Why the nursing associate programme should be field specific

Nursing children and young people requires specific skills that nursing associates undertaking a generic training programme may not acquire.

Nursing children and young people requires specific skills that nursing associates undertaking a generic training programme may not acquire.

Picture: John Houlihan


The role of the nursing associate was developed from recommendations in Health Education England’s (HEE) 2015 review Raising the Bar Shape of Caring, which recognises the vital work done by healthcare support workers in bedside care delivery despite their limited training.

The nursing associate role was developed to bridge the gap between those of unregulated healthcare support workers and registered nurses (RNs), while providing an alternative entry to nursing.

Nursing associates are expected to add to the nursing workforce, not to replace RNs, with the added assurance of regulation by the NMC.

As far back as the Platt report, in 1959, it has been recommended that sick children are cared for by nurses with the specific knowledge and skills. Project 2000 led to the development of a new register that included children’s nursing as a separate entry and allowed the pre-registration education of children’s nurses.

As a result, nursing students enter the register as RN children’s nurses after spending half of a three-year undergraduate degree programme on clinical placements in child health and half at university.

Work-based learning

In comparison, the first cohort of trainee nursing associates study on a generic programme comprising 20% academic and 80% work-based learning.

At some pilot sites, some trainee nursing associates spend this work-based learning in specific fields of practice, such as adult, mental health or children and young people.

The NMC’s working draft standards of proficiency for nursing associates state that nursing associates are responsible and accountable for their actions, with RNs being accountable for delegation of tasks.

It is important to acknowledge the differences in managing the care of children and adults. If care is to be underpinned by best practice, generic knowledge may not be enough in children’s nursing, and this is why registered children’s nurses are generally opposed to generic education.

In the changing landscape of nurse education, the future status of children’s nursing as a field of practice remains paramount. As RNs are moved away from the bedside, those delivering care must have the necessary skills and underpinning knowledge base to do so.

Evidence-based knowledge

Children’s nurses can lead the way in the development of the nursing associate role by ensuring trainee nursing associates can provide safe, effective care, underpinned by evidence-based knowledge in response to the needs of children, young people and their families.

Despite the release of the NMC’s working draft standards for proficiency, there are outstanding items to be decided, such as the role of the nursing associate in administration.

It is therefore understandable that there will be a national evaluation of the first cohort undertaking the programme. However, greater assessment is needed into the implementation of the role into specific fields of practice, such as children and young people’s nursing.

This evaluation should be a continuous process to ensure the role is fit for purpose and provides a clear pathway to RN children’s nursing for those who make progress.

About the author


Louise Bowden is a teaching and learning intern (children and young people’s nursing), University of Salford

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