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Nurse leaders celebrate five years of nursing associates in England

Nurses have been asked to share their positive thoughts and experiences about nursing associates, as the Nursing and Midwifery Council (NMC) marks five years since the first ones joined its register.

The first nursing associates were formally entered onto the register on 28 January 2019, around five years after the NMC first aired the idea of a “bridging role” from support workers to registered nurses.

“As well as being a vital profession in its own right, the nursing associate training pathway also plays an important role in career progression”

Ruth May

The role, which sits between a healthcare assistant and registered nurse, was announced in December 2015 as part of government plans to tackle NHS staff shortages.

Coming in the wake of the Shape of Caring review, it was designed to offer a new way into the registered nursing profession that allowed staff to earn while they trained and, in turn, widen access to registration.

Since the first nursing associates joined the register just over five years ago, the NMC said the number had risen to more than 10,000. Of these 5,500, according to NHS England, work in the health service.

Dame Ruth May, chief nursing officer for England, said the new role had made a “huge contribution” to providing care for patients, as well as being a new pathway for thousands into becoming a nurse.

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“As well as being a vital profession in its own right, the nursing associate training pathway also plays an important role in career progression – recognising talent and offering opportunities to healthcare support workers to progress if they want to as well as providing a potential onward route from nursing associate to registered nurse,” she said.

“I welcome every opportunity to grow our professions as we continue to increase the number of nursing associates and open up the nursing profession to more people, I look forward to welcoming them to the NHS.”

In celebration of the five-year milestone, the NMC has asked nurses, nursing associates, students and educators to share “positive stories and reflections” about the post using the hashtag #NAFiveYears on X (formerly Twitter) and Instagram.

Andrea Sutcliffe

Andrea Sutcliffe, NMC chief executive and registrar, thanked the country’s nursing associates, both current and former, to mark the fifth year of the role being a part of the profession.

She said: “We’ve come such a long way since the first cohort of nursing associates joined our register five years ago. These professionals are now embedded as valued members of nursing teams across England.

“Their compassion and commitment are clear to see, working closely with their wider teams to support peoples’ care. Whether working in hospitals or in the community, or now practising as registered nurses, they make an invaluable contribution to the public’s health and wellbeing.”

Nursing associate Emily Robinson, who works for Newcastle upon Tyne Hospitals NHS Trust, spoke positively about her decision to take on the pathway from healthcare support worker to graduate nurse via nursing associate level.

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“I decided I wanted to pursue my career further into nursing and successfully applied to be a trainee nursing associate,” she said.

“Since I started in March 2023, I spend my time working alongside qualified nursing colleagues. I

have worked in a variety of different placements, both in hospitals as well as out in the community such as in health visiting services.

“I combine working as a trainee nursing associate with university assignments and while it is hard work, I think it is a great approach to be learning while you are working.”

The nursing associate role was also now being used to help work towards the goals of the NHS Long Term Workforce Plan, according to NHS England.

A spokesperson for NHS England reiterated that, by 2036-7, it hoped to have 64,000 full-time equivalent nursing associates and will expand the number of training places to around 10,500 by 2031-2.

Health minister Andrew Stephenson added: “Nursing associates do a fantastic job supporting patients and enabling registered nurse to focus on more complex care.

“These roles will play a central part of the NHS’s Long Term Workforce Plan which will expand the number of nursing associate training places to 10,500 by 2031-3.”

However, the role was not introduced without controversay and there have been ongoing warnings that nursing associates could end up being used as substitutes for registered nurses.

The Royal College of Nursing, the Queen’s Nursing Intitute and leading nurse academics, such Dr Alison Leary and Professor Peter Griffiths, have repeatedly aired concerns about the dangers of this happening.

Just last year, the Care Quality Commission attracted criticism over a line in a report that seemed to suggest nursing associates could be used in primary care instead of registered nurses.

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Other parts of the UK have, however, begun floating the idea of introducing a similar role at band 4 of Agenda for Change, having previously held back.

The Welsh Government, earlier this month, announced it would be introducing them following a lengthy consultation into nursing in the devolved nation.

While a specific rollout date has yet to be fixed, it said it was working on the legal, legislative and practical steps needed to bring nursing associates to Wales.

As well as this, the Scottish Government said it was “committed to exploring and developing alternative routes” into nursing, hinting at the potential introduction of a band 4 regulated nursing role.

Northern Irish chief nursing officer Maria McIlgorm, however, her country’s Health and Social Care was not looking to take the idea forward at present.

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