Great NHS Gamble: Northampton trial scheme cannot become excuse for '˜nursing on the cheap'

NHS organisations in the county are trialling the use of “nursing associates” being brought in to the NHS in support roles for fully-qualified nurses.

The Department of Health has introduced 1,000 trainee nursing associates this year at 11 test sites, with a further 1,000 to follow later this year.

Among the NHS organisations participating in the trial are Northampton General Hospital NHS Trust and Northamptonshire Healthcare NHS Foundation Trust.

But the RCN has warned the new staff “must not be used as substitutes for registered nurses,” with 24,000 unfilled nursing vacancies across the country.

Nationally, The number of trainees applying to be nurses has fallen by 23 per cent this year after the Government controversially axed a bursary scheme to support students through education in a bid to save £800 million, while new figures have revealed a 90 per cent reduction in the number of EU nationals applying to work as nurses in British hospitals following the Brexit vote.

Just 101 nurses and midwives from other European nations joined the register to work here in December - a drop from 1,304 in July, the month immediately after the EU referendum.

RCN figures show there are already 24,000 unfilled nursing vacancies across the country.

Tom Sandford, director of the Royal College of Nursing in England, says he is concerned that the shortfalls will lead to a greater reliance on new nursing associates being asked to do more than what is in their job descriptions.

Mr Sandford said: “We are very worried they are going to be a nursing workforce on the cheap. We want to understand more about the training.

“It is endemic in the public sector.

“It is not just in nursing, in almost every area of public service they are looking for substitution cheaper labour.”

Mr Sandford said the RCN are now pushing for more details from health bosses on the intended use of nursing associates in the next few years as the NHS looks to plug a £22bn funding gap through the development of Sustainability and Transformation Plans (STPs).

He says he is concerned whether the plans will be achievable without enough nurses and is calling on the Government to reinstate the bursary programme, as well as reassuring EU workers they are welcome to keep working in Britain.

“We need to know we have got enough nurses. In nursing we have a very significant problem.

“Applications are down 23 per cent for nursing training. We believe that is entirely down to the removal of bursaries.”

Mr Sandford said the lack of detail in many STPs, combined with the way they have been drawn up ‘has given the appearance of secrecy and a lack of transparency and openness’.

He added the Brexit process is also contributing to the uncertainty.

“We are massively down on EU nurses at the moment, There are just under 60,000 staff with an EU nationality working in the NHS at the moment, 22,000 or 23,000 are nurses. In some emergency departments, you will find an almost completely Portuguese workforce.

“But in December only 101 nurses applied to be registered in Britain.

“EU staff have just turned off from coming here. I’m very, very concerned that the Government sends a positive message that despite Brexit you are going to continue to work here if you want to work here.

“There needs to be a very reassuring statement from the Government about the future eligibility of EU staff.

“Everybody working in the NHS is doing an amazing job at the minute. If you look at the demands on the service, staff are flat out keeping the service going as best they can.”

“I’m concerned about the workforce plans at the minute.

“You can see nursing numbers falling off a cliff in relation to the EU and training.”

Guy Collis, health policy officer at Unison, has also raised concerns about the use of nursing associates and the use of non-clinical staff without training.

“If there are ways of expanding what they’re doing and taking on other roles, providing there was appropriate training, potentially depending on the way it was done, there might be something positive to be said.

“Our concern is that with some of those it’s going to be care on the cheap.

“We’ve seen this in particular with nursing staff, there’s suggestions they will be trying to use nursing associates.

“If they’re being used in place of registered nurses there’s a concern there it’s being driven by cost cutting, rather than any desire to improve the quality of services.”

Carolyn Fox, director of nursing, midwifery and patient services at Northampton General Hospital, said the assistant roles can actually be a stepping stone into the nursing proffession.

Announcing that Northampton was to become a testbed in October, she said: ““This new role has been designed to bridge the gap between health and care support workers and graduate registered nurses,” she said.

“For health care assistants, it offers great opportunities to progress into nursing roles; for nurses, it provides practical support and skills on our busy wards; and for our patients, it means their care will be delivered by an enhanced nursing team all focused on delivering safe and compassionate care.

“On a larger scale, it’s a great opportunity for Northamptonshire and I’m delighted that our combined expertise will influence the future of our nursing workforce.”

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