Gill Miller is an organisational development lead, providing strategic direction for workforce and organisational development initiatives, including the nursing associate role, at Livewell Southwest.
Livewell Southwest is a social enterprise delivering integrated physical and mental health and social care for adults and some children’s services across Plymouth, South Hams, West Devon and some specialist services in Cornwall.
The social enterprise has been integral in the delivery of the nursing associate programme in Devon.
A year after Livewell's first cohort nursing associates qualified and joined the Nursing and Midwifery Council (NMC) register, Gillian shares the impact of the role in her organisation.
Growing our workforce with nursing associates
The nursing associate (NA) role is proving to be a revolution within our nursing workforce and brings a smile to the faces of all those involved!
We were part of the initial pilot together with our sustainability and transformation partnership (STP) organisations and chose to focus on developing the role in district nursing, where we were experiencing staffing shortages.
This was so successful that every person recruited to wave two came from a setting that had hosted a wave one trainee nursing associate (tNA) on placement. Since then our NA workforce has grown through four waves of recruitment and is established in such diverse areas as health visiting, older people’s mental health, neuro rehab and liaison psychiatry.
The NA is the cornerstone of our development pathway offer, from entry-level apprenticeships through to registered nurse degree apprenticeships. We get asked about NA opportunities every week by aspiring applicants, managers, and other organisations including care homes and charities.
The value of the role
The role has given our dedicated, compassionate support workers the opportunity to learn while they earn, to progress their careers and achieve their dreams of becoming registered. Six of our original 11 NAs will graduate as level 1 registered general nurses in summer 2020, thanks to our scholarship scheme and the apprenticeship levy.
People who use our services are able to receive much more value per contact because the NAs can do so much more as they have more autonomy than a healthcare assistant. Therefore more care needs can be addressed without having to depend on a registered nurse or more senior member of staff. This also releases the senior nurses to do what only they can do: the more complex, unpredictable, fluctuating and challenging work around care planning and delivery of specialist skills.
The NAs themselves are incredible advocates for the programme, proving themselves to be role models for everyone in the workplace from work experience students to managers. Other colleagues report the NAs mentoring up, having the confidence to educate their colleagues regardless of their positions.
Benefits and understanding
NAs have provided benefits to system working. The range of placement experience required by the NMC has meant that they have been able to represent the person within the community while working in an acute setting. They have educated colleagues in other settings about their ‘home’ service, and they have brought back insights from working in acute settings to foster closer working relationships and understanding.
The NAs carry with them an understanding of the entire patient journey. Observing the benefits they brought to the workforce led us to gift our apprenticeship levy to allow care workers to join the programme, sharing our placements and further extending the learning potential. We met with our local care homes forum and we were overwhelmed by the enthusiasm, both from managers looking to enrich their skill mix and care workers looking for an opportunity to progress to a registered role. By welcoming our care home colleagues into our community of practice, we are ensuring that care home trainees and mentors gain access to the same supervision and support mechanisms as Livewell staff. In turn, we are gaining valuable insight into this key element of our local system and fostering a shared culture of safety, quality and learning.
Above all, the NA role has brought everyone involved a huge sense of pride, bringing teams together, building confidence, fostering a culture of continuous learning and professional curiosity which will only benefit the people we serve. We are a social enterprise and as such have a commitment to our local community – now we can fulfil this further by providing not only improved care, but opportunities for an inspiring career too.
Find out more about nursing associates and establishing the role in your organisation, in our guide.