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Become an HCA

Become an HCA, AP or TNA

Health care assistants (HCAs) and assistant practitioners (APs) are a vital part of the nursing team. They can be found working in all sorts of settings, including hospitals, doctors' surgeries and the community.

Our ‘health practitioner’ members work across every healthcare discipline, including the criminal justice system, mental health and learning disability. They work with infants, children and young people and in the care of the older person, supporting registered nurses in the delivery of nursing care.

To carry out your role as an HCA safely, you must be properly trained and supervised, and your employer has a duty to make sure you are appropriately trained and that you are assessed as competent for your role. They must provide an induction for you so that you have the knowledge, skills and understanding to do your role in a compassionate and caring way, wherever you work. Each UK country has its own guidance and standards for induction. Our online learning resource First Steps for HCAs is a perfect supplement to your induction programme and can help you to build on your knowledge and understanding on a range of important issues.

Nursing associates

Nursing associates are a new support role introduced to the health care workforce. They will work alongside health care assistants, assistant practitioners and graduate registered nurses in training for two years, and attend universities and further education colleges part-time.

2,000 trainee nursing associates have begun their training. The NMC have introduced a newsletter for TNA’s. Sign up to receive the Trainee Nursing Associates newsletter.

Find out more about nursing associates.

Become an HCA

There are no specific national requirements for becoming an HCA. You simply need to apply for a job as one. Once you have been accepted, your employer will provide the training you need. You should consider getting work experience before you apply so you'll know what it’s like to work in health care. You may find it helpful to look at First Steps for Health Care Assistants for background information.


Your training will vary depending on where you work. That's because the knowledge and skills needed to work in a GP surgery, for example, are different from those required to work in a residential home or in a mental health setting. Some employers have internal training departments while others use further education colleges or offer apprenticeships, but you must be trained for the role you will perform. Find out more on the NHS Careers website.


A day in the life of an HCA

Maive is a clinical support worker. She works in a neonatal intensive care unit, which cares for babies who are born prematurely or who develop health problems while in hospital following their birth.

Maive’s unit is staffed by a multi-disciplinary team that includes specialist medical staff, neonatal nurses, clinical support workers, physiotherapists, a family care team and a transport team.

Working closely with the family care team, Maive supports the mothers, often with breastfeeding issues. She has been trained in breastfeeding and lactation management and has learnt about the impact prematurity has on babies and families. She also provides families with information to prepare them for discharge.

Maive and her fellow clinical support workers are highly valued by their colleagues. The support they provide helps to prepare parents to take their small and vulnerable babies home.


Become an AP

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

As an AP, you may be able to progress onto further education, such as secondment onto a pre-registration programme, with support from your employer.


One of the most popular ways to become an AP is to complete a foundation degree (or equivalent) in health care, which involves a combination of study and supervised practice. If you are working as an HCA, your employer may support you through a foundation degree. Make sure you find out from your employer if there are AP posts available before you train for the role.

A day in the life of an AP is varied and depends on the field you’re employed in. You can find out more about becoming an AP on the NHS Careers website.


A day in the life of an AP

Lorraine is an AP in a GP surgery in Kent. She started off as a receptionist and then became an HCA. After about five years, she started her foundation degree in health and social care. After completing it, she became an AP.

The surgery team consists of five GPs, three specialist practice nurses and one HCA. Lorraine’s role is varied. She performs spirometry, Doppler testing, ear irrigation, influenza vaccinations and B12 injections, as well as more routine general tasks in the surgery. She provides administration and support for hypertension clinics and works closely with the lead GP on child protection issues.

Lorraine’s work is delegated by registered professionals and she works within the practice protocols. But she has a certain degree of autonomy. For example, she has set up a weight management clinic, writing the protocol and designing a leaflet for patients.

Standards and regulation

First Steps

First Steps is the RCN’s most popular free e-learning tool for health care assistants. It’s a perfect resource to dip in and out of, whether you’re new to the post or looking to refresh your knowledge and skills.

Get started

other routes into nursing

Finding a job

Health care assistants are a vital part of the nursing team

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