The new Health Education England (HEE) curriculum documents, seen by the Health Service Journal, state that the trainee nursing associate should be able deliver care under the direction of a registered nurse, but “without direct supervision”, by the end of their training programme.

Earlier this year, research into staffing levels at 137 acute NHS trusts between 2009 and 2011 found that those employing more healthcare assistants had an increased risk of patient mortality.

The University of Southampton and King’s College London study showed that the chances of death decreased by seven per cent for every additional bed per healthcare assistant.

Professor Anne Marie Rafferty, an expert in nursing policy at King’s, said the new innovation risked diluting accountability for patient safety.

“It does not appear to be well thought through and is a recipe for confusion within the nursing profession, the public and other professions such as doctors about who is doing what in clinical practice," she said.

The new rules appear to have been drawn up despite the Department of Health not yet having decided which organisation should regulate nursing associates.

Lisa Bayliss-Pratt, director of nursing at HEE, said the body had consulted across the health and education systems before drawing up the new curriculum.