From Health Education England – Written June 2021 

Background 

The nursing associate role was introduced in response to the Shape of Caring Review (Health Education England, 2015), which aimed to ensure that nurses and care assistants receive consistent, high-quality education and training that supports high quality care. In 2016, Health Education England announced training places for the first 2000 nursing associates, and test sites across England were chosen to deliver the initial wave of training. The first cohorts of trainees started their programmes in January 2017 and on successful completion, were entered onto a new part of the Nursing and Midwifery Council (NMC) register in January 2019. Year on year there has been steady increase of trainees and programmes and those Nursing Associates who are now qualified are making a real difference within their teams. 
 
Nursing associates are new members of the nursing team, who are trained to foundation degree level. They work with people of all ages and in a variety of settings in health and social care. It is a stand-alone role, bridging the gap between health care support workers and registered nurses whilst also offering an opportunity, once qualified, to progress to registered nursing training. 

Opportunities in General Practice 

For General Practice, this is an exciting prospect. Those who are employed in General Practice settings can embark on a work-based learning journey that leads to a nursing associate or even registered nursing role. This is helping to increase the capacity of the general practice nursing team and offers a genuine opportunity for General Practice to ‘grow their own’ and play a key role in developing the nursing workforce needed for the future. The following information will be of interest to Primary Care Networks Clinical Directors, employers, General Practice Nurses, practice managers, Training Hub Leads and those interested in the nursing associate role. 

Key Features and requirements 

The NMC specify the requirements for pre-registration nursing associate programmes. These requirements are described in full in the Standards for Pre-Registration Nursing Associate Programmes. 
 
Students accepted onto programmes must have the capability to develop numeracy skills and demonstrate proficiency in English language and have capability in literacy to meet programme outcomes. Approved Educational Institutions (AEIs) may, in addition, require evidence of key skills level 2 in English and Maths, plus evidence of a level 3 qualification prior to enrolment on a Nursing Associate programme. 
 
To register with the NMC on successful completion of programme of learning, each trainee must: 
 
Successfully complete an NMC approved pre-registration programme foundation degree, - this is typically 2 years + 
Evidence no less than 2,300 programme hours over the 2 years. 
Be released from employed setting for at least 20% of this time for academic study. 
Be released from employed setting for at least 20% of this time for external placements. 
Evidence protected learning for remainder of programme. 

Placements and Support 

Placements are usually arranged in conjunction with the AEI and trainees should be additionally supported through an established clinical educator network. Local Training Hubs are likely to be involved in supporting placements which need to reflect a diverse range of people, across the lifespan and in a variety of settings. 
 
In return for placements and clinical educator support, it is expected that an employer of a trainee nursing associate, would also offer placements for trainees from other organisations. 
 
Trainee nursing associates will need the full support of their employer. The practice team is required to identify a General Practice Nurse, who can provide day to day supervision support and contribute to local educational progress meetings. Requirements for supervision are outlined here: NMC Standards for student supervision and assessment. 

Funding: fees, levy, salary support through the Additional Roles Reimbursement Scheme (ARRS) and HEE support 

Educational fees are required by the AEI delivering the academic programme and are currently set nationally at £15000 for the 2-year programme. 
 
If the nursing associate programme is delivered through an apprenticeship route, AEI training costs can be met by utilising apprenticeship levy. Most general practices will not be levy paying organisations, but it will be possible for a levy paying organisation to ‘gift’ some of its unspent levy to general practice a to cover AEI fees. Further guidance can be found by visiting the gov.uk web site: Apprenticeship funding 
 
Salary costs throughout the duration of the 2-year period will be met by the employing practice. The starting salary for trainee nursing associates in the NHS is the equivalent of Agenda for Change band 3, progressing to band 4 on qualification. 
 
If the trainee nursing associate is employed across a Primary Care Network, the trainee salary as well as the salary once qualified, can be fully reimbursed through ARRS. This is an attractive opportunity. For further guidance, visit DES Contract 2020/21. 
 
For trainee nursing associates starting on programme from April 2021, HEE offers a support package of £8000 (£4,000 per year over two years). This amount is payable to employers to support the work-based learning environment of trainees. A contract will be established between HEE and employer once a trainee is enrolled on programme. Release of this payment will follow agreement of the contract. 

Financial Summary 

Source of funding 
Amount 
Gifted levy 
£15,000 to cover AEI educational fees 
HEE Support package 
£8,000 over 2 years for trainee NAs 
ARRS 
Covers trainee NA salary at equivalent of Agenda for Change band 3 when employed across a PCN 
ARRS 
Covers qualified NA salary at equivalent of Agenda for Change band 4 when employed across a PCN 

Next Steps 

If all the above requirements are met and the practice team or PCN is fully supportive of proceeding, the next step would be to approach a local AEI for further details. AEIs have been procured and a list of those available can be provided. 
 
An employer guide to Nursing Associates has been produced and can be accessed via the NHS Employers website. 

For further help, advice or to discuss next steps, please e-mail your NATH or contact: 

Gill Beardmore, HEE Primary Care Nurse Workforce Lead for the East Midlands: Gillian.beardmore@hee.nhs.uk 
Heidi Davis, HEE Primary Care Nurse Workforce Lead for the West Midlands: Heidi.Davis@hee.nhs.uk 
Liz Sahu, HEE’s Relationship Manager for Apprenticeships, Midlands. For all information relating to apprenticeships, levy and list of procured AEIs: Liz.Sahu@hee.nhs.uk 
Nottinghamshire Alliance Training Hub (NATH): alliance.hub1@nhs.net 

For further information 

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