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Become a nursing associate header

Become an Assistant Practitioner

Assistant Practitioners (APs) are a growing part of the health care workforce. Sometimes known as associate practitioners, they take on more responsibilities than health care assistants, under the delegation of registered colleagues in a range of different settings.

With the introduction of the nursing associate role, we wanted to outline the role of the AP and dispel some of the myths and misinformation. This page provides information and guidance to anyone wishing to become an AP or employ an AP. We include links to APs who are happy to share their role.  

Assistant Practitioners:

  • have been in practice since 2002
  • are a highly valued and skilled support role that 'bridges the gap' in many different specialties.
  • follow a nursing or a therapy pathway
  • work within defined local policies and parameters and are accountable for their practice, to their employer, patients and the law.

Education and training

In the past, training for the AP role was via an NVQ or QCF qualification gained through work-based training. Now education and training is through completion of one of the following routes:

  • a BTEC Higher National Diploma or Higher Education Diploma, gained through part-time study
  • a foundation degree (SCQF Level 8), gained through part-time study delivered by Higher Education Institutions or Further Education Colleges   
  • a new level 5 apprenticeship that is being rolled out in England.  

Assistant practitioners maintain a portfolio, complete competencies, written exams, referenced essays and presentations as part of their education and training. 

The role will often be locally developed but there is expected commonality for preparation for the role and as part of their training APs will usually study the following: 

  • values and ethics in healthcare practice enhancing holistic person centred care
  • applied anatomy and physiological principles/clinical research in practice
  • clinical practice skills/managing long-term conditions
  • medication management training (can be either employer or college led
  • mental health across the life span
  • introduction to critical and high dependency care.

Their skills are transferable and many APs move to other specialties and fields of practice once qualified. 

In 2011 a Skills for Health Expert paper exploring the role of APs in the NHS and outlined 6 core standards for APs and summarised that the AP role sits at Level 4 of the Career Framework and is a worker who: 

  • competently delivers health and social care to and for people
  • has a required level of knowledge and skill beyond that of the traditional healthcare assistant or support worker, and
  • is able to deliver elements of health and social care and undertake clinical work in domains that were previously the remit of registered professionals. 

Areas of practice

APs work in wide range of clinical settings UK wide. These include (but are not restricted to):  

  • Trauma, neurology, rehabilitation, blood sciences, critical care, rehabilitation, emergency care, ITU, recovery, endoscopy, renal, pharmacy, clinical imaging, minor injuries, breast screening, cytology, elderly care, community district nursing teams,  Acute, GP and more recently private sector in nursing and residential homes. 

In fact, APs exist in the majority of areas in clinical practice and numbers are continuing to rise.


The AP remit is comprehensive and extended, working under unsupervised guidance from registered practitioners. APs have their own delegated caseloads making clinical decisions, within local policy and defined competence.

They undertake a range of activities which can include: 

  • cannulation/ECG /venepuncture 
  • clinical observations
  • give holistic care personal centred care 
  • escalating emergency and non-emergency care to others
  • admitting/referring and discharging patients 
  • complete full assessments care planning 
  • carry out fundamental and complex care including, personal, social, therapeutic and rehabilitative care
  • extended complex wound care and management Inc. compression / doppler assessment /vac therapy
  • medicine management/administration via different routes 
  • diabetes and hypoglycaemic management and treatment
  • catheter insertions/ management, including bladder washouts
  • bowel care and management  
  • health checks
  • scrub and assist surgical and endoscopic procedures, pre and post-operative care and recovery
  • mentor to other HCAs/Trainee AP and student nurses
  • therapy and mental health assistant practitioners undertake assessments, often recommending and implementing teaching patients, treatment plans for ongoing physical and mental rehabilitation. 

Northern Ireland

There is not a nationally recognised AP role in Northern Ireland. The agreed titles of the support workforce are nursing assistant and senior nursing assistant in health and social care and a variety of titles in the independent sector. 


There are a small number of APs in Scotland. The role is described in detail in the national guide to HCSW role development in Scotland.  


APs are employed, successfully utilised and are well represented in Wales, (Miller et al, 2014). The Developing Excellence in Healthcare Framework in Wales refers to a band 4 AP.

Career opportunities

APs have the opportunity to develop and enhance their knowledge and skills through various CPD opportunities. They may also wish to continue on to completing a BSc (Hons) or BA Degree. They also have the opportunity to progress to a registered nurse and this might be via a shortened programme. Enquire at a local university or The Open University.

A day in the life of an assistant practitioner is varied and depends on the field you’re employed in.

References and further reading