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12 October 2023

Introduction of the Nursing Associate Role in Adult Social Care

What are the difficulties? How have providers sought to overcome them?

Nurse helping someone downstairs

Evaluating the role

Since early 2019 researchers at the NIHR Health and Social Care Workforce Research Unit at King’s College London have been evaluating the development of a new registered role, the Nursing Associate (NA). With the take-up of Nursing Associates sluggish in adult social care, much of the Unit work has focused on the introduction of the role in healthcare. In an earlier scoping study (Kessler et al, 2022) we explored the reasons for the relatively low NA numbers in adult social care and the challenges faced by providers here in introducing the role. While the challenges were significant, the scoping study, nonetheless, highlighted examples of adult social care providers who had successfully introduced the NA role, begging questions about how and why they had been able and willing to do so, while others had not.

New report out today

In Autumn 2022, the Department of Health and Social Care asked us to conduct a follow-up to the scoping study, examining these questions. The aim of this follow-up piece of work (report out today) was to deepen understanding of what difficulties social care providers faced as they sought to adopt the NA role, and the steps taken by particular care providers to overcome them. Covering 11 different case study adult social care providers, varying by size, region and care setting, and based on interviews with around 50 stakeholders including NA postholders themselves, their co-workers, senior organizational and care home managers, this report presents the findings from the follow-up study. The report presents the respective case studies in terms of: why and how the care providers introduced the NA role; how they are using and managing it: and with what consequences for various outcomes.

The case studies are nuanced, with participants being open not only about what went well but about the difficulties faced in introducing the NA role. There was, nonetheless, a broad consensus that the Nursing Associate as a registered and accountable role positively contributed to the quality of social care. Founded on an intensive, placement-based degree programme designed to support the delivery of holistic, person-centred care, it was felt by many in our study that the role had the capacity to make a distinctive contribution to care delivery as the needs of residents in most, if not all, formal care settings increased in scale, complexity, and acuity.

This publication

Kessler, I., Manthorpe, J., Harris, J., Moriarty, J., & Steils, N. (2023) Follow-up Report on the Introduction of the Nursing Associate Role in Adult Social Care: Case Studies and Lessons, London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London.

King's project page

Examining the introduction of the Nursing Associate role in health and social care (with onward links to all study outputs)

In this story

Ian Kessler

Professor of Public Policy and Management

Jill Manthorpe

Professor Emerita of Social Work

Jess Harris

Research Fellow

Nicole Steils

Research Fellow