This article the fifth in a series of seven, describes the measures taken by one health board in Scotland to enhance nursing and midwifery leadership. In NHS Lanarkshire, the Leading Better Care Programme was implemented locally by engaging all members of the nursing and midwifery teams, including healthcare support workers (HCSWs). This article discusses how NHS Lanarkshire is developing its HCSW workforce in response to recommendations in the Final Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry and other relevant national initiatives. HCSWs provide vital care to patients, but are unregulated and, at present, there are no UK-wide agreed standards for training and development. The article includes an overview of a scoping exercise to identify training and development undertaken by HCSWs.