vital part of the nursing workforce and their contribution is ‘both invaluable and different to that of a registered nurse’. The right skill mix of staff is needed to ensure an effective team, it adds.
Support staff ‘should never be pressured to work beyond their competencies’
‘It is important that support staff have the clinical supervision and direction of a registered nurse,’ the report states. ‘They should never be pressured to work beyond their competencies or scope of practice, nor should they be used to substitute registered nurses or fill registered nurse vacancies.
‘Developing new roles such as assistant practitioners and nursing associates should not be taken lightly. Their purpose should be clearly defined before introduction. The risk of patients receiving substandard care – resulting in direct or indirect harm – is significant.’
- RELATED: Substituting nurses with nursing assistants linked to higher patient death risk, study warns
Include more nursing specialties in staffing law, says RCN
The report also calls on the Welsh Government to widen the law to include mental health, district nursing and health visiting services.
In October, RCN Wales director Helen Whyley told the Welsh parliament’s cross-party health and social care committee that while the legislation had improved staffing transparency, nurses’ well-being at work and patient outcomes, plans to extend it had stalled.
Large number of nurse vacancies in Wales
In addition, the report warns of ‘critical challenges’ faced by the nursing workforce in Wales, highlighting that while the nursing and midwifery workforce grew 7% between March 2017 and March 2022, the rise was ‘relatively small’ compared with other professional groups in the NHS.
RCN Wales estimates there were 2,717 registered nurse vacancies in the NHS in Wales in 2022. Official figures show there were 2,667 vacant nursing, midwifery and health visiting posts at the end of June 2023.
The Welsh Government has been contacted for comment.
Read the RCN Wales report
Progress and Challenge in Delivering Safe and Effective Care 2023
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