Careers in health care support
Working in the health sector offers a huge variety of interesting, stimulating and often demanding roles. Health care assistants (HCAs) and assistant/associate practitioners (APs) work in almost every setting imaginable and are an integral part of every nursing team.
This section is designed for prospective and current HCAs and APs, employers and nursing colleagues alike. It gives an overview of the roles of HCAs and APs, their education and training, competences, applying for jobs and also signposts to many tools, resources and websites that provide further useful information on this subject.
- Understanding the role of the HCA
- The effectiveness of the role
- How to become an HCA
- How to become an AP
- Becoming a registered nurse or midwife
- Education and training
- Scholarships and awards
- Competences
- Tools
Understanding the role of the HCA
A HCA is defined as 'someone who works under the guidance of a registered health professional’. (Reference: NHS Careers and NHS Education for Scotland HCSW toolkit).
All employees should be given a job description and person specification detailing their role and responsibilities. In addition, an HCA should receive:
- a clear list of appropriate tasks that they will be expected to perform, with training to enable them to undertake the tasks competently
- a clear understanding of the boundaries; the ultimate boundary being the safety of the patient
- agreed protocols for the delivery of care
- clarification of the issues around delegation and accountability
- support and guidance in the role
- the opportunity to develop new roles as service needs allow.
The effectiveness of the role
The effectiveness of the HCA is dependent upon a number of factors, each of which can be optimised to get the most out the role. These factors include the following:
- supervision and mentoring
- access to training and development
- needs of patients/clients (herein called patients)
- HCA competences
- accountability
- defined roles for the HCA,
How to become a HCA
If you are considering applying for a job as an HCA the RCN has some resources that can help you:
- how to become an HCA
- writing a CV (PDF 489KB)
- interview skills (PDF 482KB)
- application forms (PDF 403KB)
The above RCN guides are for HCAs and APs who may be applying for their first job, or moving to a senior position. The RCN is here to help you get that perfect role.
These publications are also available in hardcopy and can be obtained via RCN Direct. Please call 0345 772 6100, select option three and quote the six digit publication code.
Once you have been accepted into an HCA post it is essential that you have induction training. The RCN’s First steps for health care assistants will guide you through the basics and your employer must ensure that you are trained and competent in each task that you will be expected to perform.
How to become an AP
The role of AP in nursing teams is becoming more popular across the UK and many pre-registration nurse training courses accept the foundation degree or equivalent to step into the second year of the course.
For more information on the role please visit:
There are also a number of reports available on the AP which can be found below:
Assistant practitioner scoping project (PDF 198.4 KB): The scoping project reviews up-to-date information relating to the development of APs and maps the current UK wide support workforce. Analysing areas including the numbers of APs in the NHS and independent sectors and the demographics of this workforce; whilst also exploring the career pathways into, and beyond, the role of the AP.
Mapping the introduction of assistant practitioner roles in acute NHS Trusts in England (PDF 574 KB)
HCAs and APs may also wish to move into roles within the allied health professions, and the AP role is well established in these fields. Please visit NHS careers for the further information.
Becoming a registered nurse or midwife
Please visit our careers in nursing page for information on funding, entry requirements and the application process. You can also visit the student community for the latest student news and events.
Education and training
HCAs must be properly supervised until competence has been assessed and achieved. Supervision requires time and effort, but time spent at this stage also allows the supervisor to apply training in a more focused and constructive manner. This enables the HCA to gain competences more rapidly and have them assessed sooner.
Only an HCA that is fully trained and competent can deliver the correct care, and minimise the risk of harm to the patient. Good clinical governance standards require that an HCA working without direct supervision must be assessed as competent to undertake the tasks being completed. Visit our page on accountability and delegation for further information.
Taking a planned approach to identifying the training needs of the HCA will ensure that the HCA is able to make a full contribution to the team.
Training is available in a range of formats so employers will need to consider what is the most appropriate format for their HCA. Information on courses can also be found on the following sites:
- Open University - professional development courses for HCAs working at levels two to four on the career framework. The RCN and the Open University offer a strategic alliance to benefit the learning and development opportunites of HCAs. As an RCN member you will receive 10 per cent discount on specific courses.
- Findfe - an A-Z of further education and sixth form colleges offering apprenticeships and health and social care courses
- UCAS - use the course search finder for universities offering health and social care foundation degrees
- FDF - information on foundation degrees
- NHS Education for Scotland HCSW toolkit - a one stop shop for employers and HCAs
Scholarships and awards
The RCN offers two scholarship schemes for HCAs and APs, the HSA charitable trust award and the Kershaw family bursary. For more information please go to scholarships and awards.
Competences
Skills for Health is the Sector Skills Council. One of its roles is to write the competences for the health care workforce.
Skills for Health describe competences as: "The descriptors of the performance criteria, knowledge and understanding that are required to undertake work activities. They describe what individuals need to do and to know to carry out the activity – regardless of who performs it."
The benefits of using a competence based approach underpinned by national competences such as National Occupational Standards (NOS) are that it:
- creates a common language for describing workforce skills
- ensures a common standard for the delivery of safe patient care
- provides a basis for role profiles and job descriptions so that recruitment can be improved
- provides a basis for education and training
- supports clinical governance
- grows your own skills base to meet your service needs
- develops a clear career framework
- gives the HCA confidence to carry out specific tasks without direct supervision.
Employers can visit Skills for Health fo a range of resources to assist in developing the workforce, from National Occupational Standards, vocational qualifications to help with workforce planning and much more.
NHS Education for Scotland (NES) has a dedicated site for HCAs and their employers. The healthcare support workers toolkit is a one stop shop of current information, resources, ideas, advice on competences, vocational qualifications and induction standards.
From January 2012, the Qualifications and Credit Framework (QCF) provides a range of qualifications suitable for HCAs and APs. Further information on the QCF is available on the following sites:
- Ofqual
- Scottish Credit and Qualification Framework
- Skills for Care
- Skills for Health
- Skills Funding Agency
- Welsh Government
- Northern Ireland Social Care Council
Tools
RCN Learning Zone
The RCN’s learning zone provides a wealth of resources that will enable HCAs and colleagues to keep updated in relevant topics. Visit the learning zone where you can write your CV and keep a record of your ongoing development. In order to access the learning zone you will need to join the RCN. Details on the benefits of membership and how to join can be found here.
RCN e-library
The RCN's library and information services can be a valuable resource whether you are at home, work or studying. There are a range of services that can be accessed online, by telephone, email or post and four libraries across the UK to visit.
You can read online articles from more than 700 e-journals including:
- British journal of health care assistants
- Nursing Standard
- Nursing and residential care
Go to the A-Z list of journals and follow the links to these full text journals.
The e-library also has a growing collection of current e-books, including:
- Chambers C and Ryder E (2009) Compassion and caring in nursing, Abingon: Radcliffe.
- Dingwall L (2010) Personal hygiene care, Chichester: Wiley-Blackwell.
- Peate I (2010) Nursing care and the activities of daily living (2nd edition), Chichester: Blackwell.
Follow the URL links from the catalogue record to view the e-book. Search the library catalogue for more print and e-books on a topic.
The RCN also has a virtual enquiry service which is really easy to use. Visit library services to access the virtual enquiry service and for help in finding useful books and journal articles.

