BACKGROUND Health care provision has moved towards an approach to patient care that challenges the traditional role boundaries of health care workers. In nursing this has resulted in the delegation of 'nursing care' to health care assistants (HCAs). This study sought to evaluate the impact of a HCA Development Programme on care delivery. Secondly, it sought to understand the preparedness of HCAs to undertake the programme and the new roles set for them. METHODS The research method was a qualitative, inductive approach. For part one, data were gathered using a 360-degree approach. Semi-structured interviews were conducted with four HCAs, eight of each of their colleagues and four patients. For part two, 12 HCAs were interviewed. Data were analysed following the principles of thematic analysis. RESULTS The findings for part one showed positive changes to the HCAs' role, which included skill and knowledge development, increased confidence and initiative and a more holistic approach to care. A range of personal and contextual factors including relationships, hierarchy, staffing, experience, responsibility, patient dependency, attitudes and values affected the development of their role. The HCAs in part two voiced positive and negative views of their role development. Of the 12 HCAs interviewed, eight were prepared to attend the programme, two were undecided, and two were reluctant to attend. CONCLUSIONS The findings indicated that while the HCA Development Programme positively influenced the role of the HCA, there was a need to invest more into preparation for the restructuring of roles.