RCN position on the role and scope of practice of the Nursing Associate
The Royal College of Nursing (RCN) has significant concerns about the increasing evidence of the substitution of Registered Nurses (RNs) with Nursing Associates (NAs). Those concerns are further strengthened by the increasing evidence of inappropriate extension to the role and responsibilities of the NA across health and care settings.
Research, and the outcomes of repeated inquiries in health care, have demonstrated the link between registered nurse staffing levels and patient outcomes, including quality of care, safety, and mortality. The evidence shows that when there are not enough registered nurses to deliver care, patients are at risk.
NAs play a valuable role within the health and care workforce, assisting the RN to provide safe and effective care. They are valued members of the RCN, and we are determined to represent their interests and advocate for their protection from exploitation by inappropriate deployment in the current nursing workforce crisis.
The RCN deplores the lack of consistent financial support to NAs who wish to undertake further study to become an RN.
The RCN is clear, based on the evidence, that Registered Nurses should not be substituted with Nursing Associates.
The RCN calls for all employers working within health and social care to ensure that where a RN vacancy exists, the vacancy is filled by an RN.
The RCN calls on employers to ensure that NAs are not pressurised to work beyond the NMC defined scope of practice, and advocates for the development of national employer codes which sets out the parameters of the role of the NA in each country of the UK where the NA role is regulated.
The RCN further reiterates our call for robust structured, demand led nursing workforce planning in all 4 countries of the UK, in line with the RCN’s Nursing Workforce Standards and considering patient need, service demand and skill mix.
The RCN is clear that the role of the NA should not exceed that laid out by the NMC as the regulator.
The RCN calls for the Nursing and Midwifery Council to clarify that the standards of proficiency which they have laid out for the NA across 6 platforms, are the established parameters for NA practice and a ceiling threshold which cannot be breached.
The RCN is clear that all NAs wishing to progress to become an RN should be funded to do so.
The RCN calls for the UK and Welsh Governments to make sufficient funding available to support all NAs who wish to do so, to undertake an educational programme to achieve a degree in nursing and so to become a Registered Nurse. In Wales, the RCN calls on the Welsh Government to make sufficient funding available for this purpose in the infrastructure providing for the introduction of this role.
