A growing number of people without the right qualifications are being recruited for registered nursing roles, the Royal College of Nursing has warned.
Staffing in the NHS
It found examples of where health and social care employers had formally opened registered nurse vacancies to people without registered nursing qualifications, or to people with different professional backgrounds, such as physiotherapy and occupational therapy. This could present a risk to patient safety, it said.
Such job adverts often come with the caveat that the successful candidate registers with the Nursing and Midwifery Council or the Health and Care Professionals Council once they have begun their role.
Pat Cullen, RCN acting general secretary and chief executive, said: “Acting in this way not only leads to vacancies elsewhere but also carries a risk to patient care,” she said. “The very fact that employers are needing to fill nursing posts in this way should set alarm bells ringing with ministers that cannot be ignored and spur them into a proper investment in the long-term future of the nursing workforce.”
The RCN gave an example of a recent advert for a matron – a senior nursing role – responsible for older people’s mental health and learning disability services, which was open to a “registered professional clinician with demonstrable evidence of working at senior level”. It did not say it required NMC registration.
Another advert for an NHS band 5 staff nurse required the successful applicant to be an “RGN/RN [registered general nurse] or hold an equivalent allied health professional qualification”.
Rachel Hollis, chair of the RCN’s professional nursing committee said that all employers in health and social care should only open registered nursing roles up to registered nursing applicants only.
“We respect and value the role of all health care professionals in the multidisciplinary team, but we believe that only registered nurses, and our nursing support worker colleagues, can deliver safe and effective nursing care,” she said.
We respect and value the role of all health care professionals in the multidisciplinary team, but we believe that only registered nurses, and our nursing support worker colleagues, can deliver safe and effective nursing care” – Rachel Hollis, RCN
In response to the union’s claims, Geraldine Walters, director of professional practice at the Nursing and Midwifery Council, said: “At a time when high vacancy and turnover rates exist right across health and social care, our registered nursing professionals are critical in providing good, safe and effective care for everyone.
“We only have to look at our latest figures, showing 2,600 more nursing associates have joined our register over the last year alone, to see just how much of a growing and vital role this is in supporting the work of registered nurses.
“However, supporting does not mean substituting them inappropriately. Registered nurses have undergone a three-year training [course] and are proficient to assess, lead and plan person-centred care for people. Nursing associates have undergone a two-year training [course] and their knowledge and skills proficiencies are commensurate with that.
“It’s absolutely up to employers to make sure they understand the differences and that they have the right skill mix in their health care settings to ensure safe, high quality care.”
The 2013 Francis report into failings at the Mid Staffordshire NHS Foundation Trust between 2005 and 2009 highlighted that patient safety was at risk when the right nursing care and leadership was not in place.
Last month, NHS England revealed that more than 11,000 nurses, midwives and health visitors have joined the health service since the pandemic began, with overall staff numbers up 3.5% in the year to January 2021.