Royal College of Nursing Criticises Nursing Associates Plan

The Royal College of Nursing has strongly criticised the plants of an NHS trust to replace over 20 registered nursing posts with associates.

East and North Hertfordshire Trust has denied that the policy represents the substitution of nurses, pointing to the fact that the posts in question are currently vacant.

But Janet Davies, Royal College of Nursing chief executive, believes that the decision is a worrying move, and that replacing nurses with associates would ultimately lead to diminished patient care.

Health Education England had designed this pilot trust as a bridge between healthcare assistant roles and registered nurses.

However, it seems that financial savings may ultimately be the motivation behind this policy.

Replacing the five nursing roles with associates will save the trust around £130,000 pounds annually, according to board papers.

Nursing associates will be paid band three wages while being trained, before moving to band four once the two-year programme is completed.

The trust had begun to review its nursing provision back in April 2016, and evidently came to the conclusion that making this decision would be a viable financial move.

But previously published academic evidence does suggest that nursing associates can reduce the quality of care delivered to patients.

Peer-reviewed studies in the United States have indicated that replacing nurses with associates can lead to increased risks to patient safety.

This could be considered particularly worrying in this region, as East and North Hertfordshire Trust has experienced higher than expected summary hospital level mortality indicator rates in five out of eight reporting periods since 2014.

The aforementioned Davies indicated that she is concerned about this associate move, and worried that it could be indicative of future trends in nursing.

“This is a worrying move and another reminder of the need for more nurses to deliver safe care. The Royal College of Nursing repeatedly warned the government that its failure to recruit and retain registered nurses would lead to nursing associates replacing them. It is just not fair on nursing associates to expect them to deliver the same standard of care as a highly trained registered nurse.”

Davies also outlined her view on the appropriate role for associates within the healthcare system.

“Support staff must supplement their work, rather than replace them. Patients are being short changed too. Health outcomes are improved when greater numbers of registered nurses with the right skills mix are on duty.”

Meanwhile, East and North Hertfordshire Trust acting chief nurse Liz Lees, outlined the ethos behind the decision-making process.

“At the heart of this work is the principle of having the right staff, with the right skills and competencies, in the right place. Incorporating these new roles within our ward-based establishment does not compromise our registered nurse to patient ratio, on which we are well within national guidance. The roles also provide an alternative route in to the graduate training programme for nursing.”


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