Training and development experiences of nursing associate trainees based in primary care across England: a qualitative study.

BACKGROUND: The nursing associate role was first deployed in England in 2019 to fill a perceived skills gap in the nursing workforce between healthcare assistants and registered nurses and to offer an alternative route into registered nursing. Initially, trainee nursing associates were predominantly based in hospital settings; however, more recently, there has been an increase in trainees based in primary care settings. Early research has focussed on experiences of the role across a range of settings, particularly secondary care; therefore, little is known about the experiences and unique support needs of trainees based in primary care. AIM: To explore the experiences and career development opportunities for trainee nursing associates based in primary care. METHODS: This study used a qualitative exploratory design. Semi-structured interviews were undertaken with 11 trainee nursing associates based in primary care from across England. Data were collected between October and November 2021, transcribed and analysed thematically. FINDINGS: Four key themes relating to primary care trainee experiences of training and development were identified. Firstly, nursing associate training provided a 'valuable opportunity for career progression'. Trainees were frustrated by the 'emphasis on secondary care' in both academic content and placement portfolio requirements. They also experienced 'inconsistency in support' from their managers and assessors and noted a number of 'constraints to their learning opportunities', including the opportunity to progress to become registered nurses. CONCLUSION: This study raises important issues for trainee nursing associates, which may influence the recruitment and retention of the nursing associate workforce in primary care. Educators should consider adjustments to how the curriculum is delivered, including primary care skills and relevant assessments. Employers need to recognise the resource requirements for the programme, in relation to time and support, to avoid undue stress for trainees. Protected learning time should enable trainees to meet the required proficiencies.

Assessing the Effectiveness of Social Indices to Measure the Prevalence of Social Isolation in Neighbourhoods: A Qualitative Sense Check of an Index in a Northern English City.

Tackling the many negative health effects of social isolation has been identified as a policy priority in the UK and consequently many local authorities are developing strategies to ascertain its prevalence through the development of social indices. This paper provides a novel assessment of the emerging approach of developing indices to identify social isolation. It provides an overview of a selection of indices being developed by local authorities across England; considers the validity of such quantitative indices; and explores the extent to which more in-depth qualitative data collected at a neighbourhood level is additionally required. It draws on evidence of a social isolation index for older people created by a northern English local authority, assessing its validity through a qualitative sense check; an innovative approach which has not been attempted elsewhere. The paper contributes important knowledge to the growing literature in this field by further developing understanding around the most effective ways of identifying, measuring, and understanding social isolation at a local level. Our findings indicate that an index, alone, is insufficient to fully capture the multifaceted nature of social isolation as relevant indicators, unique to local spaces, which cannot easily be measured quantitatively, are often excluded. The paper offers a significant and original contribution to the debate for both academics who wish to gain a greater understanding of the role indices can play in identifying those most at risk of social isolation, as well as for policy makers and practitioners who are currently grappling with this challenging concept.