Aims. This paper reports on part of a larger study and outlines Registered Nurses' and Midwives' perceptions of, and satisfaction with, trained health care assistants in a regional hospital setting in the Republic of Ireland. Background. An increased reliance upon health care assistants in the clinical setting has highlighted the need to consider how staff and patients perceive the health care assistant role. Findings. Nurses were satisfied with the work undertaken by trained health care assistants and considered that they contributed positively to patient care and supported nurses/midwives by undertaking non-professional duties. However, maternity clients reported that health care assistants were mostly giving direct care, and their availability was perceived to be better than that of qualified staff. Some nurses/midwives were reluctant to assume responsibility for delegation of direct care duties to health care assistants. Conclusion. The employment of health care assistants yields positive outcomes for staff and female clients but consideration must be given to role clarity. Further research into how qualified staff perceive health care assistants is important as such perceptions influence delegation, integration, role development and acceptance of health care assistants.