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First national framework for advanced clinical practice unveiled

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The first national framework for nurses and other healthcare professionals working at an advanced level has been revealed today, with the aim of providing a “clear and consistent approach” to training and practice.

The National Framework for Multi-Professional Advanced Clinical Practice, developed in England, states that those working in the role must be registered with a regulatory body and must also have trained at master’s level.

“This will optimise the ways in which new and existing advanced clinical practice roles are developed and used”

John Clark

This could include a postgraduate certificate, postgraduate diploma or full master’s degree, according to the framework published jointly by Health Education England, NHS Improvement and NHS England.

Working at a master’s degree level means having the ability to make sound judgements in the absence of full information, and to manage varying levels of risk when there is complex, competing or ambiguous information or uncertainty, noted the document.

As part of their master’s level training, advanced professionals must have covered and been assessed in four key areas – core capabilities within a specific clinical area, education, research, and leadership and management.

However, the framework does not state that advanced clinical practitioners (ACPs) must be able to prescribe. This contrasts with a voluntary accreditation scheme for advanced nurses launched by the Royal College of Nursing earlier this year, which requires registrants to also hold a prescribing qualification.

Today’s framework states that ACPs “must be able to initiate, evaluate and modify a range of interventions”, which ”may include prescribing medicines, therapies, life style advice and care”.

Later on it highlights that some skills, such as prescribing, “are only legally allowed for certain professions” and that this should not stop all professionals from becoming advanced practitioners.

All ACPs will be expected to meet the requirements laid out in the framework by 2020. However, the document acknowledged that some parts of the existing workforce would need different levels of support to provide evidence showing they could meet the requirements.

Due to advanced practice developing so quickly – and the potential for some professions to be regulated at this level in the future – the framework will be reviewed in a year’s time, stated the document.

“[Advanced clinical practitioners] must be able to initiate, evaluate and modify a range of interventions”

National advanced practice framework

It said a national framework was needed because local regions had come up with their own varying definitions over the past decade about what advanced practice was.

Some employers may need to review whether parts of their existing workforce had been given an “advanced” job title when they were not working at this level, noted the document, adding that doing so would “make sure that there is no misunderstanding by the public and the multidisciplinary team”.

Earlier this year, a new study revealed that hundreds of unregistered care staff were working in NHS roles that held advanced or specialist nursing titles.

The research, led by Professor Alison Leary at London South Bank University, also found that nurses working in advanced roles had a wide range of extra qualifications – from no additional training to PhDs.

Launching the framework today, John Clark, HEE’s director and dean of education and quality, said its aim was to provide a “clear and consistent approach” to the development of advanced clinical practice across England.

“It achieves this by setting out recommendations for the development, implementation and evaluation of advanced clinical practice by defining the practitioner core capabilities and by identifying a recommended standard of education for advanced clinical practice,” he said.

“This will optimise the ways in which new and existing advanced clinical practice roles are developed and used to enhance care and improve health outcomes for local people,” he added.

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Readers' comments (1)

  • karen Webb

    Excellent news! This framework is great and I am glad that medical prescribing is NOT included in the definition as that is only one possible aspect of advanced nursing practice

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