Oxfordshire NHS Trusts are rolling out a new "nursing associate" role. There are currently 40,000 nursing vacancies in the UK, with Oxfordshire having twice the national average vacancy rate due to the high cost of living in the county. The nursing associates will undergo a 2 year training programme and be paid at band 4, as opposed to the three years training required to become a registered nurse who are paid at a minimum of band 5. The national shortage os trained nurses is a combination of different factors, including removal of the bursary, the high cost of university education and a historic shortage of training places.
Ian Mckendrick, Communications officer for Oxfordshire UNISON Health branch said "Oxfordshire residents should be concerned about Oxfordshire's NHS Trusts replacing band 5 registered nurses with less trained band 4 "nursing associates". Research has repeatedly shown that having fewer higher trained nurses to look after people threatens qualty of care. THE NHS previously used less trained State Enrolled Nurses to deal with the shortage in fully trained nurses. The role was abadoned in the early 1990's to increase nursing standards by increasing the amount of training nurses needed to meet an ever more complex role. The return to this staffing solution is a step backwards. Do the government and health managers think reducing the overall skill level of nurses is acceptable when it will undermine patient care?
Trusts are claiming this is the answer to the problems recruiting enough fully trained nurses, and having to spend extra on agancy nurses to fill gaps in the rotas. However the staffing crisis in Oxford is signifcantly worse than elsewhere due to the high cost of living. If Trusts can't retain band 5 nurses how do they expect to retain ones paid at band 4? We believe the solution is to pay the equivalent of London weighting to enable Trust's to recruit and retain all grades of NHS staff in the county. This won't solve the national shortage of nurses, but if money is available to train nursing associates, why isn't money being made available to fully train them to the current minimum standard required to be a registered nurse.
We believe this is about slashing the wage bill to try to get nurses on the cheap, and puts patients at risk. We saw what happens to patient care in Mid Staffordshire Hospitals scandal when financial pressures undermined nursing. People died as a result. The government has orchestrated the lack of trained nurses and spent years preparing to roll out less trained, lowered paid replacements. We have to ask why Trust executives are quietly going along with this. They need to make it clear to what extent they are prepared to fill band 5 posts with band 4 nursing associates and how many band 5 registered nursing posts will disappear in their skill mix reviews. They should be held responsible for any fall in the quality of aptient care and not be allowed to pass this on the inadequately trained staff.
We know on some wards the money to employ staff is being used to train the new band 4 nurse associates, which will impact on the numbers of fully trained nurses employed, and that there are plans to mask what is happening behind "skill mix reviews" - effectively saying we don't need so many fully trained nurses - when we clearly do not have enough already.
UNISON will be insisting that these reviews do not result in the reduction of the numbers of higher qualified staff required to be on duty, and that if nursing associates are to be used they should be instead of band 3 posts to drive the overall skill level up, not drive it down. One solution to this mess is for nursing associates to be immediately enrolled in paid training to turn them into fully trained nurses. This way we have the numbers of fully trained nurses we need and skill levels and patient care in Oxfordshire's hospitals is protected. Of course this will require money from central government - and in the end this is what nursing associate role and the planned skill mix reviews are really about - with the quality of patient care a secondary consideration."