Sandy Harding, RCN Wales Associate Director (Professional Practice):
“This announcement of the introduction of a regulated band 4 nursing role for the NHS in Wales without a full public consultation on the introduction of the role is disappointing, especially given the warning we issued at the start of the year.
The RCN supports and recognises the importance of nursing support workers (NSWs; known as health care support workers (HCSWs) in Wales) developing within their role. However, there have been instances in England where registered nursing associates (RNAs) have reported that they have been exploited and this must not happen in Wales. There is further evidence of RNAs not being supported to progress their careers into registered nursing; within Wales there are already many available routes through Health Education Improvement Wales (HEIW) for this to happen.
The Health Minister has said she’s committed to consulting on “developing the parameters of practice for the new role" but for such a huge change to patient care in Wales this is simply not enough – there should be public consultation and scrutiny from the Welsh Parliament.
With almost 3,000 registered nurse (RN) vacancies in NHS Wales – and due to current financial pressures – there is a real risk to patient safety if boundaries become blurred and health boards employ band 4 RNAs instead of filling the vacancies with appropriately qualified nursing staff. Whilst both RNs and RNAs are accountable for the care they provide, it is only the responsibility of the RN to assess care needs, plan, lead and manage care, and evaluate the care provided.
The minister’s statement finishes with “this is a momentous decision for nursing and is vitally important for the quality and safety of care provided to patients as well as improving patient outcomes.” There is no evidence to suggest that patient safety and outcomes would be improved with the introduction of RNAs within Wales.
It’s unfortunate the minister didn’t fully consult with the RCN – as the voice of nursing – prior to making this momentous decision. Of course, the RCN will work with the Welsh government to ensure the risk to patient safety is minimised and that the nursing workforce clearly understands their responsibilities and scope of practice.”
