arrow_up-blue blog branches consultations events facebook-icon facebook-icon2 factsheet forum-icon forum hands key link location lock mail measure menu_plus news pdf pdf2 phone policies publications related search share subjectguide twitter-icon word youtube-icon

Bridging the gap

 Lindsay Cardwell 22 Feb 2017

Assistant Practitioner Lindsay Cardwell looks at how her role fits with trainee nursing associates.

As a member of the Health Education England (HEE) Communications sub group, over the past year I’ve been able to influence the new trainee nursing associate (TNA) role.

HEE have been tasked, by the Department of Health, to deliver this new role and the first 1,000 trainees took up places at sites around England last month.

I have attended meetings, alongside RCN staff and fellow AP and HP Committee member Lorraine Hicking-Woodison, where I have voiced the concerns of all nursing staff, but in particular APs.

The TNA role has many similarities to APs. Like us, TNAs provide support to health care assistants (HCAs) and to registered nurses. The role has been described as ‘bridging the gap’ between HCAs and nurses.

TNAs also undertake a two years of study and supervised practice, like APs, although only at universities.

In light of this, many APs, including myself, have asked what the purpose is of TNAs when APs already exist. While the roles are similar, there are differences and because of this, a need for the role of APs.

One significant difference is the recent decision by the Nursing and Midwifery Council (NMC) to regulate the nursing associate role. This leaves a big question about what happens to APs like myself who have campaigned, for a number of years, for the regulation of support roles.

TNAs will carry out a broader range of general tasks but only alongside nurses, whereas APs work with a variety of health care staff and carry out more specialist tasks.

After two years of training, nursing associates will be able to apply for a further two year nursing degree course, or apply for an apprenticeship to become a registered nurse. Although not all nursing associates will choose this route, it does mean that the AP role will need to exist.

These differences may present opportunities for APs. APs who are interested in becoming nurses could also potentially follow this route, and the decision to regulate TNAs is a chance to reiterate the RCN’s call for the mandatory regulation of support roles.

The RCN has been clear that the nursing associate role must not be a substitute for registered nurses, but it’s also important that we also monitor the impact on support roles.

Alongside the RCN, I’ll continue to follow the roll out and evaluation of the TNA role closely over the next two years, and to put the case forward the case for APs everywhere.


Lindsay Cardwell

Lindsay Cardwell

South West member of the UK RCN Health Practitioner Committee

Assistant Practitioner and member of the Health Education England (HEE) Communications sub group on nursing associates.