The Royal College of Nursing (RCN) has set out new definitions for nursing support worker roles, separating them into two levels in a bid to offer ‘greater clarity’.
This comes as the RCN recognised instances where staff have been expected to work ‘beyond their defined roles’ or ‘outside their scope of practice’.
The two levels set out by the RCN are:
- Supportive level – includes health care assistants, health care support workers and equivalent roles.
- Assistive level – includes registered nursing associates, assistant practitioners and equivalent roles.
Under the supportive level, the RCN said: ‘They will work within the team under the supervision of a registered nurse, delivering delegated task orientated care consisting of routine, high-volume activities with little variance.
‘They have knowledge and understanding within the nursing support worker context, developed by education and training to the standard set for this level by the country of employment within the UK. They are responsible for recording their activity promptly and accurately, with any matters of concern escalated promptly to the registered nurse.’
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And under the assistive level, it said: ‘In addition to the supportive level descriptors, staff at this level have a deeper level of knowledge, skills and training, meeting the standards set for this role by each country in the UK.
‘For nursing associates, this includes the NMC standards. This enables them to carry out a broader range of activities, use their initiative and apply problem-solving skills within their agreed scope of practice, particularly in familiar, low-risk and predictable situations.
‘Where appropriate, they can be delegated to guide the supportive level nursing support workforce, while remaining under the supervision of the registered nurse.’
These definitions relate solely to the support workforce that is supervised by a registered nurse, the RCN insisted.
A statement on the RCN website clarified: ‘Nursing support workers are collaborative members of nursing and multidisciplinary teams, providing person-centred nursing care across health, social care and education settings.
‘While they are responsible for their own actions, all nursing care they deliver is delegated and supervised by a registered nurse. Their role supports and assists registered nurses in delivering safe and effective care for individuals and populations.’
The RCN acknowledged that a broader group of support workers exists across health and social care settings, often referred to as health and social care support workers, but insisted that they fall outside the scope of this definition.
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The statement added: ‘Due to workforce shortages, in practice, there are cases where staff are expected to work beyond their defined roles. We don’t consider this to be acceptable.
‘Therefore, this definition reflects what we believe should be happening in practice.’
The definitions were developed as a collaboration between the RCN Professional Nursing Committee and the Nursing Support Workers Committee, facilitated by a Joint Partnership Board and supported by the RCN professional forums and fellows.
Wendy Preston, head of nursing workforce at the RCN, said: ‘We hope that these definitions and level descriptors will provide clarity, particularly regarding who nursing support workers are, as well as where responsibility and accountability sits – this is a positive step for the nursing workforce.’
Ms Preston added: ‘Members have informed us that they are sometimes asked to work outside their scope of practice, and we are seeking to ensure that staff and patient safety is upheld.
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‘Registered nurses are sometimes not fully aware of their responsibility and accountability that delegation brings. This definition and level descriptors will help to provide clarity.’
Last year, the Queen’s Institute of Community Nursing (then QNI) called for ‘clear guidance’ on the ‘scope and limits’ of nursing associates amid reports of those in post running independent clinics in general practice.
And previously, the RCN warned general practice nurses were increasingly being substituted with nursing associates in a move which is ‘devaluing’ the profession and their skills.
