POLICY: Registered Nurses and Health Care Support Workers

This briefing is a summary of established RCN positions that refer to the education of the registered and non-registered nursing workforce. The briefing highlights that:

• the registered nursing workforce should remain an all graduate profession
• the RCN does not support the return of the second level Registered Nurse
• there are defined accountability and delegation responsibilities for Registered Nurses
• all health care support workers (HCSWs) should be regulated in the interest of public protection
• HCSWs must be supported to develop the knowledge and skills required to deliver competent and compassionate patient-centred care
• a structured career framework for HCSWs should be developed
• responsibility for the overall nursing care of the patient and clinical decision making lies with the Registered Nurse and cannot be substituted by an HCSW or assistant practitioner (AP)
• staffing levels and skill mix should be determined appropriately using professional judgement, guidance and tools
• in relation to safe staffing, there is an association between the number of Registered Nurses and better patient outcomes.

The government announced on 17 December that it is creating a new route into nursing, by introducing a Nursing Associate role. The RCN has welcomed this recognition of the value of HCSWs, and the development of an initiative which will allow them to build their skills and to access training via a clear structure. The scheme also offers the opportunity for those in supporting roles to take a shorter route into graduate nursing. The fundamental role of the Registered Nurse does not change – studies show that the number of Registered Nurses has a significant impact on patient outcomes, and this is backed up by the World Health Organization. We will be responding in full to the consultation to ensure that this new role is fully funded, without detracting from the wider workforce, and above all is an asset to care and to patients.

For further information, please email papa.ukintl.dept@rcn.org.uk