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Royal College of Nursing sounds warning over Welsh government introduction of Nursing Associates in Wales

Press Release 04/01/2024

The RCN warning comes after the biggest review of nursing without any mandate, public consultation, or scrutiny by the Senedd.

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. 

There is 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.  

The evidence is undeniable: the professional knowledge, skills and judgement of the registered nurse makes a critical difference to patient safety. Low nurse staffing levels are associated with up to 26% higher patient mortality, longer hospital stays, higher infection rates and a greater incidence of falls and pressure ulcers.  

I welcome the acknowledgement of the protection the Nurse Staffing Levels (Wales) Act 2016 provides to patient care and how it can be used to mitigate any substitution of registered nurses by registered NAs. It is imperative that the Welsh Government strengthens this protection by extending the Act to where NAs will be employed.

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. Given this is a change to government policy and was not in the 2021 Welsh Labour manifesto, the RCN will 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.

The RCN will do everything to work with the Welsh Government to minimise this risk to patient safety and enhance nursing care to provide the best possible outcomes to patients."

 ENDS


Notes to editors

Nursing Associates (NA) have been part of the Nursing and Midwifery Council (NMC) register since 2018 (England only).

The NMC sets out clear differences between the Registered Nurse (RN) and NA roles and responsibilities. Whilst both are accountable for the care they provide, it is the responsibility of the RN to assess care needs, plan, lead and manage and evaluate the care provided. The scope of practice of the NA is to provide, monitor and contribute to integrated care.

Introduction of NA role in Wales

The Royal College of Nursing (RCN) is the voice of nursing across the UK and is the largest professional union of nursing staff in the world with over half a million members in the UK, including 30,500 members in Wales.

For more information, contact the RCN Wales press office at 02920 680 769 or email mediawales@rcn.org.uk