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Staffing issuesJun 9, 2021

Patient safety could be compromised as physios and other AHPs take up 'designated nursing roles'

The Royal College of Nursing (RCN) issued a press release today (9 June) claiming that increasing numbers of NHS posts are being opened up to physiotherapists and other allied health professionals (AHPs), despite them being designated as ‘registered nursing (RN) roles’.

The release points to ‘growing instances’ of staff lacking nurse qualifications taking up registered nursing roles – a practice that it says ‘leaves patients without professional nursing care and compromises safety’.


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Appointing physios and other AHPs to 'nursing posts' could pose patient safety risks

Power Diary
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'Valuing' the nursing role in junior and senior posts

The press release states: ‘We’ve found examples where employers have formally opened registered nurse vacancies to people without registered nursing qualifications, or from different professional backgrounds, including physiotherapy and occupational therapy.'

It is based on a position paper titled RCN position on preserving safety and preventing harm valuing the role of the registered nurse, which is available on the RCN’s website.

This states that more and more vacancies ‘that require a registered nurse’ – from band 5 posts up to associate director of nursing level – are being advertised on NHS and other websites. The advertisements indicate that other registered health care professionals – generally AHPS – can apply.

The ‘only caveat’, the paper points out, is that applicants must be registered with the Nursing and Midwifery Council or the Health and Care Professionals Council (HCPC). 

In one recent example, a band 5 staff nurse post was advertised as being open to applicants holding either an RGN/RN or an ‘equivalent AHP qualification’.

Impact of AHPs taking over nursing roles 'under-researched'

The paper says the RCN welcomes the NHS Long Term Plan’s call for the planning, delivery and evaluation of care to take more of multidisciplinary healthcare team approach.

It ‘equally acknowledges the significant role that AHPs play in health prevention and the improvement of health and wellbeing of patients’. The paper states: 'However, there is minimal research or literature surrounding the impact on patient outcomes of AHPs undertaking registered nursing roles/tasks or in their undertaking of nurse leadership roles.’

While acknowledging that the title of matron is not a title protected in law, the RCN paper ‘challenges the perception’ that an ‘AHP matron’, can match the level of ‘clinical nursing supervision and leadership for nursing’ offered by a nursing one.

People could be 'misled'

The paper raises the possibility that having people in matron posts who lack nursing backgrounds could create false expectations.

‘An AHP matron can provide the management function which is only part of the nursing matron role. Indeed the use of titles such as matron, or ward sister/charge nurse by those who are not nurses can be misleading in the attribution of knowledge or skills to the post holder that they do not in fact possess.’

'Risks to patient care'

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]

RCN acting general secretary and chief executive 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.’

Rachel Hollis, who chairs the RCN professional nursing committee, added: ‘We need to see all employers in health and social care ensure that where a vacancy exists for a registered nurse, this is open to registered nurse 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.'

For more information, see: https://www.rcn.org.uk/about-us/our-influencing-work/position-statements/rcn-position-on-preserving-safety-and-preventing-harm-valuing-the-role-of-the-registered-nurse

Author: Ian A McMillan
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