‘Advanced’ nursing associate job adverts labelled exploitative
Posted 20 June 2024 - 15:00
Some nursing associate adverts promise band 5 status, clinical leadership and other responsibilities, but devalue nursing and are ‘dangerous’ says nurse leader
The development of ‘advanced’ nursing associate roles is ‘dangerous’ and is devaluing nursing, according to a nursing leader.
RCN England director Patricia Marquis told Nursing Standard that she is aware of some NHS trusts who have even advertised nursing associate jobs at band 5 level.
While that is fairly uncommon, she said many employers are seeking band 4 nursing associates with skills and duties outside their scope of practice, including clinical leadership, line management of staff cohorts and assessment of patients.
Some nursing associate roles are ‘a clear substitution’ for a registered nurse
‘It’s completely muddying the waters,’ added Ms Marquis. ‘There was a role in London where they had a vacancy gap for a registered nurse and advertised for a band 5 advanced nursing associate.
‘It a clear substitution. We can’t get a nurse, so we’ll upskill a nursing associate and it will be cheaper. We are also seeing job roles that say they will assess patients and should provide clinical leadership. It doesn’t fit.’
One advert for a London trust describes the role to include ‘managing a cohort of junior staff’, while a recent advert for a trust in the Midlands says the role provides a route to a band 5 level.
Nursing associates must pass a two-year degree
Nursing associates were introduced in 2019 in England and the role is regulated by the Nursing and Midwifery Council (NMC), with 10,560 currently on the register.
Employers can only employ people for the role who are qualified with a two-year nursing associate foundation degree, which is typically achieved through the apprenticeship route.
Guidance required to stop ‘unscrupulous employers’
But with the scope of the nursing associate job description seemingly straying into that of a registered nurse, Ms Marquis has called for a review by the NMC, NHS and other employers to provide clear guidance on the role and its remit, and to protect the integrity of the registered nurse role and stop exploitation of nursing associates.
Ms Marquis added: ‘Guidance needs to be laid down somewhere to prevent unscrupulous employers exploiting this situation, where maybe nursing associates are being asked to run clinics but without the extra training or the extra salary.’
The nursing associate role is set to be launched in Wales, with training due to begin in autumn 2025.
‘We need some long-term evaluation of the impact of nursing associates on patient outcomes and patient care,’ said Ms Marquis. ‘Rolling out, at the minute, a non-evidence-based role is frankly high risk and dangerous, and doesn’t follow a safety model.’
The NMC’s executive director of professional practice, Sam Foster, said: ‘Employers are responsible for making safe decisions about role and skill mix. Where this doesn’t happen, we’re committed to working with the NHS, the Care Quality Commission and our partners to understand and address the concerns. This is key to ensuring people receive the safe, effective and kind care they have the right to expect.’
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