November 2016 advice to the Department of Health on the oversight of the role of nursing associates - interim report
Why did we write this advice?
In August 2016, the Department of Health asked the Professional Standards Authority for Health and Social Care (the Authority) to provide advice on what would be the appropriate level of oversight for the emerging role of the Nursing Associate. ‘Oversight’ refers to a number of mechanisms, including – but not limited to - statutory regulation. In order to reach a recommendation, the Authority was asked to pilot its new methodology ‘Right-touch assurance’. This is an evidence-based process for assessing the risks of harm in an occupation or profession, and the appropriate level of assurance needed to mitigate them. It was, therefore, also an opportunity to test out the new model with a view to further developing and refining the Right-touch assurance approach. Use of this model is in line with the principles of Better Regulation and will help to ensure that the form of oversight chosen is likely to be commensurate with the risk of harm to patients and avoid any undue regulatory burden on health and care services.
Scope of the work
The bulk of the information, evidence and data for the assessment was to be provided by Health Education England (HEE). The Department of Health also convened weekly teleconferences with the Authority, representatives from the Governments of Scotland, Wales and Northern Ireland, HEE and the Nursing and Midwifery Council. It was not within the scope of this work to assess the need for, or shape, the emerging role of Nursing Associate nor to carry out formal impact assessments on any recommendations made.
It emerged from the evidence that there is not yet clarity about the scope, clinical practice and working environments envisaged for Nursing Associates as the role or roles is/are still in development. We are therefore unable to provide a definitive recommendation to government at this stage. Given the short timetable available to do this work we have agreed with the Department that we will submit this interim report. This summarises work undertaken to date, the additional evidence that would be required to finalise our assessment, some of the methods of assurance that could be considered for the role when its scope is further defined and tested. In our conclusion we also suggest an interim position on oversight of the role.