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What is the role of a nursing associate in mental health?

Acceptance of the role is driven by the reality of nursing shortages

Increased acceptance of the role in mental healthcare has been driven primarily by the pressing reality of nursing shortages

It is now five years since the nursing associate (NA) role was first proposed in England. The plan was for NAs to be trained with generic healthcare skills through a two-year course and the role to bridge the gap between care assistants and registered nurses in the workforce.

Nursing associate role to complement registered nursing roles

This development created considerable anxiety in the nursing profession initially. These fears were somewhat reduced by the Nursing and Midwifery Council taking on the role of NA regulation and chief nurses carefully framing the NA role as part of the ‘nursing family’, complementing, as opposed to replacing registered

Increased acceptance of the role in mental healthcare has been driven primarily by the pressing reality of nursing shortages

Picture: iStock

It is now five years since the nursing associate (NA) role was first proposed in England. The plan was for NAs to be trained with generic healthcare skills through a two-year course and the role to bridge the gap between care assistants and registered nurses in the workforce.

Nursing associate role to complement registered nursing roles

This development created considerable anxiety in the nursing profession initially. These fears were somewhat reduced by the Nursing and Midwifery Council taking on the role of NA regulation and chief nurses carefully framing the NA role as part of the ‘nursing family’, complementing, as opposed to replacing registered nursing roles.

In mental health services acceptance of the role has also been driven by the persistent and pressing reality of nursing shortages and recognition that the NHS is unlikely to be able to recruit the number of registered nurses needed for expanding services any time soon, despite optimistic central projections.

NAs are now increasingly entering the mental health workforce in England – the other UK countries have their own training options – with NHS Digital figures for March 2021 showing 260 employed, mostly in inpatient settings, and 700 more moving along the training pipeline. Decisions are now having to be made as to where and how NAs will work in nursing and multidisciplinary teams.

How nursing associates might be able to work in mental health services

Many NAs were formerly respected and valued support workers and will bring a wealth of experience with them. But, due to the newness of the role, there is – as yet – no evidence about the best way to use NAs in mental health services.

Some limited evidence suggests that approaches to NA employment vary between NHS trusts, with some reporting NAs in qualified staff numbers, others replacing support worker roles with NAs, and with some associates employed as additional newly funded staff.

Such variation provides a valuable opportunity to test different models and places an onus on NHS trusts and research funders to support evaluation processes.


Find out more

NHS Digital (2021) NHS Workforce Statistics March 2021 Staff Group, Care Setting and Level


Neil Brimblecombe @NeilBrimblecom1 is professor of mental health at London South Bank University, and consultant editor of Mental Health Practice

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