Why you should read this article:

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To refresh your knowledge of the nursing associate role and the reasons why it was introduced

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To recognise the barriers and challenges in implementing the nursing associate role in general practice

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To consider how the nursing associate role could be better supported and more widely accepted in general practice

Background The nursing associate role was introduced to help reduce staff shortages in the NHS by bridging the gap between healthcare assistants and nurses. However, there is evidence that its implementation in general practice has been limited.

Aim To understand why, how and to what extent the nursing associate role has been implemented in general practice and what the barriers and enablers have been.

Method Semi-structured interviews and focus group discussions were conducted with a purposive sample of general practice staff in north east England. Template analysis based on a priori themes drawn from the literature was used to analyse the data.

Findings A total of 17 interviews and three focus group discussions were conducted with 29 GPs, managers, nurses, nursing associates, trainee nursing associates and healthcare assistants from five general practices. The barriers to the implementation of the new role included a lack of clarity about the place and purpose of nursing associates, a mismatch between nursing associate training and practices’ needs, tensions around professional boundaries, and challenges in developing a professional identity.

Conclusion In general practice settings, the role of nursing associate is not yet fulfilling its original purpose and it needs to be better supported, accepted and implemented.