Celebrating the revalidation of the first ever Nursing Associates on the NMC register

This year we’re celebrating the revalidation of the first ever nursing associates. I’ve been reflecting on the journey of those who were the first to join the Nursing and Midwifery Council register as nursing associates, and my personal and professional pride in being a partner on that journey.

The genesis of the nursing associate role in England was captured in the Shape of Caring Review (2016) commissioned by HEE (Health Education England) and led by Lord Willis. This review identified an ambition expressed by nurses across health and social care that a new role, positioned between health care support workers and registered nurses, should be developed in England. The ambitions for this role evolved through national workshops and three core elements of the role were established:

1.    The role should work alongside nurses across all services and settings and be regulated by the Nursing and Midwifery Council.

2.    Nursing associates are to be a unique professional nursing role that draws knowledge, skills and competence from all four of the nursing fields of practice.

3.    There should be clear progression pathways both into the nursing associate role and from nursing associate to registered nurse.

This new role captured political attention and there was impetus to move from concept to reality. The scale of appetite became clear when a large number of nurse leaders responded to a call to support the first two waves of the nursing associate programme in England by developing test site partnerships. This interest became even clearer when over 8,000 health care assistants applied for the first 2,000 places. Across these 8,000 individuals, we saw breadth in age, cultural diversity, gender and years of experience. We were recruiting talent from the communities that the partnerships serve and that was incredibly exciting to see.

These first 2,000 individuals had the opportunity and challenge of becoming England’s first trainee nursing associates. They commenced their programme with more unknowns than knowns about the role, with these developing during their training. HEE established a national community of practice for the trainees that I would attend, along with Emma Westcott, who led the nursing associate programme at the NMC. We listened to their questions and their experiences – both highs and lows. We also had the privilege of witnessing the emergence of potential leaders of this new profession.

These trainees were the ambassadors, the champions and also the shapers of the role. The growth of the role in the health and social care workforce was dependant on services and settings realising its worth, but the acceptance of the role was fundamentally on the shoulders of those who were forging its path. Some of them spoke nationally about their role and their voices and vision were powerful in advocating their value.

The first trainee nursing associates graduated and became registered nursing associates with the NMC as their regulator in January 2019. It was a time of celebration for those nurse leaders who pioneered the role, their teams who supported the trainees, the academic leaders who developed programmes at pace and, of course, the trainees – who together had faced challenge, yet followed their ambitions to know more, do more and make a change.

Over the last three years we have seen the number of nursing associates grow to over 6,800 and witnessed the role developing in a broad range of settings and services. Each year since the register opened I have tweeted asking ‘where are you now’ and the responses come in thick and fast. Nursing associates are in education, clinical practice, in a range of services and some have moved on to becoming registered nurses.

When I moved from Health Education England to become a deputy chief nurse at an NHS Trust in 2019, I was able to experience policy in action. Our first trainee nursing associates were becoming registered nursing associates and the discussions were around deployment: where would they add the most value and how could they augment nursing care to improve patient experience. Their knowledge and experience across all four nursing fields was going to strengthen the person-centred care our patients needed. Throughout the pandemic they shone, without any doubt this new profession stood shoulder to shoulder with our registered nurses and our teams to deliver care to our patients and their families.

The three ambitions of the nursing associate role have been achieved. It is a unique professional role regulated by the NMC, it draws knowledge, skills and competence from all four fields of nursing and, for those that wish to, there is a career pathway into becoming a registered nurse.

As our first nursing associates have their reflective revalidation discussions, I hope that they are remembering the journey that they have been on. I hope they remember the impact they have had on the care of patients and the public they support, their influence on the teams around them and the effect they have had on those of us that partnered with them on their journey. At one challenging time I was asked why I remained so determined to support this new profession; my answer was because I met the people that would become this new profession and they gave me hope.

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