Examining the introduction of the Nursing Associate role in health and social care
About this study
In 2015 the government announced the creation of a new nursing associate role designed to help bridge the gap between health and care assistants and registered nurses. It is a stand-alone role that is designed to provide a progression route into graduate level nursing. Nursing associates work with people of all ages and in a variety of settings in health and social care. It is hoped that nursing associates will free up registered nurses to focus on more complex clinical care and help with some of the workforce recruitment and retention problems in health and social care.
We are examining the introduction of the nursing associate role and the extent to which it has achieved the policy aims of providing a new route into nursing and of reducing the skills gap between health and care assistants and registered nurses.
The study was introduced on the Unit blog: 25 June 2019.
Funding
This research is funded by the National Institute for Health Research (NIHR) Policy Research Programme, through the Policy Research Unit in Health and Social Care Workforce, PR-PRU-1217-21002. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Methods
This multi-method study is collecting data from nursing associates, directors of nursing and care, senior nurses and care workers, workforce planners, nursing and social care educators and researchers, regulators, policymakers, other stakeholders, patients, service users and carers. The project began with interviews with key informants and experts on the early impact of nursing associates. This was accompanied by an analysis of key policy documents and a literature review. Directors of nursing have been surveyed about their views and experiences, with a second survey to follow and other data collection from social care stakeholders. A series of in-depth case studies were planned across a range of different health and social care organisations spread across England and two were completed prior to the halting of fieldwork due to Covid-19. A second series of interviews is now underway with key informants and experts to investigate how the COVID-19 pandemic and its legacy are likely to impact on the NA programme – or if it has already done so.
Impact
This is an important and high-profile policy development in nursing and engagement with policymakers is informing the study aims and methods. Early discussions with the Cabinet Office are complementing regular communications with the Department of Health and Social Care and Health Education England.
Publications
14 February 2023: Warner, M., Kessler, I., Manthorpe, J., & Stoye, G. (2023) Patterns of Employment amongst Nursing Associates: Evidence from the Electronic Staff Record. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London.
20 April 2022: Kessler, I., Manthorpe, J., Harris, J., Moriarty, J., & Steils, N. (2022) Evaluating the introduction of the Nursing Associate role in social care. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London.
10 November 2021: Kessler, I., Steils, N., Harris, J., Manthorpe, J., and Moriarty, J. (2021) The Development of the Nursing Associate Role: The Postholder Perspective. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London.
27 September 2021: Kessler, I, Harris, J, Manthorpe, J, Moriarty, J and Steils, N (2021) The Introduction and Development of the Nursing Associate Role: Policymaker and Practitioner Perspectives. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London.
21 June 2021: Kessler, I. et al. Challenges to Work Organisation in Health and Social Care: The Introduction of a New Work Role. Presentation to International Labour and Employment Relationship Association (ILERA) Study Group on Public Sector Employment Relations, (virtual) ILERA World-Congress
28 February 2021: Kessler, I., Steils, N., Harris, J., Manthorpe, J., and Moriarty, J. (2021) NHS Trust Survey 2020 on the Nursing Associate Role: Emerging Findings. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London.
Interim Report
Our Interim Report was published on 28 September 2020. It was accompanied by two case-study reports, and was discussed in a blog and a webinar – all available below.
23 November 2020: Webinar on interim findings: Recording (YouTube) | Presentation (pdf)
28 September 2020: Read Ian Kessler's blogpost on our Interim findings (the three reports listed below)
Kessler, I., Steils, N., Samsi, K., Moriarty, J., Harris, J., Bramley, S., & Manthorpe, J. (2020) Evaluating the Introduction of the Nursing Associate Role in Health and Social Care: Interim Report. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London.
Kessler, I., Steils, N., Samsi, K., Moriarty, J., Harris, J., Bramley, S., & Manthorpe, J. (2020) Evaluating the Introduction of the Nursing Associate Role: The Cambridgeshire and Peterborough NHS Foundation Trust Case Study. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London.
Kessler, I., Steils, N., Samsi, K., Moriarty, J., Harris, J., Bramley, S., & Manthorpe, J. (2020) Evaluating the Introduction of the Nursing Associate Role: The Livewell Southwest Case Study. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London.
Conferences
Manthorpe, J. and Moriarty, J. (2022) Nursing associates in adult social care – a bumpy road for implementation, ASCRU PRU Showcase, 5 and 6 April.
Publications
14 February 2023: Warner, M., Kessler, I., Manthorpe, J., & Stoye, G. (2023) Patterns of Employment amongst Nursing Associates: Evidence from the Electronic Staff Record. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London.
20 April 2022: Kessler, I., Manthorpe, J., Harris, J., Moriarty, J., & Steils, N. (2022) Evaluating the introduction of the Nursing Associate role in social care. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London.
10 November 2021: Kessler, I., Steils, N., Harris, J., Manthorpe, J., and Moriarty, J. (2021) The Development of the Nursing Associate Role: The Postholder Perspective. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London.
27 September 2021: Kessler, I, Harris, J, Manthorpe, J, Moriarty, J and Steils, N (2021) The Introduction and Development of the Nursing Associate Role: Policymaker and Practitioner Perspectives. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London.
21 June 2021: Kessler, I. et al. Challenges to Work Organisation in Health and Social Care: The Introduction of a New Work Role. Presentation to International Labour and Employment Relationship Association (ILERA) Study Group on Public Sector Employment Relations, (virtual) ILERA World-Congress
28 February 2021: Kessler, I., Steils, N., Harris, J., Manthorpe, J., and Moriarty, J. (2021) NHS Trust Survey 2020 on the Nursing Associate Role: Emerging Findings. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London.
Interim Report
Our Interim Report was published on 28 September 2020. It was accompanied by two case-study reports, and was discussed in a blog and a webinar – all available below.
23 November 2020: Webinar on interim findings: Recording (YouTube) | Presentation (pdf)
28 September 2020: Read Ian Kessler's blogpost on our Interim findings (the three reports listed below)
Kessler, I., Steils, N., Samsi, K., Moriarty, J., Harris, J., Bramley, S., & Manthorpe, J. (2020) Evaluating the Introduction of the Nursing Associate Role in Health and Social Care: Interim Report. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London.
Kessler, I., Steils, N., Samsi, K., Moriarty, J., Harris, J., Bramley, S., & Manthorpe, J. (2020) Evaluating the Introduction of the Nursing Associate Role: The Cambridgeshire and Peterborough NHS Foundation Trust Case Study. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London.
Kessler, I., Steils, N., Samsi, K., Moriarty, J., Harris, J., Bramley, S., & Manthorpe, J. (2020) Evaluating the Introduction of the Nursing Associate Role: The Livewell Southwest Case Study. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London.
Conferences
Manthorpe, J. and Moriarty, J. (2022) Nursing associates in adult social care – a bumpy road for implementation, ASCRU PRU Showcase, 5 and 6 April.

Principal Investigators
Ian Kessler
Professor of Public Policy and Management
Jo Moriarty
Senior Research Fellow