Advanced Practitioner

Please Click Here for the Advanced Practice Notice Board for Advanced Practice information and updates.

Advanced practice is a level of practice in which a practitioner has demonstrated their ability to work autonomously at a high level (level 7/ Masters level) across all four pillars of advanced practice. The four pillars of advanced practice are clinical practice, leadership and management, education, and research

Read the role of governance in advanced practice, and how the Governance Maturity Matrix can help effectively implemented this into organisations.   (Advanced practice | NHS Employers)

Non-Medical Prescribing Bulletin - Summer 2024 (SWAY)

In this issue, we turn our focus to:

  • National updtaes

  • Reports and policy

  • Focus on: Pharmacists as Non-Medical Prescribers

  • CPD

  • Articles

  • Resources

  • Library services

To view please click here.

Advanced Practice Bulletin - June 2024

In this bulletin you will find:

  • Local and National updates

  • Reports and Publications

  • Continuing Professional Development

  • Articles

  • Electronic Resources

To view please click here.

Advance Practice Bulletin for March 2024

In this bulletin you will find:

  • Local updates

  • National updates

  • Reports and Publications

  • Continuing Professional Development

  • Articles

  • Electronic Resources

To view please 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.

Advance Practice Bulletin - August 2023 (SWAY)

In this bulletin you will find:

Local, Regional and National Updates and much more 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 practitioner, advanced nurse practitioner, ‘advanced paramedic practitioner; advanced physiotherapist practitioner; or advanced pharmacist.

It is recognised that the  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 Advanced Practicitioner is being used throughout this text, it includes all working with an advanced level qualification, that may have a different job title.

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 Advanced Practitioner 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 Practice at Masters Level, you may want to consider submitting an ePortfolio.  See: ePortfolio (supported) Route - Advanced Practice (hee.nhs.uk)

The difference between Enhanced and Advanced level of practice

The education level of enhanced practice covers the graduate professional workforce who are delivering the majority of clinical activity, those who have moved beyond novice/competent and who are not working at the level of advanced practice.

For more information see this webinar

Enhanced practice focuses on expert clinical practice in the professional’s field or sphere of work but not necessarily advanced level across the other three pillars of advanced practice i.e. education, leadership and research. Enhanced level practice makes a significant and essential contribution to patient care and clinical services.

 

For further information see: Enhanced practice | NHS England | Workforce, training and education (hee.nhs.uk)

Advanced Practitioner - 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 Practice

When working in Advanced Practice (AP), 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 practice

There is a not a set list of tasks that Advanced Practitioners 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 Advanced Practitioner.

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 practice in England (2017) - Advanced Practice (hee.nhs.uk)

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

Advanced Practitioners Networking Forum (Hertfordshire and West Essex Primary Care)

The networking forum is a pier support group for all trainee and aspiring and experienced Advanced Practitioners working in General Practice.  The aim is to share good practice, help and support each other in working across the 4 pillars of advanced practice and the highs and lows of working in an advanced role in primary care.  The network can be whatever you want it to be. It is your group and therefore needs to be led by its members; you. Quarterly virtual meetings will be held on Microsoft Teams and facilitated by the Training Hub.  Please ensure you have access to a camera and microphone to take part in the Networking events.

 Suggested topics for networking forum are: 

  • Journal club – someone decides on a research paper to discuss, this will be circulated before the event to give time for members of the network to read.

  • Topic presentations

  • Sharing of innervations and quality improvement ideas

 Advanced clinical masterclasses  

 Mid and South Essex ICB is offering these monthly Advanced Clinical Masterclasses, on different topics, taught by specialists with advanced level practice.  The Masterclasses are open to aspiring, trainee and qualified advanced practitioners, primary/community/acute care, across east of England region.  This is an opportunity to network with Advanced Practitioners working in different clinical settings.

Advanced Clinical Masterclasses and Network Calendar 2024/25

Date

Time

Topic

Joining link

Wednesday 13th November 2024

12.30 to 13:30

Burns

Join meeting

Tuesday 10th December 2024

12.30 to 13:30

General

Register Here

Wednesday 18th December 2024

12.30 to 13:30

Endocrine

 Join meeting

Tuesday 21st January 2025

12.30 to 13:30

General

Pending link

Wednesday 23rd April 2025   

12.30 to 13:30

General

Pending link

Tuesday 22nd July 2025

12.30 to 13:30

General

Pending link

Wednesday 22nd October 2025

12.30 to 13:30

General

Pending link

To join the mailing list to receive Advanced Practice updates email: hwetraininghub@nhs.net

The WhatsApp group has been set up as a platform in-between Network meetings to allow the group to ask Advanced Practice relevant questions and to share relevant information.  To join please email the hwetraininghub@nhs.net with your mobile number.

Advanced Practice Forum Webinar Library - watch previous recordings

10th June 2024

17th April 2024

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 Advanced Practitioner?

In 2023 the NHS published a workforce plan; ‘NHS Long Term Workforce Plan’

“The plan recognised advanced practitioners as one of the seven priority professional sectors requiring significant growth to support and drive service transformation and develop new and innovative ways of working. The plan articulates the continued drive to develop the advancing practice workforce as part of the multi-disciplinary team, recognising the impact these roles can have not only on improving patient care, but also increasing the number of senior clinical decision makers within the NHS to improve productivity and increase capacity.” (2024, NHSE East of England Faculty for Advancing Practice)

  • Guidance document: 
    Readiness for advanced practice: A guide for aspiring and trainee advanced practitioners - What to expect through your advanced practice journey. Published May 2024 by the East of England Faculty for Advancing Practice regional webpage. Link here: Readiness for advanced practice (hee.nhs.uk)

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 practice? | Health Education England (hee.nhs.uk)

A day in the life of an Advanced Nurse Practitioner

The MSc (Level 7) Advanced 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 and support in the workplace.

For information about the training course see here: 

Please see the following document for further informaiton: Routes into advanced practice.pdf

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

Before applying for training as an Advanced Practitioner, you need to secure support from your employer.  This will depend on employers need for an Advanced Practitioner and clinician capability. When Advanced Practitice 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 AP Apprenticeship – with clinical supervision in the workplace. A portfolio of evidence against the AP framework will also need to be compiled.

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

Workplace Clinical Supervision

Routes into Advanced Practice
Download

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