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Assistant practitioners are being ‘overlooked and pushed to one side’

Some feel the introduction of nursing associates threatens their role

Some feel the introduction of nursing associates threatens their role


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Assistant practitioners are warning that some employers are looking to down-band or dissolve their role in favour of the new registered nursing associate role.

RCN health practitioner committee chair Lindsay Cardwell said she had been contacted by assistant practitioners in England who claim they have been downgraded or their jobs are under threat since the arrival of the new role.

‘Dissolved’ role

Ms Cardwell said there are around 5,000 assistant practitioners in England. They hold a foundation degree in health and social care, should be paid at band 4, and act as support staff to nursing and therapy teams in most areas of clinical practice.

‘One woman who works on a trauma ward and has been qualified for ten years contacted me because her employer said her role is being "dissolved" due to nursing associates,’ Ms Cardwell said.

‘I am also receiving emails from our assistant practitioner members who are experiencing problems with their bands... staff are being downgraded.’

Similar responsibilities

The first cohort of nursing associates qualified at the end of January after two years of training.

There is a tension between the two roles because they are so similar, Ms Cardwell said. ‘The two roles sit next to each in clinical settings, in pay banding, and with very little difference in remit, but assistant practitioners play a valued, highly skilled support role that "bridges the gap" in many different specialties.’ 

Only the nursing associate role must be registered with the Nursing and Midwifery Council, but the RCN is making a case for regulation of assistant practitioners. 

Government response

A Department of Health and Social Care spokesperson told Nursing Standard that the government had no plans for statutory regulation, stating that this was not always ‘the most proportionate or effective’ means of assuring the safe and effective care of patients. 

He added: ‘Assistant practitioners perform a highly valued role designed to improve patient care, and they remain a valuable part of a flexible workforce.

‘They contribute a range of skills as part of a multidisciplinary team, and are able to work across allied health professions as well as nursing. We expect them to continue to play an important role across the NHS.’

An assistant practitioner’s view

One healthcare support worker, who qualified as an assistant practitioner in 2016 and has a foundation degree, said there have never been any band 4 roles in clinical settings at her trust, despite the organisation funding training in this area. 

‘I have spoken to several other qualified assistant practitioners and we all feel the same, that we are being overlooked and pushed to one side in favour of nursing associates,’ she said.

Lack of clinical work

‘We were told while training that there would be at least one assistant practitioner working clinically on every ward in the hospital eventually. However, since qualifying, there have been no assistant practitioner ward-based jobs advertised.

‘I am concerned that we are not being employed at my trust as we thought we would be, and as we were trained to be – we feel that our two years at university have done nothing to help our careers. 

Devaluing roles 

‘Many qualified assistant practitioners who had their training paid for by the trust are still working as band 2 healthcare assistants (HCAs), or band 3 HCAs if they are lucky. This completely devalues our qualification and does nothing to engender trust in our employers.’



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