Nursing Times Resources for the nursing profession 
One in six trainee nursing associates are quitting their courses before they qualify, according to an independent evaluation of the role, which found that its introduction had been welcomed as a positive move overall.
Of those who dropped out, almost a quarter did so because they could not meet the academic standards, with poor grasp of maths a “key factor” in this.
“We recognise that further work and research is required”
Mark Radford
Health Education England commissioned research firm Traverse to review the pilot phase of the nursing associate programme, which involved two initial cohorts of trainees between 2017 and 2019.
According to the review's findings, published today, there was “considerable interest” in the new course, with around 8,000 people applying for 2,000 places.
However, the report raised concern about the attrition rate on the programme.
Mark Radford
Over the two years included in the analysis, 16% of trainees dropped out before they completed their studies.
Among the top reasons, alongside ill health and other personal issues, was failure to pass the academic assessments, which was true for 23% of trainees.
This means 4% of the 2,000 people who started the programme across the two waves left the course because they could not meet the standards.
The drop-out rate was highlighted by the report authors as an issue that needed to be addressed as the programme continued to be developed.
They called on HEE to explore whether pre-application numeracy programmes should be offered more routinely to help applicants secure the necessary competence to begin the course.
They noted that “academic bridging programmes” focused on maths and English had already been established in several areas of England, in order to “maximise participation in the programme”.
As another way to tackle the attrition rate, the report authors said HEE should look at developing a part-time trainee nursing associate programme.
“The evaluation has found that trainees have struggled with the workload, which has impacted on their personal lives and work-life balance,” they said.
“A part-time approach could help to attract a greater number of trainees who have family and caring responsibilities and would help to reduce attrition from the programme.”
Meanwhile, the evaluation found “limited understanding and acceptance” of the nursing associate role from other clinicians during work-based placements and named this as a “key challenge”.
“The role is being considered as a stepping stone to becoming a registered nurse”
Lisa Bayliss-Pratt
“This has improved over time, especially in settings where nursing associates are based and can demonstrate their value, and as the expectations of the role have become clearer,” said the report.
“However, it is felt that ongoing efforts are needed at both local, regional and national levels to raise awareness and buy-in about the role.”
In light of the findings, HEE has committed to implementing a recommendation made in the report to develop nursing associate ambassadors to fly the flag for the profession.
The ambassador roles would be held by recently qualified nursing associates, who would work with a range of stakeholders from the health and care system to “promote” and “advocate” for the role.
Lisa Bayliss-Pratt
This could involve raising awareness of the nursing associate role in pre-registration nursing education programmes, noted the report.
The ambassador scheme should be supported by a comprehensive communication programme to “educate and inform existing colleagues of the scope and practice of the nursing associate role”, it added.
Overall, the evaluation team received positive feedback about the introduction of the nursing associate programme.
The programme was found to have offered an opportunity to go to university for some students who may not have been able to otherwise due to family commitments and financial circumstances.
Seven out of 10 surveyed trainees said they felt that the new role would lead to improvements in the quality and safety of patient care, and close to half believed it would support and free up the time of other professionals.
Approaching the end of the training programme, 85% of trainees questioned felt prepared to enter the workforce as a nursing associate.
A key motivation for introducing the nursing associate role was to provide another route into registered nursing.
The evaluation found nearly half (47%) of trainees intended to enrol onto a pre-registration nurse degree programme within three years of qualification as a nursing associate.
Looking ahead, the report authors said HEE should commission “robust research and evaluation” about how qualified nursing associates were being recruited and deployed in the different workplace settings.
“I’m pleased to see the positive findings of this report”
Andrea Sutcliffe
HEE chief nurse Mark Radford welcomed the findings of the report and confirmed that the organisation was in the process of identifying candidates to be considered as nursing associate ambassadors across England.
“We recognise that further work and research is required to ensure that the profession is supported and utilised in the workforce of health and social care as part of the multi-disciplinary team,” added Mr Radford.
Professor Lisa Bayliss Pratt, HEE’s former chief nurse and lead for the development of the nursing associate role before leaving to become pro vice-chancellor at the University of Coventry, said: “It is clear that the trainee nursing associate role is becoming an integral part of the health and care workforce, playing a key role in supporting patients, carers and their families up and down the country.
“It is also pleasing to see that the role is being considered as a stepping stone to becoming a registered nurse, as was originally intended when the role was created.”
Andrea Sutcliffe
Nursing associates are regulated by the Nursing and Midwifery Council, with the first qualified staff joining the register in January this year.
Andrea Sutcliffe, chief executive and registrar of the NMC, said: “I’m pleased to see the positive findings of this report.
“As we look forward to celebrating the first anniversary of the nursing associate role coming onto our register next year, this report reflects what we are seeing too.”
Why don they just admit it has been a huge mistake and concentrate their efforts and finances on returning the bursary.
* don’t
The lack of basic numeracy should have been identified by the course providers before the trainees were recruited. This is a failure of management.