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Boost to advanced nurse training in A&E workforce plans

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The number of advanced nurse practitioners working in accident and emergency settings is set to grow over the next two years, as part of national workforce plans to address “significant pressures” on emergency departments in England.

A national framework for all advanced clinical practitioners (ACPs) is also set to be launched next month to provide a definition of the capabilities required for the role.

“The national competency framework, credentialing process and central commissioning will provide the foundation for growing this workforce”

A&E workforce plan

A fast-track training programme for ACPs – including nurses – will be set up with funding for 42 to start working at 14 trusts this year, according to national bodies NHS Improvement and Health Education England, which have published the plans today with the Royal College of Emergency Medicine.

The programme will see a further 84 ACPs funded to work at A&E departments next year.

The plans outline a series of workforce initiatives designed to tackle staffing problems among medical and other healthcare professionals. They were revealed today at the same time as a package of “contingency actions” designed to help frontline services cope with pressures this winter.

The new document – titled Securing the future workforce for emergency departments in England – stated that ACPs played a “vital and increasing role” in many emergency departments and came from a range of professional backgrounds, including nursing, pharmacy and physiotherapy.

It added that there was “significant scope to grow this workforce group in a more systematic way”.

By doing this, A&E departments would benefit from an increased skill-set among staff who are able to provide cover, senior nurses would be given the opportunity to develop their careers, and reliance on expensive medical locums would be reduced, according to the plans.

“A culture that supports learning and challenge enhances patient safety, leads to fewer clinical incidents [and] improves morale”

A&E workforce plan

Meanwhile, a national framework outlining the definition of an ACP, their level of practice and required competencies will be published in November.

This framework will “help ensure a more consistent approach to the training, deployment and outcomes” for ACPs, stated the workforce document.

In addition, a voluntary credentialing scheme for ACPs developed by the RCEM in 2015 will be piloted. Under the scheme, 183 trainee ACPs are currently gathering evidence on their practice, with around 135 expected to apply for accreditation.

The initiative mirrors a similar credentialing scheme for advanced practice launched by the Royal College of Nursing earlier this year. It represented the first opportunity for advanced nurse practitioners to be recognised for their practice through a national scheme.

The nursing regulator currently does not set standards for advanced nurse practitioners. Recent research revealed some NHS trusts are giving advanced job titles to unregulated support staff, sparking calls for advanced nurses to be regulated. 

“The national competency framework, credentialing process and central commissioning of ACP places will provide the foundation for growing this part of the workforce as part of multi-professional teams,” according to the plans published by NHS Improvement, HEE and the RCEM.

The organisations said they also wanted to ensure A&E departments were effective training environments for staff, but acknowledged this was ”often squeezed out” due to pressures.

“A culture that supports learning and challenge enhances patient safety, leads to fewer clinical incidents, improves morale and ensures that staff feel valued,” stated the plans.

Therefore, from April 2018 the group will fund and work with 45 trusts, thought to have the worst training problems, to help them develop strategies for clinical educators.

Trusts will be expected to match the funding provided by the group and the strategies will be aimed at doctors, physician associates and ACPs to ensure training is inclusive.

Jim Mackey

Jim Mackey

Source: Neil O’Connor

Jim Mackey

“This will involve funding of specific clinician time for shop floor training and assessment against RCEM and other curricula. The programmes will be implemented in conjunction with the local universities and training providers,” said the group.

Following today’s proposals, which focus on doctors, NHS Improvement, HEE and the RCEM said they would take part in further work to tackle the significant challenges facing emergency department nurses.

RCEM president Dr Taj Hassan said: “We are delighted to be launching this vision for our emergency departments, which sets out to tackle the clinical workforce challenges facing the service.

“We will increase our trainee numbers significantly, provide initiatives to expand the junior multi-disciplinary workforce and share best practice on sustainability,” he said.

NHS Improvement chief executive Jim Mackey noted that the hard work by A&E staff to ensure patients received high quality care despite staffing pressures.

“The commitment to train more emergency medics year-on-year and to develop the roles of advanced nurse practitioners and associate physicians further, while working to reduce the attrition rates of our current staff, provide a clear plan on how we and our partners will work together to tackle some of the staffing pressures facing emergency departments,” he said.

  • 2 Comments

Readers' comments (2)

  • The only reason this is happening is because it's cheaper to employ an ACP than a locum SHO who will want at least £60 an hour. It's all about money, they don't don't care about nurses' career progression.

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  • I am all for nurses progressing and for some this is an obvious career choice, but what happens to the nurse that wants to 'nurse'. We are so busy as a profession trying to prove ourselves that we are starting to lose focus on why many of us started in this profession in the first place.
    Moving the experience and seniority into a more clinical less nursing role isn't always the best use of resources.
    It might be nice to accept that nurses are useful too, and not just a substitute for our medical colleagues.

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