CENTRAL MANCHESTER UNIVERSITY HOSPITALS NHS FOUNDATION TRUST. Cheryl Lenney, Chief Nurse

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1 CENTRAL MANCHESTER UNIVERSITY HOSPITALS NHS FOUNDATION TRUST Agenda Item 9.4 Report of: Cheryl Lenney, Chief Nurse Paper prepared by: Dawn Pike, Director of Nursing Anne Marie Varney Head of Nursing (Workforce) Date of paper: December 2016 Subject: Introduction of the Nurse Associate Role Indicate which by Information to note Purpose of Report: Support Resolution Approval Consideration of Risk against Key Priorities Recommendations The nurse associate role will be a new role to the nursing workforce, which has the ability to support the safe, effective delivery of care to patients and families. Any risks to the introduction of this role will be mitigated through the Trust Implementation Group. Members of the Board of Directors are asked to note the contents of this paper and the work being undertaken to ensure that the introduction of the nurse associate role supports registered nurses to deliver high quality patient care. Contact: Name: Dawn Pike, Director of Nursing Tel:

2 Executive Summary 1.1 The bi annual Nursing and Midwifery Safer Staffing Papers received by the Board of Directors has outlined the challenging workforce supply position currently facing the profession and the actions the Trust has been taking to mitigate this challenge. 1.2 The introduction of the nursing associate role to the workforce will support the Trust in ensuring that there are sufficient nursing support roles with the right skills and underpinning knowledge to deliver safe and effective services over the next 5 years. 1.3 This paper will provide a briefing on the Trust plans to introduce the Nursing Associate role to the nursing workforce as part of a national pilot sponsored by Health Education England (HEE) over the next two years. 1.4 In December 2015, the Department of Health announced plans to introduce a new nursing support role - the Nursing Associate - to work alongside healthcare support workers and fully qualified nurses focusing on the delivery of patient care The core principles of this role defined by the Department of Health, is to bridge the gap between healthcare support work and registered nursing roles through an apprenticeship learning of on the job learning leading to a foundation degree, release registered nurses to utilised their specialist skills and provide an alternative workforce to address the registered nursing workforce challenges. 1.6 Following a period of consultation led by HEE, during early 2016, formal approval to progress plans to develop and pilot the Nursing Associate role was announced in May Greater Manchester was successful in being selected as one of the Nursing Associate Pilot sites in October 2016, to support the implementation of 230 trainee nursing associate places from January 2017 across twelve providers in partnership with three local Higher Education Institutes. 1.8 The Board are asked to receive this paper, and note the Trust plans to implement the nursing associate role from January 2017 as part of the Greater Manchester collaborative programme of work Page 2 of 6

3 1. Introduction 1.1 This paper provides a briefing on the Trust plans to introduce a new role of Nursing Associate to the nursing workforce to support the delivery of high quality nursing care. 2. National Context 2.1 In December 2015 the Department of Health (DH) announced plans to introduce a new nursing support role of nursing associate. The nursing associate role will work alongside healthcare support workers and registered nurses focusing on the delivery of patient care. 2.2 The DH identified that the core principles for this role is to bridge the gap between healthcare support worker and registered nursing roles, enabling registered nurses to be released to spend more time using their specialist training to focus on clinical duties, leading the overall coordination of patient care and clinical decision making. 2.3 On behalf the DH, HEE undertook a consultation process in early 2016, to enable providers of healthcare, staff and the public to contribute to the structure and function of this new nursing associate role. The Trust contributed to this consultation process, 2.4 In May 2016 the HEE consultation was concluded and funding was identified to support the training for 1,000 nursing associate roles from January The training for these roles will be delivered through an apprenticeship style programme leading to a foundation degree. 2.5 In the future it is anticipated that the nurse associate training will be aligned to apprenticeship standards enabling Trusts to provide this training through the Apprenticeship Levy that will be available from May The nurse associate training programme will be aligned to graduate nurse training outcomes, thereby providing opportunities for nursing associates in the future to access shortened undergraduate nurse training programmes. Work is also underway nationally to agree an apprenticeship model that will result in a graduate registered nurse through an apprenticeship scheme. 2.7 In October 2016 the Secretary of State announced 3 the plan to regulate the nursing associate role following consultation and has requested that the Nursing and Midwifery Council (NMC) consider undertaking this function. The NMC Council will meet in January 2017 to consider this request and are likely to agree to undertake this function. The decision to regulate will strengthen the professional credibility of the role; provide public reassurance and accountability, assuring the standards of training and scope of the role, which will include elements of medications administration for some patient groups. 3 Page 3 of 6

4 3 Greater Manchester Workforce Context 3.1 In summer 2016, Greater Manchester Directors of Nursing held a series of workshops to discuss the withdrawal of pre-registration bursaries, managing the impact of planned reductions to Multi Professional Education and Training funding and the opportunities to work collaboratively across Greater Manchester in terms of implementation of the nursing associate role. 3.2 As a result of the workshops a Project Delivery Group was commissioned reporting to the GM Strategic Workforce Board. This programme of work is led on behalf of Greater Manchester Directors of Nursing by the Chief Nurse CMFT, who chairs the Project Delivery Group. The PMO infrastructure is hosted by CMFT and the Project Delivery Group provides strategic oversight for three key nursing workforce programmes: Impact of the introduction of the student loan to replace the current bursary programme for under graduate nursing and Allied Health Professional education and training. Development and implementation of the Nursing Associate role to support the Greater Manchester 5 year vision and delivery of a sustainable workforce for the future. Impact of the removal of post qualification funding and development of apprenticeship frameworks to support future delivery of multi professional education and training and continuing professional development. 3.3 The project group submitted a bid to HEE and for funding to support the introduction of 300 trainee nursing associate roles across 12 GM providers in August 2016 and in October 2016 HEE announced that Greater Manchester had been selected as one of eleven national pilot sites to develop the role. The bid provides the funding for the programme of training and the placement support infrastructure for 230 trainee nursing associate roles across Greater Manchester. 3.4 The trainee nursing associates will be employed by providers during the 2 year training programme as Band 3 nursing assistants (based on the nationally agreed job description). The education entry requirements for the role have been agreed as a minimum of English and Maths GCSE grade C or Functional skills Level Work is currently being undertaken nationally to develop the job description for the Nursing Associate role. Page 4 of 6

5 4 Greater Manchester Nursing Associate Pilot 4.1 Directors of Nursing have identified providers nursing associate requirements based on the possible future workforce requirements and continued challenges with the supply of registered nurses. The Table 1 summarises the allocation of training places across Greater Manchester partnership. Table 1: Greater Manchester Trainee Nursing Associate roles by provider. Provider Organisation / CCG No. Trainee Nurse Associates CMFT 68 UHSM 16 The Christie 8 Tameside NHST 20 Stockport NHSFT 16 Stockport CCG 3 Salford NHSFT 11 Pennine Acute NHST 48 Pennine Care 4 Trafford CCG 6 Bolton NHSFT 12 WWL Greater Manchester will receive funding for the 2 year period from HEE for each candidate on the programme ( 5,000 per annum for programme delivery cost which will be paid directly to the HEI) and placement tariff of per annum which providers will utilise to develop the infrastructure to support work based learning and assessment of trainee nursing associates. 4.3 As the nursing associates programme is work based learning, trainee nursing associates will form part of the funded nursing assistant establishment within their clinical placement. The trainees will be released from their post for 1 day per week to attend university, there is no back fill funding for this attendance. 5 CMFT Nursing Associate Programme 5.1 The Trust identified opportunities to establish in excess of 70 nursing associate roles across the hospital and community setting, excluding Maternity and Critical Care environments at this stage. The Trust has been allocated 68 trainee nursing associate training places. This is the largest number of trainees at one provider and the Trust will be working with all three Higher Education Institutes. 5.2 To manage the implementation of the role within the Trust a Project Implementation Group has been established chaired by the Head of Nursing (workforce) which reports to the Nursing and Midwifery Workforce Group, led by the Director of Nursing. Page 5 of 6

6 5.3 The Trust will support 2 programme pathways for the trainee nursing associates; Adult and Paediatric nursing. It is envisaged that the pathways will be split into 4 placements allowing trainees to develop knowledge and skills in medical, surgical, community and a speciality setting (i.e. cardiology, gastroenterology). 5.4 Following a successful advertising campaign the Trust received 600 applications with 200 applicants being shortlisted and interviewed by Trust staff and Higher Education partners. Conditional job offers have been made to 68 candidates 66% of the candidates are existing nursing assistants who are currently employed by the Trust and will undertake the programme on a secondment basis. 5.5 There will be a requirement to work with HEE to formally evaluate the education and training and further work will be required once the impact of regulation has been considered. 5.6 The Chief Nurse will keep the Board apprised of the development of the new role and once established will report on the role through the biannual safer staffing report. 6 CONCLUSION 6.1 The Board of Directors are asked to acknowledge the work undertaken to support the further development and transformation of the workforce through the introduction of the role of Nursing Associate. Page 6 of 6