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Trainee nursing associates could be included in ‘minimum safe staffing numbers’

Nursing Associates could be included within minimum staffing numbers in order to ‘adequately safeguard patients’.



student nurses learning

Proposed changes mean training nursing associates may be included within ‘minimum staffing numbers’.

New proposals from the Nursing and Midwifery Council (NMC) mean that Nursing Associates could be included within minimum staffing numbers in order to “adequately safeguard patients”.

Proposed changes meaning NHS trusts would be given a choice in how they deliver training to nursing associates.


One option would be the traditional supernumerary model – where students are extra to the minimum number of staff required for safety and the same as student nurses.

A new second option would see trainee nursing associates included within ‘minimum staffing levels’ but trusts would need to demonstrate to the NMC how students would receive “appropriate learning time”.

The NMC says the second option would give employers a better idea of the costs associated with nursing associate apprenticeships” and the ability to allocate learning time around service pressures.

The Apprentice Levy.

NMC Council papers reveal that “The NMC has been encouraged to consider the possible impact of supernumerary status on the take-up of nursing associate opportunities.” as the apprentice levy, which funds nursing associate training, can only be spent directly on the training of nursing associates rather than backfilling gaps during supernumerary periods.

However, a survey completed by NursingNotes of 412 trainee nursing associates reveals that 91 per cent believe they would have ‘increased learning opportunities’ with a more traditional supernumerary status. 72% said they had missed learning opportunities because they were unable to be released from practice.

Only 1 in 20 respondents said they were classed as supernumerary in practice.

The regulator has published new standards for the role which are due to be approved by the NMC later this month.

The NMC has confirmed that nursing associates will be subject to the same conditions of practice as registered nurses; adherence to the code of conduct, revalidation, registration fees and fitness to practice proceedings in the event something goes wrong.

Keeping patients safe.

Geraldine Walters, Director of Education and Standards at the NMC said: “It’s clear from what we’ve seen and heard that trainee nursing associates are appreciated by those they’re caring for, and that the nurses they are working alongside recognise the potential of the role now and in the future.

“We know just how important it is that students who are training ‘on the job’ have time away from their everyday duties to learn. We’re confident that the plans we’ve outlined today will not only support students to learn and keep patients safe but also work for employers too.

“We look forward to seeing the first qualified nursing associates caring for people across England from January next year.”

‘Significant Concerns’.

Donna Kinnair, acting Chief Executive and General Secretary of the Royal College of Nursing, said: “We have significant concerns around the NMC’s decision not to treat trainee nursing associates as supernumerary. The alternative protected learning time is ill-defined and without an overarching quality assurance framework, it is hard to see how nursing staff, educators and the public can be confident in this approach.

“There is a strong rationale that supernumerary status allows nursing staff to learn effectively and safely. Any move away from this approach must be supported by robust evidence and planning.”

The first set of registered nursing associates are due to qualify in pilot sites in January 2019.


One in six nursing associates drop out before qualifying, finds report

Despite this trainees showed “high levels of enthusiasm and commitment to the programme”.



Group of nurses in meeting

Only 65% of trainee nursing associates said they planned to work as a nursing associate once qualified.

An independent evaluation of the nursing associate role commissioned by Health Education England (HEE) has found that while there are “high levels of enthusiasm and commitment to the programme”, one in six nursing associates are dropping out before completing the course.

Attrition rates for trainee nursing associates fell slightly below that of student nurses, with 18% leaving before completing the course.


While ill health and personal issues were some of the most common reasons for leaving the programme, nearly a quarter (23%) withdrew because they failed to meet the academic requirements of the programme – with numeracy skills cited as a key issue.

One trainee said they found the “attitudes towards the role and the negative feedback about Nursing Associates” challenging.

Only 65% of trainees said they intend to continue working as a nursing associate once qualified as the programme is often seen as a stepping stone to becoming a registered nursing.

Highlighting challenges.

Mark Radford, Chief Nursing Officer, Health Education England said the report “highlights some challenges that we must address to ensure that students such as ensuring the quality and oversight of placements, attrition and numeracy support.”

“We also recognise that further work and research is required to ensure that the profession is supported and utilised in the workforce of health and social care as part of the MDT. I am pleased to be able to report that we are in the process of identifying candidates to be considered as NA ambassadors across England.

Commenting on the report, Andrea Sutcliffe, Chief Executive and Registrar for the Nursing and Midwifery Council (NMC), said; “Having had the pleasure of meeting many nursing associates across the country, I am continually inspired by their enthusiasm and dedication for providing care and they should be very proud of the difference they make for the people they support.”

“I look forward to seeing how nursing associates continue to develop and be supported in their work, long into the future.”

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UCAS accused of having an ‘outdated’ view on nurses

They describe the nursing role to prospective students as looking after people when they are sick or injured.



Student Nurse Lecture Theatre

UCAS describes nurses as providing “support to doctors and other medical staff”.

The Universities and Colleges Admissions Service (UCAS) has been accused of having an “outdated” view on nurses after it described the profession as providing “support to doctors and other medical staff”.

UCAS describes the nursing role to prospective students as looking after people when they are sick or injured. Adding; “You’ll provide support to doctors and other medical staff, take blood and urine samples, and in some cases, you may carry out minor surgical procedures.”


Nurses, alongside a multitude of other healthcare professionals, have taken to social media calling for the description to be amended so it “adequately reflects nursing in the 21st century”. They also criticised the article for failing to highlight a large number of health promotion and research roles frequently undertaken by the profession.

BJ Walto, a senior member of the Royal College of Nursing (RCN) commented that the description is “inaccurate, demeaning and totally misleading portrayal of nursing.”

Tom Wavlin, a Lecturer in Adult Nursing & Admissions Tutor at the University of Plymouth, suggested the description could instead read; “an autonomous practitioner of nursing who works closely with other healthcare professionals”.

In comparison, the Nursing and Midwifery Council (NMC) website reads; “Registered nurses play a vital role in providing, leading and coordinating care that is compassionate, evidence-based, and person-centred. They are accountable for their own actions and must be able to work autonomously, or as an equal partner with a range of other professionals, and in interdisciplinary teams.”

A spokesperson for UCAS said; “It’s clear that our current role profile for nurses doesn’t reflect the amazing work that nurses across the country do each day, and we welcome the feedback we’ve recently received.

“We want to make sure that students considering their future options have up-to date information about all different careers available to them.

“We’re currently updating all of our job profiles and are in touch with nursing experts to help us make sure that we better reflect the roles and responsibilities of nurses today.”

UPDATE (17/10/19 09:55): This article was updated to include a comment from UCAS.

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