A petition has demanded better recognition and support of the nursing associate role, amid concerns of its misuse by employers and limited career progression opportunities for registrants.
Martyn Davey, a nursing associate at East Quay Medical Centre in Bridgwater, Somerset, launched the petition last week and it has since gathered more than 850 signatures.
“It’s pretty much like a postcode lottery of how nursing associates are used”
Martyn Davey
He was one of the first nursing associates to train in England and has been registered for more than seven years.
“I’ve consistently heard stories of nursing associates being undervalued, misused or even forced out,” he told Nursing Times.
“So, this petition really was to respond to the widespread issues. After years of being regulated professionals, we’ve seen many things happening.”
The nursing associate role was introduced in England in 2017, with the first registrants joining the Nursing and Midwifery Council (NMC) register in 2019.
The band 4 regulated role was designed to bridge the gap between healthcare support workers and registered nurses.
According to the latest NMC data, more than 11,500 nursing associates are now working across health and care in England.
In 2026, Wales will train its first cohort of nursing associates, while Scotland and Northern Ireland are still exploring the idea of introducing the role.
However, concerns persist about how nursing associates are deployed across organisations and the lack of support for those in post.
At a national nursing associate conference, held last month, delegates highlighted ongoing confusion about the role by other professionals and limited opportunities for those in post to develop.
Now, Mr Davey’s petition has called for vital recognition of the nursing associate workforce, including consistent deployment and opportunities for registrants to flourish.
It has highlighted the absence of a national career pathway for nursing associates and a lack of understanding among many employers about the role’s scope.
Despite being regulated professionals, and having undergone training for two years, Mr Davey warned that some nursing associates were being treated like unregistered staff.
He said: “It’s pretty much like a postcode lottery, in that sense, of how nursing associates are used.
“One trust will say that nursing associates are allowed to give out medication and stuff like that, and then others are told they can’t even take blood pressure.”
The petition has also raised concerns about newly qualified nursing associates struggling to find jobs and facing pressure to “top up” their qualification to become registered nurses, regardless of their career aspirations.
“As soon as we qualified in April 2019, I remember [they said], ‘Right, now we get to talk about if you want to become a nurse’,” Mr Davey said.
“I think it’s because there isn’t any career progression. There aren’t any other doors to open up for you to be able to do different things within your role, so you are kind of pigeonholed.”
Mr Davey warned that the NHS was losing hundreds of nursing associates every year due to poor support and misuse of the role.
“We’re just losing brilliant staff,” he said, adding: “We need to be involved, and we do [need to be] part of that team.”
Mr Davey’s podcast, Just a Sharp Scratch, inspired the petition.
Through the podcast, he has explored how similar roles in other countries, such as enrolled nurses in Australia and licensed practical nurses in the US, are utilised effectively within their respective healthcare services.
“They’re being used appropriately, that’s in their scope of practice, but they feel as though they’re actually benefitting and helping the healthcare system,” Mr Davey said.
In England, however, concerns have been raised about nursing associates being used as substitutes for registered nurses to fill workforce gaps, leading to exploitation.
“Many of us raised concerns that nursing associates would be exploited”
Alison Leary
The petition has called on the Department of Health and Social Care, NHS England and healthcare leaders to provide national recognition and clarity to the nursing associate role.
It has advocated for sustainable and clearly defined nursing associate jobs across the NHS and the development of a structured career pathway.
Mr Davey said: “I feel as though the nursing associate role could be better understood and recognised.
“It’s not a criticism against the NHS or the Department of Health – there’s been hurdles in the way and I think we’ve just slipped through the net.
“We need to go back to basics again, look at this with fresh eyes, and get nursing associates involved in creating this kind of programme and a way forward.”
Professor Alison Leary, chair of healthcare and workforce modelling at London Southbank University, told Nursing Times that the petition “very much reflects” feedback she had heard from nursing associates.
“The role is variable in terms of scope and value to employers,” she explained.
“We also hear frequently about the lack of opportunity for progression and lack of support from employers to top up to [registered nursing], with self-funding being the only option.”
Alison Leary
Professor Leary noted that the role was intended to “bridge the gap” between registered nurses and healthcare assistants, but “that gap was never clearly articulated”.
She added: “Many of us raised concerns that nursing associates would be exploited, providing skilled care for lower pay, and indeed that is something that appears to be happening.”
Meanwhile, Su Hickman, registered nursing associate and clinical skills lead at Aria Care, told Nursing Times that she was “proud” that the petition was gathering support.
She said: “I have been vocal since 2019 about how poorly nursing associates are treated and the lack of progression.
“Also, it’s time the nursing associate is recognised as essential in the private sector not just NHS.”
A Department of Health and Social Care spokesperson acknowledged the importance of nursing associates, stating that they “help free up registered nurses to focus on more complex clinical care”.
“They will not replace registered nurses, and it is important that nursing associates are correctly recognised for the vital work they do,” the spokesperson said.
“The NHS has faced chronic workforce shortages for years.
“Bringing in the necessary staff will take time, but we are committed to delivering the biggest expansion of NHS staff in history, including hiring more nurses, as part of our Plan for Change.”
NHS England was contacted for comment.
More on nursing associates
