From healthcare assistant to nurse

A healthcare assistant can become a registered nurse through four main routes: a full-time nursing degree, a registered nurse degree apprenticeship, a step through the nursing associate role, or a secondment where your employer pays you while you study. Only the apprenticeship and the secondment let you keep earning, and both depend on your employer having funded places. Every route ends with registration on the Nursing and Midwifery Council (NMC) register, which is what allows you to work as a nurse.

Where you start and where you end up

Most NHS healthcare assistants in England are on band 2 or band 3. Band 2 is a single point of £25,272 in 2026/27. Band 3 runs from £25,760 to £27,476. A newly registered nurse starts at band 5 on £32,073, rising to £34,592 and then £39,043 at the top of the band. Nursing associates, the halfway role, are band 4, which runs from £28,392 to £31,157.

Those are England figures after the 3.3 per cent award from 1 April 2026. Scotland, Wales and Northern Ireland have their own scales; see nurse pay in the UK for each nation.

Route 1: nursing degree at university

This is the standard route and the one with the most places. You apply through UCAS to an NMC-approved degree in adult, children’s, mental health or learning disability nursing. Entry usually asks for level 3 qualifications, such as A levels, a BTEC or an Access to HE diploma, plus GCSE English and maths or equivalents.

For a working HCA the difficulty is money. A degree is full-time with long placements, so keeping a contracted job alongside it is hard, and many students do bank shifts instead to keep some income and their NHS links. Your HCA experience counts strongly in the application and interview, because you already know what ward work involves.

Route 2: registered nurse degree apprenticeship

Here your employer takes you on (or keeps you on) as an apprentice, pays your salary and funds the degree through the apprenticeship levy. You study with a university part of the time and work the rest, and you pay no tuition fees. Places are usually advertised internally first, and trusts often expect applicants to be existing staff with a good record. Competition is stiff and the course takes longer than full-time study. Our guide to the nursing degree apprenticeship covers entry requirements, pay and how to apply.

Route 3: nursing associate first, then top up

The nursing associate role was created partly as a ladder for HCAs. You train through a foundation degree, usually as an apprentice, and register with the NMC as a nursing associate. You then work at band 4 while you decide whether to go further.

Qualified nursing associates can take a shortened registered nurse course or apprenticeship that recognises their earlier training. That splits the journey into two stages with a pay rise in the middle, which suits people who cannot commit to the whole thing at once. The role itself is described in nursing associate: the bridge between HCA and nurse.

Route 4: secondment and sponsored study

Some trusts second HCAs onto a university degree. You keep your contract and some or all of your salary, and you usually agree to work for the trust for a period after you qualify. Others offer part-funding, flexible rotas around lectures, or a guaranteed job on qualifying. Schemes like these come and go with local budgets, so ask your ward manager, the practice education team or the trust’s learning and development department what is running now. If you are asked to sign an agreement to repay costs if you leave early, read it carefully and ask your union rep to look at it first.

Getting ready while you are still an HCA

Whichever route you aim for, these improve your chances.

• Finish the Care Certificate and any higher-level healthcare support qualification your trust funds, because these show you can study alongside work.
• Sort out maths and English early. If you do not have GCSE grades that universities accept, functional skills courses are often free or cheap through local colleges.
• Ask to shadow registered nurses in tasks you do not normally see, such as medicines rounds, care planning and discharge.
• Keep notes of specific situations you handled, so you have real examples for a personal statement or an apprenticeship interview.

Say you want to train at your appraisal. Managers who know your plans are more likely to put your name forward when an apprenticeship or secondment place appears.

What changes once you register

Qualifying moves you from band 3 or 4 to band 5 and puts your name on the NMC register. You become accountable for your own practice, take on delegation and supervision of support staff, and have to keep your registration current through NMC revalidation. Most trusts also run a preceptorship programme for newly registered nurses, a supported first period with protected learning time and a named preceptor.

NMC registration carries an annual fee. It is on HMRC’s approved list, so you can claim tax relief on professional fees once you are paying it.