British NHS trusts replacing nurses with non-nurses compromises safety, warns RCN

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Patient safety is being compromised across the NHS because of a growing practice of employing staff without nursing qualifications in nurse roles, the Royal College of Nursing has warned.

It has found repeated examples of jobs previously limited to registered nurses being opened up to either less qualified nursing staff or to other non-nursing workers.

The RCN has warned this erosion of the safety critical role for nurses in healthcare goes against published research which shows substituting registered nurses with other staff increases death rates on wards and leads to worse outcomes for patients.

In some adverts posted on the NHS jobs website, NHS trusts were found by the RCN to be advertising roles such as ward matrons to non-nurses who didn’t even need to be registered with the Nursing and Midwifery Council as long as they were registered with another regulator for allied health professionals.

In another example, a registered nurse was viewed as interchangeable with a less qualified nursing associate, despite the role expecting the applicant to plan and assessing care packages and work independently. Nursing associates should be under the supervision of more senior staff.

Chief executive of the RCN Pat Cullen said: “Filling registered nurse vacancies with those who are not registered nurses is not filling those vacancies. Acting in this way not only leads to vacancies elsewhere but also carries a risk to patient care.

“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.”

While the government has committed to having an extra 50,000 nurses working in the NHS by 2024, the NHS has around 40,000 nursing vacancies before the start of the pandemic. Increasing patient demand has meant more patients needing treatment which has meant workforce numbers, while growing, are still not enough for staff to work safely.