Wales ‘considering’ nursing associate role

The Welsh Government is seeking to introduce nursing associates or a similar role to Wales.

A government spokesperson confirmed that it was “considering” the introduction of a band 4 regulated nursing role.

Currently, the only such role that exists in the UK is the nursing associate, which was rolled out in England in 2019.

The Royal College of Nursing (RCN) in Wales has raised concern about the proposals and the lack of consultation so far.

The news comes after Wales’ national chief nursing officer (CNO) Sue Tranka told Nursing Times in October that she was looking into a new band 4 nursing role, though did not specify that it would be regulated.

In a statement today, a Welsh Government spokesperson said: “We are considering the introduction of a regulated band 4 nursing role for NHS Wales subject to the necessary UK legislative amendments and we will be publishing a statement shortly with more details.

“As part of this work we have undertaken a comprehensive review of literature, evidence gathering and extensive stakeholder engagement. This found there remains significant utilisation of the band 4 role and an inconsistent approach to its implementation across NHS Wales.”

RCN Wales director Helen Whyley warned that, while nursing associates could have a beneficial impact, there was a risk of Welsh health boards using them as an “alternative” to registered nurses, which was a threat to patient safety.

Helen Whyley

She also suggested that the change was being done without enough external scrutiny.

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“This is a radical change in patient care in Wales and I am disappointed there has been no public consultation or parliamentary scrutiny on this decision,” she continued.

“Patient safety must be the top priority for the Welsh Government.

“The evidence is undeniable: the professional knowledge, skills and judgement of the registered nurse makes a critical difference to patient safety.”

Ms Whyley aired concerns about where funding for this new role would come from, noting claims from the Welsh Government that there was “no cash in the system”.

She added: “The introduction of regulated NAs has the potential to increase recognition and reward for band 4 support workers along with opportunities to develop their career.

“But the RCN is very concerned, given the current harsh pressures of reduced public funding in the NHS, that achieving the potential for benefits in this change will be difficult to accomplish.”

Sue Tranka

Wales CNO Ms Tranka made mention of her plans for a new band 4 nursing role during her 2023 CNO Summit, which took place at the end of last year.

Speaking to Nursing Times at the time, Ms Tranka said she was “not certain” if the new role would be the nursing associate or something different.

She said: “For me, this is not about a title, it’s about – what does the pathway entail for these nurses?

“I’m not sure I necessarily want to replicate the nursing associate model, not that there’s anything wrong with that. I just don’t know what the outputs are going to tell me.

“And when I’m informed by the decisions that have been taken, then I can make a decision together with key partners. And then we can work with our ministers to understand what it is we want to put into place.”

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The introduction of the nursing associate role in England was met with similar concerns about registered nurse substitution.

As yet, the other UK countries – Scotland, Northern Ireland and Wales – have not opted to introduce the role, which is intended to sit at a level between healthcare support worker and registered nurse.

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