What are the Four Specialisms Within Nursing?

Breeze Academy May 26, 2022
Nurse preparing injection

If you’re a nursing student, or someone wishing to become a nurse, it’s important to know early on that, before you become a qualified registered nurse, you must choose a nursing specialism that will shape the remainder of your studies, and determine your career path.  In this article, we discuss the four nursing specialties, as well as routes to becoming a nurse in the UK, and how nurses can progress throughout their careers. 

So, what are the four specialisms within nursing? Registered nurses in the UK must choose a specialty during their studies, either Adult Nursing, Paediatric Nursing, Mental Health Nursing, or Learning Disability Nursing. This is an important decision that will shape the careers of nursing students. 

Read on to learn more about the different nursing specialties, as well as how to become a nurse in the UK, and progression opportunities for nurses. 

What are the Four Nurse Specialisms?

When you train to become a nurse in the UK, there are four key nursing specialties that you will need to choose from before continuing your learning and progression in the field of nursing. Each specialism offers a wide range of roles, each with plenty of scope for progression (1). 

Adult Nursing

As an adult nurse, you’ll care for adult patients with a wide range of long-term and short-term health concerns. You will be responsible for assessing their needs and appropriately planning their care, as well as evaluating results (1). 

Your aim as an adult nurse is to improve your patient’s quality of life, whatever their situation. As such, you’ll need to build a trusting relationship with your patients, and be able to juggle a heavy workload to get the best results for those in your care (2). 

Paediatric Nursing

As a paediatric nurse, you’ll care for children of all ages, from newborns through to older teenagers. You’ll be treating a wide range of conditions, whilst also providing support for parents and carers. What is important to consider with paediatric nursing is that you’re not just caring for a small adult; children have very different, wide ranging, and specific health needs, and you’ll need to have a good understanding of healthy child development to succeed (1, 3). 

Key skills required in paediatric nursing include strong communication, the ability to interpret child behaviour, and strong observation skills. 

Mental Health Nursing

Mental health nurses deliver specialist care to patients struggling with their mental health, helping them to manage their condition either with medication, or through therapies. Your role as a mental health nurse is to support your patient’s recovery, whilst also helping them to live independent, fulfilling lives. 

As such, you’ll need strong communication skills and a great deal of empathy. You’ll need to build strong, trusting relationships, and be able to offer support to both patients, and their loved ones. You’ll also need to understand the legalities around mental health nursing in order to be able to identify when a patient is at risk of harming themselves, or others (1, 4).

Learning Disability Nursing

Learning disability nurses provide specialist healthcare to help people with a wide range of learning disabilities, helping them to live fulfilling, independent lives, as well as supporting their families and carers. You may end up working in a range of healthcare settings, including patient’s homes, education, residential care centres, and hospitals, and may be required to work long shifts to provide 24-hour care. 

You’ll be responsible for improving or maintaining both physical and mental health as appropriate, reducing barriers to patient’s living independent lives, and supporting them in living a fulfilling life (1, 5).

Bonus: Nursing Associate

A new nursing role within the NHS in England is nursing associate. The role works almost like an apprenticeship, with one day of formal learning per week, and work-based learning for the remaining days. In this role, you’ll have the opportunity to work across all four specialties on your way to becoming a registered nurse (1, 6). 

As a nursing associate, your duties are likely to include:

  • Undertaking clinical tasks
  • Supporting patients and their families
  • Ensuring the privacy, dignity and safety of patients
  • Performing and recording clinical observations
  • Recognising issues relating to safeguarding children and vulnerable adults
  • Discussing and sharing information on patient’s condition and behaviour with registered nurses

How to Become a Nurse in the UK

Those wishing to become a nurse in the UK will need to complete a university degree in nursing, as well as registering with the Nursing and Midwifery Council (NMC) (7).  However, it’s important to note that a traditional three-year, full-time degree is not the only way to become a nurse (although a degree-level qualification is still required). Part time degrees, nursing degree apprenticeships (8), and the nursing associate programme (6) are great alternatives which offer a more flexible route into nursing. 

Learn more about how to become a nurse in the UK in our recent blog

Nursing Progression Opportunities

Upon successful completion of a nursing degree, students will become registered nurses. However, there are several nursing Bands that shape the career progression of nurses.

Band 5 - Newly Qualified Nurses

Newly qualified registered nurses begin their career at Band 5, usually within a hospital setting. Many wards have clear career progression paths in place for newly qualified nurses, as training opportunities are vital for progressing within Band 5, and on to Band 6. 

As of 2020, Band 5 salaries typically start at £24, 907, moving up to £26, 970 within 2-4 years. The very top salary available at Band 5 is £30, 615 (8). 

Band 6 - Nursing Specialist or Senior Nurse

Band 6 nurses are similar in skills and duties to Band 5, but are more specialised. To progress to Band 6, Band 5 nurses must train in a specialist area such as intensive care, paediatrics, or long-term care. Salaries start at £31, 365, rising to £37, 890 for nurses with 7+ years of experience (8). 

Band 7 - Advanced Nurse or Nurse Practitioner

Band 7 nursing roles will usually require a master’s degree or equivalent, however, most NHS trusts tend to be happy to support nursing staff in achieving this. Responsibilities at this level include conducting detailed clinical assessments, making diagnoses, and prescribing medication. Many roles at this level are those that you would typically associate with a doctor.

Salaries at Band 7 start at £38, 890, rising to £44, 503 for those with 7+ years of experience (8). 

Band 8 - Modern Matron or Chief Nurse

Modern matrons or chief nurses are typically heads of nursing. At this level, you’ll still carry out the duties of lower bands, but will also manage a large team. As such, communication and management skills are essential (8).

Salaries for Band 8 nurses begin at £45, 753, rising to £87, 754.

Band 9 - Consultant Level Nurse

Band 9 nurses are the most senior nurses within the NHS, helping to shape high-level decision making, and providing education. Reaching this level will require a career-long dedication to the field of nursing, as well as your own personal development. You’ll also need specialist skills and additional qualifications on top of standard nursing qualifications (8). 

 Roles at this level start at £91, 004, rising to more than £100,000.

CPD for Nurses

A great way for more junior-level nurses to gain the skills and knowledge needed to progress through the different nursing Bands is to complete CPD in specialist areas. Breeze Academy is one of the UK’s leading healthcare CPD providers, offering a number of specialist CPD courses, such as Acupuncture and Dry Needling, Sports Massage Therapy, Clinical Yoga Teacher Training, and Strength and Conditioning Training. 

Take a look online today to see how our nursing CPD courses can help you to continue your professional development, and begin working towards your next Banding. 


  1. NHS - Health Careers - Types of Nursing

  2. NHS - Health Careers - Adult Nurse

  3. NHS - Health Careers - Paediatric Nursing

  4. NHS - Health Careers - Mental Health Nursing

  5. NHS - Health Careers - Learning Disability Nurse

  6. NHS - Health Careers - Nursing Associate

  7. Royal College of Nursing - Become a Nurse

  8. Global Nurse Force - What are the Different Nursing Bands?

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