Trainee Nursing Associate Apprenticeships

The Nursing Associate (NA) role is a new role being introduced in England to bridge the gap between registered nurses and health care support workers to deliver hands-on, person-centred care as part of the nursing team. The role is regulated by the Nursing and Midwifery Council (NMC).

Trainee nurse associates can either earn while they learn as part of an apprenticeship programme or apply direct to university. Currently, most nursing associate training programmes are being delivered through the apprenticeship route. However, a growing number of universities are now offering direct entry programmes, for which trainees will need to fund their own study. You can find a list of all approved programmes on the NMC website or visit UCAS to search for self-funded courses open to application.

The role was introduced in response to the Shape of Caring Review (2015), to help build the capacity of the nursing workforce and the delivery of high-quality care. It will be a vital part of the wider health and care team and aims to:

  • support the career progression of healthcare assistants
  • enable nurses to focus on more complex clinical work
  • increase the supply of nurses by providing a progression route into graduate-level nursing.

Employers that have invested in the nursing associate role as part of wider workforce planning and skills mix transformation have seen a number of benefits, including:

  • improved service delivery and patient care
  • improved staff retention through career progression
  • the ability to ‘grow your own’ nursing workforce
  • investing in a tried and tested training programme, accredited by the NMC.

To find out more, please view:

In January 2017, Health Education England (HEE) launched a trainee nursing associate programme, with the first two waves of trainees based at 35 partnerships that delivered a programme of education and training in academic and work-based settings.

2017 test site partnerships

Each partnership was aligned with a Sustainability and Transformation Partnership (STP) footprint and composed of at least one employer and one education provider (Higher Education Institution). Employers included care homes, acute, community and mental health trusts and hospices, and primary care (GPs), representing the variety of settings in which nursing associates will provide care for patients. Two thousand trainee nursing associates joined the programme within waves 1 and 2.

Nursing associate rollout 2018 onwards

Expansion of the role has continued into 2018 (wave 3) and 2019 (wave 4). In 2018 around 5,000 Trainee Nursing Associates were enrolled onto programmes. HEE is committed to a further 7,500 starting the programme by March 2020.


Health Education England (HEE) commissioned an independent evaluation of the first two years of the programme to June 2019, which was published in October 2019. Read the evaluation here.

Traverse has been commissioned by HEE to continue evaluation of the introduction of nursing associates in 2019-20. This has included a ‘deep dive’ into how organisations involved in the programme have deployed nursing associates in different sectors and the benefits and challenges associated with investing in the new role.

Download the Primary care deep dive which summarises findings from an analysis of HEE data and in-depth interviews with employers.

To run a trainee nursing associate apprenticeship programme you will need to:

Funding via the apprenticeship levy

Employers can use the apprenticeship levy to fund a nursing associate apprenticeship programme. The levy is paid by all employers who have an annual pay bill of £3 million or more. The rate is set at 0.5 per cent of the total pay bill and is paid to HMRC through the PAYE process. Those with a pay bill of less than £3 million don’t pay the levy and use different arrangements to pay for apprenticeship training.

Read Nursing Associates and the Apprenticeship Levy: A quick guide.

Find out more about the apprenticeship levy is, and how to use it within the NHS on the NHS Employers website.

For more on introducing a trainee nursing associate programme, please see the NHS Employers nursing associate handbook under ‘Establishing your nursing associate training programme’

Recruitment – entry requirements

As a minimum, trainee nursing associates will need GCSEs grade 9 to 4 (A to C) in Maths and English or Functional Skills Level 2 in Maths and English. They will also need to demonstrate:

  • their ability to study to level 5 foundation degree level
  • the values and behaviours of the NHS Constitution
  • a commitment to completing the Nursing Associate Apprenticeship programme.

Note that some universities may have additional requirements. Aspiring trainees without the relevant Maths and English requirements will be asked to sit a numeracy and literacy assessment as part of the recruitment process. Most education providers will request that trainees then achieve a level 2 literacy and numeracy qualification prior to starting the programme.

Functional skills training and examination is free to any learner who does not hold Maths and/or English GCSE at C or above (or equivalent). If you have employees who need further support with functional skills, you can direct them to your local further education college.

Applicants from non-English speaking countries will also need to have successfully completed a recognised English language test.

For more, please view the Functional skills toolkit produced by HEE London here.

Please direct any potential trainee nursing associates to the nursing associate website for more information on the role.

Newly qualified nursing associates may need time to adjust to the increased responsibility and accountability associated with being registered. You can support them to do this by:

  • promoting the role throughout your organisation
  • creating a formal job description and scope of practice
  • supported medicines administration procedures
  • offering preceptorship programmes.

For more on how to engage nurses and other health and care professionals in the new role, please visit NHS Employers: How do you involve staff in understanding the need for and placement of trainee nursing associates?

A preceptorship is a period of support and guidance for new registrants. HEE developed best practice guidance on preceptorship for nursing associates in 2018.

The wave 2 evaluation of the HEE nursing associate programme found that preceptorship programmes can have several benefits for recently qualified nursing associates. See Introduction of nursing associates – year 2 evaluation report, Traverse, October 2019.

The Nursing and Midwifery Council (NMC) have published the following Standards for Trainee Nursing Associates: