Careers resource for the clinical support workforce

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Welcome to this resource which aims to help you to understand the development and career opportunities available for support workers across health and care. 

Support workers are a vital part of the multi professional team. Whether you would like to develop your knowledge and skills within a different setting or undertake a formal qualification to take on a role such as nursing associate, associate practitioner or registered nurse, there are many different opportunities to enable you to provide safe, compassionate care to people.

This section continues to be developed to recognise these different career routes and therefore please come back to visit it regularly as we add more personas.

Moving up



Name: Dave

Job title: Nursing support worker 

Setting: Mental Health Inpatient Ward

Dave has been a nursing support worker working on various wards in a Mental Health NHS Trust for 6 years. He has been keen to develop his knowledge and skills and has spoken to the Ward Manager and the Practice Development team about this. He has attended in-house study days but has not had the opportunity to develop his skills more formally.  

Goals and Needs: He would like to develop his knowledge and skills to be able to better support service users and the nursing team. He feels he has a lot more to offer and has considered training to be a Nurse in the past.

How do you make this change

A nursing associate is a member of the nursing team who is trained to work with people of all ages and across all four fields of nursing: adult, children, mental health, and learning disability.

The role is regulated by the Nursing and Midwifery Council and therefore there are set education and practice standards which must be achieved to become a Nursing Associate. 

To become a Nursing Associate you will need to undergo a 2-year apprenticeship programme, during which time you will be employed as a trainee Nursing Associate. Some universities will also offer this programme as a direct entry programme.

What do you need to do to become a Nursing Associate

Having some experience in a health care role, such as care assistant is essential for most employers, although not all.

The Care Certificate is a set of 15 standards that sets out the knowledge, skills and behaviours expected if you are 'new to care'. It is ideal if you have completed this certificate before applying for a trainee Nursing Associate role. 

The admissions criteria for acceptance onto the Nursing Associate programme includes evidence of level 2 Maths and English skills. Evidence of a GCSE result at grade C (4) for Maths and English would be sufficient. If you do not have this, then you will be asked to sit a numeracy and literacy assessment as part of the recruitment process. Preparing for this assessment is recommended; your employer may provide support to help you with this. Most education providers will request that you then achieve a level 2 literacy and numeracy qualification before you start the programme.

For those coming from overseas, a successfully completed language test such as an International English Language Testing System (IELTS) achieving a minimum overall level of 7 (from 5 December 2018, although, a minimum overall level of 7 is required, a level 6.5 in writing will be accepted alongside a level 7 in reading, listening and speaking), or the Occupational English Test (OET) at level B. 

You need to be able to demonstrate the values and behaviours of the NHS Constitution. 

Education and training

The Nursing Associate programme is currently an apprenticeship, which means that you will be supported to undertake this by a healthcare employer. The programme is 2 years in length, which includes work-based learning, placements across different settings and a formal academic programme in an approved education institution.

Some universities will also offer this programme as a direct entry programme.

Personal characteristics

  • Ability to adapt to changing settings and situations
  • A strong work ethic
  • Compassion
  • Attention to detail
  • Quick thinking 
  • Strong communication skills
  • Technology savvy

Where can I find out more

Where the role can lead

While many people wish to continue working in the role, some may wish to progress to be a Registered Nurse. 


Priti - GP nurse

Name: Davina

Job title: Community support worker

Setting: In the community

Davina is a community support worker who has been a nursing support worker for 18 years. She fell into a care support role when she was very young and has done a number of roles in hospital and community settings. She started working in care homes and then moved to the local NHS Trust.  She worked for two years on the orthopaedics ward before moving to endoscopy as a senior technician/HCA. She never wanted to be a registered nurse (RN) so looking at the different roles available she has decided to become an become an Assistant Practitioner (AP) as she is keen to develop her skills.

Goals and Needs: Davina feels she has a wealth of experience and expertise and a very good knowledge base to build on, She enjoys responsibility and knows that in the community setting she will have an opportunity to work more independently, albeit with registered nurses. Davina likes working in a team.

What is an assistant practitioner

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

Assistant practitioners are a highly valued and skilled support role that 'bridges the gap' in many different specialties and may work in a nursing OR a therapy role.

All assistant practitioners work within defined local policies and parameters and are accountable for their practice, to their employer, patients and the law.

How do you make this change

Taking on opportunities to develop and courses to undertake. For example NVQ level 3 in Health, NVQ Assessor award; level 3 PTLLS teaching qualification (Preparing to Teach in the Lifelong Learning Sector). Any CPD that enhances the role and builds knowledge and understanding.

What do you need to do to become an assistant practitioner

Speak to other assistant practitioners and to your line manager about development opportunities. Don’t be frightened to ask employers to support further training and education as it benefits the patients.

Education and training

Maths and English at either GCSE grade C and above or at Level 2 and a minimum of NVQ Level 3 in a health related subject to be accepted on to practice.

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.

Personal characteristics

Empathy, patience, understanding, strength to commit to studying and working fulltime and passion for the role and patient care.

Where the role can lead

Assistant practitioners may be able to use their previous academic and experiential learning (a process called APEL) from any of the above level 5 academic qualifications in to the 2nd year of a Registered Nurse BSc programme,

In practice progression can be in roles in education, governance, research or different clinical areas.

Change care setting


Geeta - Cancer care specialist nurse

Name: Kaitia

Job title: Nursing Support Worker

Setting: In a hospital

Kaitia is a Nursing Support Worker in the Oncology department at her local hospital. She has been working as a NSW for a number of years in different departments. She has experienced caring for a relative with cancer and found the experience very harrowing. It has prompted her to think carefully about what she wants from work. She saw the way services worked for her relative and felt it could improve. She read about the role of care navigator and feels this would be an interesting role and a role that would help patients and their relatives.

Goals and Needs: Kaitia recognises the benefits of working in a team. She enjoys being part of a multi-professional team and feels she is a good team player.  She would like a role that she and other people regard as valuable. She doesn’t want to train to be in another role or be a Registered Nurse.

What is a cancer navigator

The role varies depending on who employs them but here are a few things a care navigator does to make the difference in the experience of care that patients received:

  • Explaining and demystifying the jargon to patients
  • Making sure that care and support is appropriate
  • Personalised advice can save time and anxiety
  • Ensuring the right care is being accessed. This includes for someone who is due to be discharged from hospital or living at home and just needs a little support and advice.
  • Help to plan ahead and use help to stay as independent as possible.  Not wanting or needing care just now but would like to know what services there are available to help you stay at home and independent for as long as possible.
  • Following the loss of a love one. It can come as a shock to family following a bereavement just how much the person who has passed was doing for their partner or spouse and it is clear that some help needs to be put into place.

How do you make this change

There are many ways you can get experience of working within a particular team focusing and the best way would be to talk to the Clinical Nurse Specialist (CNS) team and shadow them in their role for valuable work experience.   Find out if there is a Care Navigator in post and speak to them about their role and arrange time to shadow them.  Care Navigators are a really friendly bunch who are only too willing to share their knowledge and experience.

Gain an understanding of the role of the CNS as Care Navigators work very closely with them and it is useful to know how you to best support them.  Identify any transferable skills you can bring to the role. Take a look at the Macmillan websites which has some valuable information on different cancer types.

What do you need to do to become a Care Navigator

Seek courses or modules that cover the essential knowledge and skills to work as a Care Navigator such as The Association of Medical Secretaries, Practice Managers, Administrators and Receptionists (AMSPAR) Introduction to Medical Terminology and/or Health Service Administration.  Once in post, Macmillan offer some excellent courses such as Advanced Communication courses and the Recovery Package and Motivational Interviewing.

Education and training

  • The Care Certificate
  • RCN Introduction to leadership programme
  • GCSE A-C grade in English or equivalent
  • RSA III is helpful as is AMSPAR or equivalent secretarial experience and ECDL or proven equivalent experience in MS Package, email and Internet browsers

Personal characteristics

  • Excellent written and verbal communication skills combined with an effective and courteous telephone manner
  • Able to demonstrate tact and diplomacy
  • Ability to contribute to team and be a part of the MDT (multi-disciplinary team)
  • Ability to deal with people who are distressed but work within own scope of practice.
  • Able to negotiate with other teams to ensure an effective journey for patients throughout the organisation.
  • Analytical skills & problem solving skills.
  • Ability to work under pressure and exercise judgement when dealing with inquiries.
  • Flexible and adaptable to the changing needs of the service.
  • Ability to work without supervision and use own initiative.
  • Ability to concentrate even with frequent interruptions and unpredictable working pattern
  • Effective in managing own time
  • Ability to prioritise; to be organised and flexible.
  • Able to effectively accommodate adhoc demands to existing workload
  • Neat, tidy and able to portray a professional image

Where the role can lead

A nursing career or possibly operational management or an education role.


Name: Agnieszka

Job title: Assistant Practitioner (AP) and Health Care Support Workers (HCSW) training lead

Setting: in the general practice setting

Agnieszka is a part time assistant practitioner (AP) in general practice. She is also the Health Care Support Workers (HCSW) training lead a group of GP Practices and delivers the regional Health Care Assistant course which incorporates the Care Certificate. The STEP programme is a blended learning programme, which is a combination of learning at a distance and in a classroom. Students have a timetable where they will attend workshops and for the remaining learning requirements, can complete the e-learning outcomes within the agreed time span.

Goals and Needs: Agnieszka feels she has a wealth of experience and expertise and a very good knowledge base to build on. She enjoys responsibility and knows that in the general practice setting and in her teaching role she can work more independently. She likes working in a team. 

What is an AP teacher

The main responsibilities for an AP or HCSW in a teaching role are to ensure that healthcare assistants achieve outstanding progress throughout the course. This is accomplished by careful planning, teaching and class management. They will be involved in the designing and delivering of teaching materials and use of appropriate teaching and assessment methods. They are also responsible for making sure that teaching plans are regularly reviewed and refreshed.

The teaching consists of independent learning and taught workshop sessions that are devised to challenge thinking, foster debate and develop the ability of students to engage in critical discussion and rationale thinking and of course, to be fun!

Teachers need to be aware of and make provision for HCAs who have different learning styles and needs. All students need support as and when needed via face to face meeting, telephone or emails. Throughout the course students will undertake workplace activities and competencies which need to be signed off by their workplace mentor. They will liaise with the mentors to ensure understanding of their responsibilities.

Teachers contribute to setting assignments, marking all activities and ensuring all students are given feedback every step of the way. Once the portfolios have been completed, they will check that the student has achieved the learning outcomes, aims and objectives of the course and award before the portfolios are submitted for internal and external verification. During this period, teachers will liaise with examination bodies to arrange inspection dates, and once the students have their achievement confirmed by the awarding body it is their responsibility to ensure the certificates are sent to the students.

How do you make this change

To move into this role, you could make contact with the local Human Resources (HR) department or your line manager to express an interest. If you do not currently have a teaching post in your setting, then identify where there is a training need that you feel would be an appropriate topic for you to teach. Don’t be afraid to put yourself forward.  Most people interested in teaching and learning come upon this role by chance.

Speak to registered nurse colleagues who lead, for example the Practice Nurse Advisor as they will need the support of an AP or HCSW advisor. Find opportunities to contribute and look for the support and encouragement from colleagues.

You will need a passion for teaching!   

What do you need to do to become an AP teacher

To become an AP teacher, you will need the capability to work independently, be able to multitask and to work under pressure. You will have to prioritise and meet deadlines. You will need the ability to learn quickly and adapt to new structures and procedures.  Passion for innovation and continuous improvement with a willingness to embrace change is essential.

Your ability to develop practical solutions to problems and a commitment to take a hands-on approach is vital. You should be able to demonstrate assertiveness resilience, accountability. and have a good knowledge of tutors’ professional duties and legal responsibilities.

Education and training

For this level of practice, you will certainly need one of the following:

  • a BTEC Higher National Diploma or Higher Education Diploma
  • a foundation degree (SCQF Level 8)   

It is also useful to have or be prepared to undertake one of the following:

  • a nationally recognised award in Education and training
  • NVQ level 3 Assessor award
  • level 3 Award in Education and Training

Several organisations you may do some teaching for run Train the Trainer courses that help to familiarise you with the programme you will be delivering. It is very important to understand the fundamentals of training and develop knowledge of the key concepts in practical training. Successfully completing one of these qualifications will provide a fundamental understanding of the roles and responsibilities of a teacher/trainer in relation to legislation, equality, diversity, inclusivity and meeting the needs of learners.

Also being able to structure learning, plan and deliver sessions, using appropriate resources and teaching methods. You should also be able to identify the characteristics of effective assessment and feedback. 

Personal characteristics

You will need some essential personal skills to become an AP or HCSW teacher/trainer. You must have a passion for learning and teaching and strive for high quality safe and effective patient care.  You should be enthusiastic about the course you are teaching and encourage students to share the same passion.

Leadership is important. A good teacher leads by example and has the ability to lead and guide the students and manage a number of personalities as well as being sensitive to different points of views.

You will need exceptional organisational skills and must have remarkable communication abilities and a good sense of humour too!

Where can I find out more

Start by researching what happens with HCA teaching provision in your setting. Contact your HR department and ask about possible opportunities and express an interest that you would like to develop your career as a teacher. Ask other teachers for their help and advice and see if they can sign post you in the right direction. Be prepared-find out where you can access a train the trainer course.

Where the role can lead

Further develop your teaching role by undertaking a level 4 award in the Internal Quality Assurance of Assessment processes and Practice.

This award provides the knowledge and skills to effectively quality assure vocational based qualifications. It means that as the teaching team grows, the principles and practices of internal quality assurance techniques and criteria for the monitoring the quality of assessment of other teachers in our team are enhanced.



Diego - Mental health nurse Name: Cammile

Job title: Nursing Support Worker

Setting: In a hospital

Cammile is a nursing support worker on a colorectal ward of the local university hospital trust. He started this work to get an idea of working in the NHS and see what he would like to do in terms of his career.

Goals and Needs: Cammile likes to be organised. He is interested in why diseases happen and the best ways of treating them as well as preventing them. He is really keen to work in an environment where he has time to read and act on what is good practice.

What is a research practitioner

A Research Practitioner is a highly skilled individual who works in Clinical Research Delivery in a patient facing setting. This individual will undertake a number of roles to facilitate Clinical research including but not limited to recruitment of study participants, patient observations, venepuncture, data capture as well as liaising with external stakeholders to deliver Clinical Research both safely and effectively.

Currently, it is an unregistered role however, the National Institute of Health Research and Academy for Healthcare Science are collaborating for Clinical Research Practitioners to be a professionally accredited role.

How do you make this change

Email the local Research team at the trust and ask for an insight day. Speak with your line manager and ask for support to do this. Speak to Research staff who come into the ward  area. Don’t be afraid to ask questions.

What do you need to do to become a research practitioner


  • Camille worked as a Health Care Assistant (Band 2) for 10 months in a colorectal ward in Nottingham University Hospitals to get an insight in working in the NHS.
  • Currently a Research Practitioner (Band 4) in Oncology. Has been in the role for 2 years.
  • Camille is a member of the Research Practitioners forum/network in Nottingham, working in collaboration with National Institute for Health Research looking to get an accredited qualification for Research Practitioners. This involves meeting every other month, mapping skills and competencies to be standardised.

Education and training

  • Good level of education is required although diploma/degree isn’t always necessary.
  • Most of the training is done on the job, such as Good Clinical Practice and Informed Consent.
  • It does help if you have some basic lab experience although training be done on the job for this.

The following once in role:

  • Informed consent training
  • Good Clinical Practice training (1 day training – online/classroom, NIHR run, updated every 2 years)
  • Future Learn Course (online) on Improving Health Care through Research
  • Multi-professional education meetings in oncology – learning about different treatments, clinical updates
  • Developing skills in leadership and project management through the Research Practitioner Forum/Network

Personal characteristics

  • Friendly, confident and approachable.
  • In-depth understanding of the research processes (through HE and experience)
  • Good communication skills
  • A range of clinical skills (vital signs, venepuncture & cannulation – can be learned on the job, ECGs – can be learned on the job, depending on the need of service)
  • Keeping in touch with others in the same role. This can involve meetings every other month, mapping skills and competencies to be standardised.
  • You need to have good organisation and time management skills as you will be expected to manage your own workload.
  • You need to be good with computers as you will be have to use a number of different computer systems.

Where the role can lead

This role can lead to higher level posts within Clinical Research. As the accredited registration comes into force, hopefully this will lead to better standardisation and clearer routes for progression.

Page last updated - 15/01/2020