A nursing associate (NA) has been raising the profile of their profession through a regular podcast which challenges the stigma and misinformation that can surround the role.
Martyn Davey trained as part of the first cohort of nursing associates in 2017 and almost seven years later, he says he will ‘never do anything else.’
Mr Davey set up a NA Facebook group during his training and today the group has almost 5,000 members, bringing together NAs from across the UK to share their experiences in the role.
Shortly after founding the group, Mr Davey started ‘Just a Sharp Scratch’ – a regular podcast which now has 19 episodes with guests including Professor of healthcare and workforce modelling Professor Alison Leary, general practice nursing associates, and practice nurse educators.
‘There was a need for a kind of platform where nursing associates could share their experiences, insights and the vital contributions they have made to healthcare,’ he told Nursing in Practice.
‘So, my goal was to create a community where nursing associates feel heard, valued and inspired, whilst also educating the public and healthcare professionals about the significance of our role.’
Nursing associates in primary care
For the past four years Mr Davey has worked at East Quay Medical Practice, an experience which he says has shown him how NAs ‘can play a very crucial role’ in primary care.
‘By providing consistent and personalised care to patients, they [NAs] can help manage chronic conditions, perform routine health checks and support health promotion and disease prevention initiatives,’ he said.
Mr Davey sees the additional time that NAs can spend with patients as useful for enabling registered nurses and doctors to ‘focus on those complex cases’, also allowing NAs to spend more time educating patients.
Part of Mr Davey’s role is supporting men, of a similar age to him, to manage their diabetes better.
‘I’m looking to utilise my role as a nursing associate in an educational way. I am diabetic, so that gives me a boost in a sense of being able to relate to them on their level, to educate them on their care,’ he said.
‘So, I can talk, I can monitor them, and if I feel as though there’s concerns, I can bring those straight back to the doctor for the patient to be revalued. It’s a kind of holistic approach.’
Controversies around the role
Some controversy has surrounded the NA role since its introduction in 2019, with concerns around role substitution and that those in post are at risk of exploitation by employers.
In a previous interview with Nursing in Practice last year, the Royal College of Nursing’s (RCN) professional lead for primary care, Heather Randle, warned that the college was ‘seeing a lot of role substitution’ since the introduction of ARRS, particularly with NAs and care coordinators being used in place of general practice nurses (GPNs).
In March, statistics from the latest Primary Care Workforce Quarterly Update revealed that the number of NAs working in general practice and primary care networks (PCNs) had risen by 55.5% in 2023, while the number of nurses had risen by just 4.5% in the same period.
NAs can be employed in general practice under the Additional Roles Reimbursement Scheme (ARRS), which can be used by primary care networks to reimburse the salaries of some roles.
GPNs are currently excluded from the scheme, though an enhanced level practice nurse role was added this year.
A recent report from the Queen’s Nursing Institute (QNI) has raised concerns that GPNs have been expected to provide education and supervision for ARRS staff – namely NAs – and in many cases, for less pay.
Changing perceptions
Mr Davey says ‘things could always be better’ but believes ‘perceptions of the role have definitely evolved’ since he started the podcast.
‘Initially, there was some kind of scepticism and lack of kind of understanding about nursing associates and what they do,’ he said.
‘Over time, more people have seen the positive impact of nurse associates on patients.
‘There’s been a kind of growing recognition and respect for the role, and NAs are increasingly seen as an integral member of the healthcare team.
‘Many nursing associates have reached out to say how the podcast resonates with their own experiences and really and makes them feel less isolated in their struggles.’
Room to improve
Outside of the podcast, Mr Davey believes the NA role needs to be examined ‘with fresh eyes’ to ‘revalue’ the role and ensure better policy is developed to protect professionals.
‘It’s making sure that the nursing associate role isn’t used and abused, so more protections are needed to ensure that NAs are not being exploited.’
For Mr Davey, that means more clarity around continuing education, professional development, and fair pay.
‘There needs to be some form of being able to develop this role. Clearer guidelines on scope of practice and responsibilities would prevent NAs from being overburdened with tasks beyond their role,’ Mr Davey said.
And he suggested that NA pay should be ‘looked at on an induvial basis, not in a blanket form’.
Calls for clarification on the nursing associate role have been echoed by the QNI, which issued a statement seeking ‘clear guidance on the scope and limits of nursing associate practice’ earlier this year.
‘We’re here to stay and we’re here to support’
Several years into his role, Mr Davey doesn’t think he ‘will ever leave’.
‘You are being able to take away patients from nurses who aren’t needing their care at that point in time,’ he said.
‘It’s not about taking over and becoming a cheap nurse. It’s about supporting and being able to take the pressure off, so nurses can focus on that critical patient that really needs their help.’
Going forward, Mr Davey plans to raise the profile of NAs even further.
‘We’re here to stay [and] we’re here to support – not to be looked at like a cheap nurse, because we’re not,’ he said.
‘I’m passionate about getting this role into positions that will make a difference to nursing associates. I’m very much in contact with people in good, high places to be able to hopefully implement that in the future.’
He added: ‘In order to look after nursing associates, you have to have nursing associates in the room.’
