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Backlash over plans for regulated band 4 nursing role in Wales

Backlash over plans for regulated band 4 nursing role in Wales

The Welsh Government is ‘considering’ the introduction of a regulated band 4 nursing role in Wales.

But the Royal College of Nursing (RCN) has warned the role – which appears similar to the nursing associate post in England – should not be seen as an ‘alternative’ to the employment of registered nurses.

It comes as concerns continue around general practice nurses in England being increasingly substituted by nursing associates.

Registered nursing associates have been working in England since 2019 and are a band 4 position regulated by the Nursing and Midwifery Council. They were introduced to help bridge the gap between registered nurses and health and care assistants, and cannot currently practice in Wales, Northern Ireland or Scotland.

While the Welsh Government has not confirmed if the new regulated post will be known as ‘nursing associates’ in Wales, a spokesperson said: ‘We are considering the introduction of a regulated band 4 nursing role for NHS Wales subject to the necessary UK legislative amendments and we will be publishing a statement shortly with more details.’

They added: ‘As part of this work we have undertaken a comprehensive review of literature, evidence gathering and extensive stakeholder engagement.

‘This found there remains significant under-utilisation of the band 4 role and an inconsistent approach to its implementation across NHS Wales.’

While recognising the benefits of regulated nursing associates, RCN Wales claimed this work by the Welsh Government had come without public consultation and little scrutiny.

Helen Whyley, RCN Wales director, said: ‘This is a radical change in patient care in Wales and I am disappointed there has been no public consultation or parliamentary scrutiny on this decision.

‘Patient safety must be the top priority for the Welsh Government.’

She warned there was ‘a real danger that under financial pressure, health boards will see the employment of nursing associates (NA) as a potential alternative to the employment of registered nurses creating a risk for patients’.

Ms Whyley added: ‘The introduction of regulated NAs has the potential to increase recognition and reward for band 4 support workers along with opportunities to develop their career, but the RCN is very concerned, given the current harsh pressures of reduced public funding in the NHS, that achieving the potential for benefits in this change will be difficult to accomplish.

‘The Welsh Government has not identified additional funding for the employment and education of this new role of NA; indeed, they claim there is no cash in the system.’

Ms Whyley pledged that the RCN would ‘be scrutinising this new policy to ensure that funds for registered nursing education in Wales are not stripped out, nor that of the existing registered nursing workforce budget’.

A report published by RCN Wales in November warned the use of support staff in roles and tasks that require a registered nurse was ‘a very real risk’.

Meanwhile, the RCN’s primary care lead Heather Randle warned recently that since the introduction of the Additional Roles Reimbursement Scheme in general practices in England – which provides funding for nursing associates and other multidisciplinary roles – practice nurses are increasingly being substituted by other staff.

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