Advanced Clinical Practitioner

Advanced level practice isn’t a specific role, it includes all practitioners who have progressed to an advanced level through further education and training.

Advance Practice Bulletin - August 2023 (SWAY)

In this bulletin you will find:

Local, Regional and National Updates and much more click here

Advance Practice Bulletin - November 2023 (SWAY)

In this bulletin you will find:

  • Local and National updates

  • Reports and Publications

  • Continuing Professional Development

  • Articles

  • Electronic Resources

To view please click here.

Advanced practitioners work across a range of professional backgrounds and settings including but not limited to nursing, pharmacy, paramedics, other allied health professions, and midwifery. The term advanced practitioner is used as a consensus umbrella term to encompass the wide range of registrants who work in advanced practice roles, often with variable job role titles, for example (though not exclusively): advanced clinical practitioner, advanced nurse practitioner, ‘advanced paramedic practitioner; advanced physiotherapist practitioner; or advanced pharmacist.

It is recognised that the  Advanced Clinical Practitioner (ACP) title is relatively new.  Nurses who have been working at an advanced level for some time, having usually completed an RCN Advanced Nurse Programme or have gone through the RCN Credentialing route, may have a slightly different title, e.g. Advance Nurse Practitioner (ANP) or Advanced Level Nurse Practitioner (ALNP).  Although the term ACP is being used throughout this text, it includes all working with an advanced level qualification, that may have a different job title.

Enhanced and Advanced Practice

The first Advanced Practitioner were nurses.  The Royal College of Nursing, Nurse Practitioner programme started in 1992. Initial development of the nurse practitioner role took place in primary care-based settings, such as general practices and projects working with homeless people.  Although this is still where a lot of nurse practitioners practice, the role is now expanding beyond primary care and registered nurses. 

It is recognised that some nurses have been using the title ‘nurse practitioner’ or ‘advanced nurse practitioner’, without undertaking the appropriate level of further education to develop the knowledge and competence that are necessary to work safely, efficiently, and effectively, at this advanced level of practice. Back in 2007, the Nursing and Midwifery Council talked about regulating advanced nurse practitioners to enhance public protection, and current ‘modernising nursing careers’ discussions (DH, 2006, NMC, 2007).  Yet, the role is still not regulated.  Health Education England (HEE) are currently working with professional bodies and other stakeholders to develop a collaborative approach to standardize advanced practitioners.  For information about this work please see: Welcome - Advanced Practice (hee.nhs.uk)

This is a transition period of standardisation of the ACP role, it is important that existing nurses working at advanced level, are not forgotten as they are a very valuable member of the workforce.  If you didn’t complete your Advanced Clinical Practice at Masters Level, you may want to consider submitting an ePortfolio.  See: ePortfolio (supported) Route - Advanced Practice (hee.nhs.uk)

Advanced Clinical Practitioner (ACP) Scope of Practice

Definition

Your scope of practice is the limit of your knowledge, skills and experience and is made up of the activities you carry out within your professional role.  As a registered health care professional, you must keep within your scope of practice, always ensuring you are practicing safely, lawfully, and effectively.

Advanced Clinical Practice

When working in Advanced Clinical Practice (ACP), your scope of practice is personal to you and your profession.  Some aspects of advanced practice are within scope (such as prescribing) and some are not (such as regional nerve blocks) but are within the individual’s scope or capability. Registered professionals can develop skills outside the scope of their primary registration to meet clinical service needs in the NHS.  These advanced skills need to be recorded and evidenced in the individuals’ scope of practice and agreed with their employer.  Clinical Supervision needs to be in place to support the monitoring/clinical governance of advanced practice, recorded in your scope of practice.   

Defining your scope of advanced clinical practice

There is a not a set list of tasks that ACPs can and cannot perform, this will vary from registrant to registrant.

Your scope of practice will develop with you and may become narrower in scope, depending on the area you are working in as an ACP.

When deciding whether a particular activity falls within your scope of practice, or when moving into a new scope of practice, you will need to consider whether the training and support you’ve received adequately equips you to perform the activity safely and effectively.

When thinking about your scope of practice, ask yourself the following:

  1. Do I have the skills and knowledge to carry out the activity safely and effectively?

  2. Can I complete training or receive other support (such as supervision) that will give me the skills and knowledge needed to carry out the activity safely and effectively?

  3. Is the activity restricted by law (e.g. prescribing) and, if so, can I legally do it?

Further information

Multi-professional framework for advanced clinical practice in England

Nurses

Core Capabilities Framework for Advanced Clinical Practice (Nurses) Working in General Practice / Primary Care in England : ACP Primary Care Nurse Fwk 2020.pdf (hee.nhs.uk)

NMC Regulatory body : The Nursing & Midwifery Council - The Nursing and Midwifery Council (nmc.org.uk)

HEALTH AND CARE PROFESSIONS Including: Paramedics, Physiotherapists, Dietitians

Regulatory body: About us | (hcpc-uk.org)

Paramedic (Specialists in Primary and Urgent Care) Core Capabilities Framework : Paramedic Specialist in Primary and Urgent Care Core Capabilities Framework.pdf (hee.nhs.uk)

Physiotherapists advanced practitioner : Advanced and consultant practice physiotherapy | The Chartered Society of Physiotherapy (csp.org.uk)

Dietitian advanced practitioner : Advanced Practice | British Dietetic Association (BDA)

Scope of Practice Template
December 2022
Download
Signposting for Scope of Practice
December 2022
Download

Hertfordshire and West Essex ACP Forum

To provide a support network for professional development and pier support to Advanced Clinical Practitioners, at all stages of their development; from student to experienced practitioner. 

Although the forum is open to all ACPs, from all disciplines, the ACP forum has been set-up by nurses, so is likely to have a nurse focus. As the forum evolves, it is recognised that there may need to be other branches of the forum to meet the specific needs of pharmacist, paramedics and other allied health professions working in general practice who would like the support of an ACP Forum.

Forum frequency will be every two months, for one hour, on a Tuesday lunchtime, starting September 2022.  Sessions will be recorded for those unable to attend the live forum. 

Delivery will be virtual via Microsoft Teams.  This is the best format for reaching an audience across the large geographical area of Hertfordshire and West Essex.   

Following a discussion with ACPs, as a starting point, the following format has been agreed:

The contents of the ACP forum will alternate between, a learning topic requested by members, with a speaker and an internal learning topic, led by members, followed by a general discussion, questions and support.

The focus of supporting ongoing development will be around the four pillars of advanced practice:

image for the text

The WhatsApp group is optional, it will be set-up and available for anyone who is a member of the Forum.  The purpose is to have a platform in-between Forums to allow the group to ask ACP relevant questions and to share relevant information. 

A register of members will be kept by HWE Training Hub, information will include, name, surgery of employment, qualification, when and where attained, or current study institute, title, email address and mobile number (latter only if requested to be on WhatsApp group).  Members will be emailed directly about training events, dates and topics of forums and any other relevant information that is specific to ACPs.

To join the ACP Forum please email: hwetraininghub@nhs.net

Advanced Practice Forum Calendar 2024

Date

Time

Topic

Joining link

Wednesday 17th April

12.30 to 13.30

Irritable Bowel Disorder for the non-specialist

Click here to join the meeting

 

Wednesday 12th June

12.30 to 14.30

To be confirmed

TBC

Tuesday 20th August

12.30 to 13.30

To be confirmed

TBC

Wednesday 16th October

12.30 to 13.30

To be confirmed

TBC

Tuesday 10th December

12.30 to 13.30

To be confirmed

TBC

To request joining instructions email: hwetraininghub@nhs.net 

(N.B. You will need to be a member of the forum to receive joining instructions.)

ACP Webinar Library - watch previous recordings

31st January 2024

25th July 2023

23rd May 2023

28th March 2023

Tuesday 24th January 2023

22nd November 2022

So, you want to be an ACP?

In addition to practicing their professional discipline (nursing, pharmacist, physio, Paramedic etc.) at an advanced level they:

  • Assess, diagnose, plan, implement and evaluate treatment/interventions and care for patients presenting with an undifferentiated diagnosis.

  • Diagnose and manage both acute and chronic conditions, integrating both drug- and non-drug-based treatment methods into a management plan.

  • Prescribe and review medication for therapeutic effectiveness, appropriate to patient needs and in accordance with evidence-based practice and national and practice protocols, and within scope of practice.

  • Work with patients in order to support compliance with and adherence to prescribed treatments.

  • In addition to clinical practice, the role also encompasses leadership and management, education, and research.

For further information see :

What is advanced clinical practice? | Health Education England (hee.nhs.uk)

A day in the life of an Advanced Nurse Practitioner

The MSc (Level 7) Advanced Clinical Practice Course is over 3 years. It is a structured pathway. However, accreditation of prior learning is accepted and reviewed on application. Before applying, applicants must have funding secured with their employer and support in the workplace. For information about the training course see here: MSc Advanced Clinical Practice | Courses | Uni of Herts

For information about the seven fundamental considerations which underpin supervision in advanced clinical practice, to support practitioner development, see:  Workplace Supervision for Advanced Clinical Practice - Advanced Practice (hee.nhs.uk)

Before applying for training as an ACP, you need to secure support from your employer.  This will depend on employers need for an ACP and clinician capability. When ACP training support is agreed, funding for training needs to be sourced from the Training Hub, to undertake a PG Dip/ MSc Advanced Clinical Practice or ACP Apprenticeship – with clinical supervision in the workplace. A portfolio of evidence against the ACP framework will also need to be compiled.

Funding is currently available, to enquire email the training hub: hwetraininghub@nhs.net

Workplace Clinical Supervision

ACP and Continuous Professional development (CPD)

The aim of continuous professional development (CPD) is to provide employees and employers with the ability to deliver high quality, safe and effective person-centred care.  It is the cornerstone of post registration practice.

Workplace clinical supervision for advanced clinical practice is a basic expectation and is fundamental for the ongoing success and support of the role.  It will need to cover the seven fundamental considerations which underpin supervision in ACP.  For detailed information see here: Workplace Supervision for Advanced Clinical Practice - Advanced Practice (hee.nhs.uk)

Continuous Professional Development (CPD)

CPD can take many forms, from ongoing study at university, virtual and in-person half or whole day updates, attendance at a conference, eLearning, reading academic research papers, observing other clinicians to attending a conference.  The importance thing to consider is that it is relevant to your learning needs.  These should have been identified in your ‘individual learning plan’, in collaboration with your clinical supervisor.  Your learning needs also need to encompass the career framework, ‘Four Pillars of Practice’.

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CPD Links

Advanced Practice Conference – theme ‘Empowering People, Transforming Care’

Monday 7 November 2022 and Thursday 10 November 2022 

For more information see : Advancing practice conference - Advanced Practice (hee.nhs.uk)

Medical Webinars for GP & Healthcare CPD

Various topics and dates

For topics see: Medical Webinars for GP & Healthcare CPD | NB Medical

Understanding Blood results

Various dates; face to face and Virtual learning

Understanding Blood Results - Venous and Arterial Access - M&K Update (mkupdate.co.uk)

Practitioners Development – courses suitable for Advanced Practitioners

Various topics; face to face and Virtual learning

https://www.pduk.net/scheduled-courses#list

Heart and Lung Masterclass

Various dates; face to face and Virtual learning

Heart & Lung Assessment Masterclass - Physical Examination - M&K Update (mkupdate.co.uk)

Useful Websites and Resources

https://advanced-practice.hee.nhs.uk/

Advanced Practice | East of England (hee.nhs.uk)

Advanced Level Nursing Practice Section 2: Advanced level nursing practice competencies | Royal College of Nursing (rcn.org.uk)

https://www.hee.nhs.uk/sites/default/files/documents/Signposting%20for%20CPD.pdf

Multi-professional framework for advanced clinical practice in England.pdf (hee.nhs.uk)

How to become...an advanced nurse practitioner - Nursing in Practice Nursing in Practice

https://www.nhsprofessionals.nhs.uk/campaigns/gp-bank/advanced-clinical-practitioners

ACP Forum Facilitators

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