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Proud of nursing associates: who they are and why they are important

Updated Tuesday, 27 February 2024

What is the role of the nursing associate in England and what positive impact can they have on the health and social care teams they work in? Gemma Ryan-Blackwell explains.

This content is associated with The Open University's Nursing and Healthcare courses and qualifications.

Who are nursing associates?

Firstly, and most importantly, nursing associates (NAs) should not be viewed as a ‘cheap nurse’ – they bring essential knowledge and skills to a healthcare team. When valued and deployed effectively, they facilitate high quality patient care. 

The nursing associate (NA) role was proposed in England in 2015 following the Shape of Caring review (Health Education England, HEE, 2017) and is regulated by the Nursing and Midwifery Council (NMC). Professional regulators ensure that their registrants are fit to practise in their profession. Unlike non-registrants, such as healthcare support workers, registrants are accountable to the NMC which means they need to be able to account for their actions or omissions and abide by a professional code of conduct (NMC, 2018) to ensure the quality and safety of patient care.

The nursing associate role sought to ‘bridge the gap’ between the registered nurse and healthcare assistant in the healthcare team (HEE, 2017; NMC, 2022). Nursing associates contribute to most of the care for patients under the supervision of a registered nurse, but they do not complete all tasks that a registered nurse would. It is known that the nursing associate role is being utilised in many different healthcare environments (e.g., GP practices, inpatient settings, intensive care, prisons, private nursing homes, social care and in the community) and that employers have differing policies about what the nursing associate is able to do in practice. However, NAs are usually involved in the essential patient facing care, taking a more generic psychological, social and biological approach rather than a specialist, field specific approach to patient care that registered nurses would in their role. The difference between a nursing associate and registered nurse is summarised in the table. Essentially, the registered nurse will lead/co-ordinate and the NA delivers/implements

Table 1 The similarities and differences between the nursing associate and registered nurse (West, 2019) 

Nursing associate Registered nurse
Be an accountable professional  Be an accountable professional 
Promote health and prevent ill health  Promote health and prevent ill health 
Provide and monitor care  Provide and evaluate care 
Work in teams Lead and manage nursing care and work in teams 
Improve safety and quality of care  Improve safety and quality of care 
Contribute to integrated care  Co-ordinating care 
Assessing needs and planning care (e.g., initial assessments and writing initial care plans) 

Why do we need nursing associates?

We know that there are a range of challenges for trainee nursing associates (TNAs) and NAs working in practice and the role is relatively new. Research shows that NAs have a significant and important part to play in healthcare teams but rarely is this widely noted (Thurgate & Griggs, 2023). It is our ethos at the Open University that everyone should be encouraging, empowering, enabling and ennobling the NA role to all stakeholders, including the public. 

Nurse holding hands with a patient.

We believe it’s important for our NAs to recognise the strengths of their role, not solely for the purposes of professional identity but so that everyone can ennoble the role and be confident in their worth as a professional in their own right.

The research report from Ryan-Blackwell & Genders (2023) (PDF document536.5 KB) , explored the strengths, opportunities, weaknesses and threats (SWOT) to NA role using semi-structured interviews and focus groups. Pages 10-12 outline the challenges and opportunities of the role and provides some information about what The Open University can do to help improve their curriculum and also what different people (e.g., learners, employers) can do to promote the role positively on p15-19. Table 1 below outlines the NA role and the positive impact they have on healthcare teams.

Table 2 What is the nursing associate role?

What is a nursing associate? 

A nursing associate is a registered professional who has the knowledge, skills and experience gained from training in practice. They are accountable to the nursing and midwifery council. The role is not specialist like a registered nurse would be. 

They engage in direct patient care to enable nurses to focus on specialist/more complex components of care and allow healthcare assistants to focus on day-to-day tasks. NAs are patient facing and this allows them to know their patients well. Unlike many healthcare assistants, NAs are highly trained and knowledgeable with understanding of theory such as body systems and processes and the evidence that underpins practice. This makes them an accountable professional, being able to justify their actions/omissions. It also allows them to understand ‘why’ things happen the way they do e.g., what changes in the body if someone has diabetes, not simply knowing that the patient has diabetes. They deliver the essential components of hands-on nursing care.

What examples do you have (either from the research report or your own practice) where the NA role has enhanced the healthcare team? 

Generic training allows NAs to care for patients from a biological, psychological and social perspective. 

They facilitate productive and efficient care e.g., caring for patients who may be low-medium dependency while registered nurses focus on higher dependency patients, requiring more specialist knowledge and extended skills.

Why is the NA role positive for the healthcare team?

NAs have high level knowledge and skills and operate with the best evidence available. They take a holistic approach to patient care, seeing the whole person and spend more time with patients so that they understand their care needs implicitly.


This article has provided you with information about the very important NA role in health and social care. You should be able to explain the strengths and opportunities of the NA role and if you read the full research report from Ryan-Blackwell & Genders (2023) you will also note the very significant challenges they face in practice and how people and organisations could help to promote the importance and positive nature of the role for patient care. 


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Health Education England, 2017. Raising the Bar Shape of Caring: A Review of the Future Education and Training of Registered Nurses and Care Assistants. London

NMC (2022) We regulate nursing associates. Online: (Accessed 7 October 2022)

NMC (2018) The Code. Online: (Accessed 8 November 2023)

Ryan-Blackwell, G. & Genders, N. (2023) Using the OU foundation degree curriculum to support trainee nursing associates to develop professional identity. ‘A framework to effectively promote professional identity in nursing associates: a realist ethnographic study’. Open University, UK.

Thurgate, C., & Griggs, C. (2023) Nursing associates 6 years on: a review of the literature. Journal of Clinical Nursing. 32, 6028-6036 


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