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First national evaluation of higher level nursing assistant roles

Posted on 6 June 2011

Researchers from the University of York have carried out the first national evaluation of the impact of introducing higher level nursing assistants into UK acute hospital wards.

A study by the University’s Department of Health Sciences found Assistant Practitioners, who support the work of registered nurses, are viewed as making a valuable contribution to patient care, being ‘visible’ and ‘knowledgeable’ at the patients’ bedside, and providing leadership for other assistants.

However, the study, funded by the National Institute for Health Research Service Delivery and Organisation programme, concluded their skills are not always fully utilised as registered nurses are sometimes reluctant to delegate tasks due to concerns about accountability.

Lead researcher Dr Karen Spilsbury said: “The Assistant Practitioner (AP) role is a significant workforce policy initiative and yet there is no national level evidence of the potential impacts of introducing the role.

“The aim of our study was to understand what impact the introduction of APs into ward-based nursing teams in UK acute hospital wards might be having on the organisation, management and quality of nursing care for patients.”

The study highlights that Assistant Practitioner roles were developed with little national policy guidance and their remit was largely negotiated in practice by key stakeholders rather than being shaped through organisational vision and job descriptions.

Researchers also found a lack of clarity about the Assistant Practitioner role, which meant it often changed depending on ward staffing circumstances. In addition, the study highlights the limited opportunities for development and promotion available to APs.

The research contributes to practice and policy at both national and local level. The findings have informed debates and discussions about the future roles of these higher level assistants and will inform any future consultations about the regulation of the assistant workforce.

Notes to editors:

  • The full report, Evaluation of the development and impact of Assistant Practitioners supporting the work of ward-based registered nurses in Acute NHS (Hospital) Trusts in England: Final report. NIHR Service Delivery and Organisation programme, 2010, is available at
  • The project was funded by the National Institute for Health Research Service Delivery and Organisation programme (project number 08/1619/159).

Contact details

Caron Lett
Press Officer

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