I have recently watched with interest as our profession has grappled with the concept of a new role, the nursing associate, entering the caring family.
The role has emerged from a variety of policy drivers and has been developed to support a workforce under strain, under numbered and suffering from the challenges of reduced investment, recruitment, retention and educational funding changes. It sits within a minefield of environmental impacts, more to do with less, social care and health under pressure and a future looking busier than ever.
The proposal to better educate support staff in health and social care has long been desired by professionals and unions alike, and the case for more recognition of these roles through regulation has also been made on numerous occasions. A career pathway for care from support worker to registrant has been requested for several years and supported by the HEE Talent for Care team.
The development of standardised education and training for support staff has been om the agenda for some time. Most recently the work of Camilla Cavendish and then Lord Willis and his team in the Shape of Caring set out the need to provide consistent opportunities for these staff to learn and, if able and they desire it, to progress. The standardisation of education, clear role definitions and career development opportunities are beginning to surface.
So why, when all of these things are finally emerging, is their potential impact being played out negatively in social media? Surely what is needed is leaderful professional debate to reinforce the careful management of this transition and protect the people we care for?
There is evidence about the current workforce. The research discussed in recent weeks cites the importance of the registrant and the impact when they are not there. Research by Kessler, reported yesterday by the highly respected Richard Griffin set out the impact of healthcare support workers. Unregistered but qualified staff already provide many hours of care supporting professionals and are well respected for it.
These new nursing associate roles, unregulated or regulated will be part of the integrated care team. There is no research as yet to advise on their function. Their influence and impact is unknown, but nursing has an opportunity to shape and evaluate it.
There is evidence of the benefits of registrants – but there is no evidence yet that these new roles, with enhanced training, development and career pathways are at odds with the desire to provide the best and safest care for people who need it. There is room for both, for surely in care delivery, roles are not mutually exclusive but part of an integrated team.
What the profession appears to fear is substitution and erosion of the nurse’s place in care delivery. Is it possible that we are challenging this new role to defend our own professional position? As leaders of nursing we need to use the current and future evidence to consider how an effective skill mix using an integrated workforce can support care in these days of efficiency and challenge. Strong nursing leadership must continue to articulate the skill mix needed in care settings and the place of all support roles, regulated or otherwise, within these teams.
This role is coming, we should welcome this investment in the training and education of our workforce, we should be grasping it and managing its implementation, ensuring that nurses continue to emerge as champions of care, and not simply of the profession.