This narrative review aims to discuss the development of the role of the Healthcare Assistant (HCAs) in acute and community settings, with particular reference to their expanding responsibilities. It also examines the existing perceptions of qualified nurses, patients and HCAs about their own roles. The purpose of this review — which is part one of two articles — was to provide a theoretical framework for a subsequent research study that examines the expanding responsibilities of HCAs in relation to the delivery of wound care in a hospice setting (part two of this article).