Union issues warning as first nursing associates join the NMC register

The RCN has warned that nursing associates should not be used as a replacement for registered nurses.

Ian Snug
28 January 2019
nurse working at desk

Newly-qualified nursing associates will be able to join the Nursing and Midwifery Council register from today.

In a ‘landmark’ move, nursing associates will become the latest addition to the health and care workforce in England today. The register is now open to the new profession, with around 1,800 nursing associates are expected to qualify over the course of the next few months.


The new role was developed by Health Education England (HEE) and has been designed to bridge the gap between health and care assistants and registered nurses.

The Nursing and Midwifery Council (NMC) claims the role is an attractive option to those who may have been working as healthcare assistants for a number of years and who want to progress. As well as being a new standalone role, it also offers an alternative route to becoming a registered nurse through further training.

Despite saying it welcomes the new role, the Royal College of Nursing (RCN) the college has warned that nursing associates should not be used as a replacement for registered nurses and should only deliver care that has been ‘prescribed and evaluated by a registered nurse’.

Not a replacement.

In a statement, Patricia Marquis, England Director at the Royal College of Nursing, said: “Nursing associates are a new addition to the clinical workforce in England, supporting registered nurses to provide safe and effective care. The role offers career progression for support staff as well as providing a new route to become a registered nurse.


“This is a valuable support role designed to work as part of the wider clinical team, however it is not a replacement for a registered nurse. Nursing associates will deliver and monitor care which has been prescribed and evaluated by a registered nurse.”

“With England facing a clear shortage of registered nurses, it is vital that employers do not attempt to fill any gaps with nursing associates. Nursing associates should never be asked to act outside their remit. This risks putting undue pressure on individuals, who must not be made to carry out duties that fall outside their regulated role. This would unfair and could potentially threaten patient safety.”

The College will be publishing guidance and resources aimed at nursing associates and registered nurses, to help support their integration into the workplace and career development.

Nurses can focus on ‘specialised areas’.

Health Minister Stephen Hammond MP, says the new role will help free up the time of registered nurses to focus on more specialised treatments.


In a statement he said; “Today marks an exciting milestone with the start of thousands of nursing associates joining the NHS over the coming years – bringing with them valuable skills which will have a hugely beneficial impact on patients. They will support nurses to deliver safe, high-quality care, crucially freeing up their time to focus on more specialised areas of patient treatment.

Adding; “Our decision to regulate nursing associates is not only a recognition of the enormous contribution they make, but will empower them to work to their full potential and place them on a firm foundation for a long and successful career in the NHS.”

A landmark moment.

Andrea Sutcliffe, the new Chief Executive and Registrar of the NMC, said; Today is a landmark moment, and I’m delighted to welcome the first nursing associates on to our register.

“The high standards that we set will ensure that this new profession plays a vital role in supporting registered nurses, promoting health and wellbeing and improving safety and the quality of care in England in the years to come.” 

Ruth May, the Chief Nursing Officer for England also added that up to 5,000 trainee nursing associate were expected to start their training in 2018 with the Government aiming for a further 7,500 in 2019.


Currently, there are no plans to introduce the role in Scotland, Wales or Northern Ireland.

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