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As of September 2024, there are 6,161 full time equivalent nursing associates employed across National Health Service trust and integrated care boards in England, and a further 1,167 in general practice organisations and primary care networks.

The following table shows the number of NHS trust and other core organisations, like integrated care boards and their predecessors, who had one or more nursing associates join the organisation over a 12-month period ending in September, each year from 2018 to 2024:

Source: NHS England’s NHS Hospital and Community Health Service Workforce Statistics.

Notes:

1. this data relates to the workforce directly employed in NHS trusts and other core organisations who are paid;
2. the data is based on a headcount and includes people returning to active service, like those returning from maternity leave or career break;
3. the data is calculated on an annual basis for each annual period in this analysis; and
4. the following two trusts are not in all time periods for turnover as they have not used the data source, the Electronic Staff Record (ESR), for all the years in this time series, and they are therefore included from the point at which a full year of data from ESR could be compared, as: Moorfields Eye Hospital NHS Foundation Trust (RP6) began using ESR in November 2018, and so is included in turnover data from the September 2019 to September 2020 period onwards; and the Chesterfield Royal Hospital NHS Foundation Trust (RFS) began using ESR in March 2021, and so is included in the turnover data from the September 2021 to September 2022 period onwards.

Nursing associates joining a body could be staff moving from another staff group or level of employment in the same organisation, likely moving from being a trainee nursing associate to being fully qualified, they could be newly employed within an organisation, having already undertaken nursing associate roles or training elsewhere, or they could be returning from unpaid breaks in service such as maternity leave or career breaks. The data is not available to assess nursing associate joiners in other NHS funded organisations, such as in general practices and primary care networks.

NHS England does not hold this information centrally. Nursing associates are one of a number of roles through which Primary Care Networks (PCNs) can claim reimbursement for salaries, and some on costs, through the Additional Roles Reimbursement Scheme. These roles provide appointments and perform clinical and administrative tasks as part of the wider general practice multi-disciplinary team. Staff recruited under the scheme are employed at a PCN level.

As of September 2024, there were 6,161 full time equivalent nursing associates employed across National Health Service trusts and integrated care boards in England. This is 424, or 7.4%, more than a year previously.

Training and retaining talented NHS staff is absolutely central to our mission of rebuilding a health service that is fit for the future. Our 10-Year Health Plan to reform the NHS will establish how to train and provide the staff the NHS needs, including nurses, to care for patients across our communities. The refreshed Long Term Workforce Plan will deliver the transformed health service we will build over the next decade, and will ensure that the NHS has the right people, including nursing associates, in the right places, with the right skills to deliver the care patients need when they need it.

The adult social care workforce is growing, with Skills for Care data reporting that in 2023/24 there were 1.705 million filled posts, an increase of 70,000 filled posts compared with 2022/23.

The independent commission, announced on 3 January, will look at how we recruit, retain, and recognise the adult social care workforce. We are already taking action through a number of reforms including introducing the first ever Fair Pay Agreement and expanding the Care Workforce Pathway (the new national career structure) to make the adult social care sector more attractive. We will support care workers to safely take on further duties to deliver delegated healthcare activities, with the right training and clinical governance in place.

In September 2024, we launched the Adult Social Care Learning and Development Support Scheme, which allows employers to claim for funding for training courses and qualifications on behalf of eligible staff. We are also launching a national recruitment campaign in February 2025 to encourage suitable candidates to apply for immediate vacancies by highlighting the varied and rewarding work available.

We have a complete apprentice pathway for nursing, from entry level to postgraduate advanced clinical practice. Nursing associates can go on to become registered nurses through a degree apprenticeship, allowing people to earn a salary while gaining a nursing qualification.

Nursing associates can also become registered nurses by completing a shortened undergraduate nursing degree. For those taking this route, the NHS Learning Support Fund provides eligible students with a non-repayable training grant of a minimum of £5,000 per academic year. The Government keeps the funding arrangements for all healthcare students under close review. The Government attempts to strike a balance between ensuring students are financially supported during their studies and delivering maximum value for money for the taxpayer.

Training and retaining talented National Health Service staff is absolutely central to our mission of rebuilding a health service that is fit for the future. Our 10-Year Health Plan to reform the NHS will establish how to train and provide the staff the NHS needs, including nurses, to care for patients across our communities. This summer we will also publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade.

The Department does not hold the information requested. As the independent regulator of nurses and midwives in the United Kingdom, and nursing associates in England, the Nursing and Midwifery Council (NMC) is responsible for nurse registration. The NMC publishes the number of UK trained nursing associates joining its register for the first time in England, which will be a close proxy for the number completing training. Skills for Care data shows that in 2023/24, there were 700 nursing associates in adult social care, a decrease of 50 from 2022/23.

The following table shows the number of UK trained nursing associates joining the NMC register in England for the first time, each financial year from 2018/19 to 2023/24:

Source: Nursing and Midwifery Council, March 2024 Annual Data Report

The Department does not hold this information centrally. As the independent regulator of nurses and midwives in the United Kingdom, and nursing associates in England, the Nursing and Midwifery Council (NMC) is responsible for nurse registration. The NMC publishes annual reports on its website detailing registration data, including the number of leavers, covering the period 2018 to 2023.

The following table shows the number people leaving the NMC register by registration type and financial year:

Source: Nursing and Midwifery Council Annual Data Report.

The following table shows the number of full time equivalent (FTE) registered nurses, including health visitors, employed across National Health Service trusts and other core organisations in England, each year from September 2013 to September 2023:

Source: Hospital and Community Health Service Workforce Statistics, NHS England.

The Department does not hold the information requested. The Nursing and Midwifery Council (NMC) publishes the number of United Kingdom trained nursing associates joining their register for the first time in England, which will be a close proxy for the number completing training. The following table shows the number of UK trained nursing associates joining the NMC register in England for the first time, in each if the last six financial years:

Source: Nursing and Midwifery Council, March 2024 Annual Data Report.

The Higher Education Statistics Agency publishes data on the number of students qualifying from higher education courses in the United Kingdom, and this includes information on a broad ranges of undergraduate nursing courses. The published data is not detailed enough to allow for the reliable identification of all students completing courses which specifically lead to registered nursing status.

As a proxy for the number of students completing nursing courses each year, the Nursing and Midwifery Council (NMC) publishes information on the number of UK trained nurses joining their register for the first time, who are resident in England. The following table shows the number of UK trained nurses joining the NMC register in England for the first time, each financial year from 2018/19 to 2023/24:

Source: Nursing and Midwifery Council, March 2024 Annual Data Report

The Department does not hold the information requested. Whilst the Higher Education Statistics Agency publishes data on the number of students completing higher education courses in the United Kingdom, it does not publish data in a detailed enough way to allow for the identification of nursing associates completing subsequent registered nursing training.

The Nursing and Midwifery Council publishes information on their register, including the number of nursing associates across the UK who have added nursing or midwifery registration status. The following table shows the number of nursing associates adding nursing or midwifery register status, in each of the last five financial years:

Source: Nursing and Midwifery Council, March 2024 Annual Data Report.

The National Homecare Medicines Committee’s (NHMC) vision for digital transformation, including e-prescribing in homecare, is available in a short video in an online-only format on the YouTube website. The digital subgroup of the NHMC is working with the National Health Service, Electronic Prescribing and Medicines Administration (ePMA) systems vendors and homecare providers to produce an output-based specification for an Electronic Prescribing System (EPS), particularly focusing on the technical aspects of homecare requirements for EPS. This will include interoperable prescribing systems. Any ePMA systems used in secondary care need to be Dictionary of medicines and devices compliant and this applies for homecare medicines too; this is needed to support interoperability.

The output-based specification aims to standardise requirements in homecare medicines e-prescribing, accelerating adoption of e-prescribing system development in homecare. This specification is undergoing final review by NHS England before publication by the NHMC.

An assessment, through a commissioned piece of user-research of homecare paper-based prescribing, was done during the COVID-19 pandemic. NHS England will use the information in this assessment to understand the issues in homecare, as well as to inform future improvement actions, particularly developing and adoption of the Electronic Prescription Service (EPS).

No assessment has been made of the impact of requirements under the Human Medicines Regulations 2012. The only advanced electronic signature (AES) is through EPS. Not many e-prescribing systems used in secondary care have the capability to meet this AES requirement.

An assessment, through a commissioned piece of user-research of homecare paper-based prescribing, was done during the COVID-19 pandemic. NHS England will use the information in this assessment to understand the issues in homecare, as well as to inform future improvement actions, particularly developing and adoption of the Electronic Prescription Service (EPS).

No assessment has been made of the impact of requirements under the Human Medicines Regulations 2012. The only advanced electronic signature (AES) is through EPS. Not many e-prescribing systems used in secondary care have the capability to meet this AES requirement.

An Information Standard Notice (ISN) which puts in place definitions that are to be used when a health professional sends or receives patient medication and allergy/intolerance information, by computer system, between care locations, has been published under section 250 of the Health and Social Care Act 2012.

The purpose is to ensure that medication and allergy information is transferred between systems and locations in a machine-readable format. This will be achieved by: transferring medication information using the newest version for the United Kingdom of Fast Healthcare Interoperability Resource, by use of either ‘Medication Codable Concept’ or ‘Medication Resource’ as is most appropriate to the use case; usage of dose syntax to transfer the amount of medication per dose as a simple coded quantity; and transferring allergy/intolerance information using Systematized Nomenclature of Medicine Clinical Terms and dictionary of medicines and devices codes.

All clinical IT systems that will be used for prescribing homecare medicines will be required to be compliant with this ISN.

The COVID-19 pandemic and the subsequent focus on recovery has seen some National Health Service trusts delay implementing Electronic Prescribing and Medication Administration, meaning the timeline for implementation has been pushed to 2025. However, the implementation of e-prescribing in NHS trusts remains a key and appropriate deliverable as part of the vision to digitally transform the NHS. Additionally, the Electronic Prescription Service, which has been widely used in primary care over the past 18 years, is being made available to all NHS trusts by March 2025, should they want to utilise it.

The information requested is not held centrally.

The Government is committed to reforming the system of regulation for healthcare professionals in the United Kingdom, making it faster, fairer, more flexible and less adversarial. A modernised regulatory framework will be introduced first for anaesthesia associates and physician associates, who will be brought into regulation under the General Medical Council by the end of 2024, before the reformed legislation is rolled out to doctors, and to the professions regulated by the Nursing and Midwifery Council and the Health and Care Professions Council over the following couple of years.

The Care Quality Commission has set out plans to introduce a new single assessment framework for care providers, local authorities, and integrated care systems, which will prevent duplication and provide a consistent and accessible means of ensuring safe and high-quality provision of care at all levels.

The Minister of State for Health, Will Quince MP, is the minister responsible for the Homecare Medicines Service.

Providers of Homecare Medicine services to National Health Service patients do so under framework agreements which may be held at different authority levels as follows:

- National level, via NHS England;

- Regional level, via NHS procurement hubs; or

- Local level via hospital trusts.

This therefore requires a high degree of centralised co-ordination for which the National Homecare Medicines Committee (NHMC) supports and advises the NHS on matters relating to homecare medicines services.

Homecare medicines services are regulated by three different regulators, namely the Medicines and Healthcare products Regulatory Agency, the General Pharmaceutical Council, and the Care Quality Commission, depending on the service being provided. The NHMC acts as the national focus for developing and improving administration and governance processes for homecare medicines services and has published a large volume of guidance and templates to support consistent best practice across the country.

Each Chief Pharmacist within each NHS trust is the responsible officer for the homecare medicines services that the hospital provides and is responsible for the monitoring and performance management of its contracts for these services.

The Care Quality Commission (CQC) do not have a role to routinely ensure that entrants to England on Health and Social Care visas and work permits are employed under the same terms and conditions as United Kingdom domiciled staff. However, as part of CQC’s regulatory role, staffing governance is considered during CQC inspections at providers. If CQC identify areas of incorrect practice they would work with relevant agencies such as the Home Office to rectify any issues raised.

CQC regulate all health and care services that want to conduct a Regulated Activity, as defined by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. CQC’s scope of registration document defines the types of organisations which need to register, including domiciliary care providers, community nursing services or integrated care teams, including district nursing, community matrons and specialist nursing services, community therapy services such as occupational therapy and physiotherapy, community intermediate care, community rehabilitation or reablement services and community outpatient and diagnostic services.

All services are regulated by CQC to ensure they meet the minimum fundamental standards of care. CQC’s regulatory frameworks refer to national best practice, and CQC expect regulated providers to demonstrate how they meet these, or how alternative methods achieve the same or better outcomes for people using services.