A nursing associate is a new member of the nursing team who can provide care and treatment in a wide range of health and care settings. The role is being used and regulated in England and it’s intended to address a skills gap between unregulated health and care assistants and registered nurses.

The benefits of having a Nursing Associate include:

• Increased capacity of a Care Home to deal with patients’ clinical needs
• Reduced emergency admissions and potential increase in hospital discharges to the Care Home
• Provides a cost effective nursing team, with the team working together within the care plan to maximize skills
• Promoting career progression from care staff towards nursing will help to support staff retention, as well as attracting good quality staff.

Our project will develop and test a workforce model for ‘arms-length supervision’ for the providers. This will look at integrating and collaborating with healthcare professionals currently involved within the care home and domiciliary care to provide support for nurse supervision. This will enable domiciliary care and care home providers without Registered Nurses on the team to employ Apprentice Nursing Associates (ANAs) and subsequently Registered Nursing Associates.  

The model will support care providers to remodel their workforce to include clinical staff and support the development of a learning culture regarding work-based learning, supervision and support. In addition it will provide professional development opportunities for existing Registered Nurses which link with care providers to provide clinical supervision and support in line with Nursing and Midwifery Council standards and university requirements for the Apprentice Nursing Associate programme. Benefits include:

• An approach to undertaking educational audit and supervision to support Apprentice Nursing Associates within the new settings of care homes and domiciliary care. 
• Registered Nurse professional development in relation to supervising and supporting learning for pre-registration nursing associates, applied to these non-traditional settings.
• Detailed workforce planning in relation to these new nursing roles in care homes/domiciliary care. 
• The extension of ANAs into new settings, and a mechanism through which they can grow will be a key driver of the creation of integrated health and care teams, enabling the care sector to lead.
• The new role – together with other local work – will create a distinct care career path into nursing.

Our research shows that there is a lot of interest from Care Homes and Domiciliary Care in having an ANA on the team. However, the reason most are interested in ANAs is precisely the reason that they cannot benefit from them; they do not have a nurse on staff. 

The benefits of overcoming this barrier are significant. As the health needs of the average recipient of care become more acute, this development would enable care providers to enhance the quality and safety of their services. At the same time, it would enable them to develop and retain excellent staff, and offer those staff a chance to progress, learn, challenge themselves and better serve their clients. 

More generally, this would be a significant development for Barking, Havering and Redbridge’s (BHR) health and care system: Given the pressure on recruitment and retention, particularly within nursing, this opens up a new channel through which to develop existing staff. Homecare staff working locally tend to live locally, and given the significant attraction, recruitment and retention issues in London’s health and care systems, those who have already shown commitment to living locally are particularly worthy of further investment. Other benefits include:

1. The development of ANAs within care homes and domiciliary care has the potential to drive the development of stronger partnerships between primary care, social care and district nursing. 
2. Apprentice Nursing Associates based within Social Care will look to add essential clinical skills and help bridge the gap between care staff and Registered Nurses.
3. Providers will learn to remodel their workforce staff to include these clinical staff.
4. Provides opportunity for the care staff to reignite a career path