Exclusive: Other UK countries also exploring idea of nursing associates

Scotland is exploring the idea of introducing a nursing associate role, while Northern Ireland has decided against doing so at this time.

The updates from both countries come after Wales announced this week that it was considering the introduction of nursing associates, or a similar band 4 regulated nursing role.

The nursing associate role, which is intended to sit at a level between healthcare support worker and registered nurse, was first introduced in England in 2019.

Until now, none of the other UK countries have followed suit.

Nursing Times can today confirm that all three devolved countries – Scotland, Wales and Northern Ireland – have had discussions about the prospect of introducing such a role, with some countries making more advances than others.

In a statement to Nursing Times, a Scottish Government spokesperson said it was working to “better understand the potential challenges and opportunities of regulation of the band 4 workforce, including the role of the registered nursing associate”.

The spokesperson added that wider discussions were simultaneously taking place in Scotland, as part of the Nursing and Midwifery Taskforce, focused on developing different routes into nursing.

“The Scottish Government is committed to exploring and developing alternative routes into nursing to ensure all viable recruitment options are established and maximised,” they said. 

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“Although funded places for nursing programmes have increased, we recognise that alternative options for entry to nursing and midwifery degree programmes will be essential moving forward.

“As part of this, the Nursing and Midwifery Taskforce is looking at the diversification of education routes and the widening of access through earn as you learn models.” 

“We’ve certainly been involved in some discussions with Wales”

Maria McIlgorm

Meanwhile, Northern Ireland confirmed that it had previously been in talks with Wales around introducing the nursing associate role.

Despite this, the country will not be taking these discussions further at this time.

In an interview with Nursing Times, the chief nursing officer for Northern Ireland, Maria McIlgorm, said: “[Among] the healthcare support worker staff, there is a proportion of that staff that will work at different grades.

“We’ve certainly been involved in some discussions with Wales.

“But at this point in time, our priority is to grow our [registered] nursing graduates within Northern Ireland.”

Amid these announcements, Royal College of Nursing (RCN) branches across the UK have raised concerns about the proposals and the lack of consultation on the matter.

RCN Scotland director Colin Poolman told Nursing Times that the union had “not been involved in the work the Scottish Government has undertaken” in this area.

Colin Poolman

He said: “The RCN has been clear with Scottish Government and employers that the development of the healthcare support worker workforce must provide additionality to nursing teams and not result in the substitution of registered nurses by healthcare support workers.”

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Mr Poolman echoed concerns raised by RCN Wales earlier this week that nursing associates may be used to plug gaps in the registered nursing workforce, which could be a threat to patient safety.

He added: “We are concerned that, although the introduction of regulated nursing associates has the potential to increase recognition and reward for band 4 support workers along with opportunities to develop their career, given the current pressures of reduced public funding in the NHS and recruitment and retention challenges, there is a real danger that under financial pressure, health boards will see the employment of nursing associates as a potential alternative to the employment of registered nurses, creating a risk for patients.”

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