Advanced nurse practitioners in the UK will for the first time be able to receive accreditation for their role, under a new scheme being developed by the Royal College of Nursing.
The voluntary scheme, set to be launched for testing in November and introduced fully next year, aims to ensure the role is better recognised by employers as well as assuring patients of nurse expertise.
“This our most risky bit of nursing in terms of indemnity”
There is currently no restriction on the use of the ANP title and there are no national competency standards set by the nursing regulator.
Under the RCN’s new accreditation scheme, ANPs will be required to have a master’s degree and also be able to prescribe independently.
The college said the requirement was to reflect that student nurses were now educated via undergraduate degrees and that advanced practice must be demonstrated through training at a higher level than that.
ANPs should also be able to “open and close episodes of care”, including assessment, diagnosis and treatment - which requires prescribing, according to the RCN,
The RCN currently accredits training courses for ANPs but does not require these courses to be at master’s level – though this will change once the scheme has launched.
Meanwhile, the Nursing and Midwifery Council also does not require nurses to be recorded separately on its register if they practise at this higher level and does not set standards for the role.
“We are concerned with the continuing development of nursing practice”
RCN director of nursing, policy and practice Donna Kinnair, who is leading the work, said formal recognition of ANPs was important to provide reassurance about the safety of the role, as these nurses were often working at the boundary between nursing practice and medicine.
She said she was “struck” by the amount of ANPs that were removed from the NMC register following fitness to practise hearings, and that she believed this could be due to their level of practice not being recognised by the NMC and also the profession more generally.
The new scheme will require ANPs to re-credential every three years by demonstrating continued practice and learning and development.
Credentialing will also help to “kitemark” services led by ANPs and improve workforce planning to ensure there are enough trained for the future, said Ms Kinnair.
It will be open to all nurses practising at an advanced level – including non-RCN members – in both the NHS and other sectors.
Dame Donna Kinnair
Speaking to community nurses at the Queen’s Nursing Institute conference last week, Ms Kinnair admitted there were some “tensions” that still needed to be addressed during piloting the scheme.
This included the fact some nurses currently practising at an advanced level had not undertaken master’s level training.
She also said there was a “huge problem” building around problems with indemnity arrangements for ANPs, due to there being no agreed definition of the role and the difficulties that created for employers in making arrangements.
She said she hoped negotiations with insurance providers to tackle these issues could begin once the credentialing scheme had been launched.
“The reason why I thought this was a good area to look at [to begin with] is this our most risky bit of nursing in terms of indemnity,” she said.
“I’m hoping, once we have done this ground work and got the credentialing up, we can start to have those negotiating conversations about them being nurses and what is it you don’t recognise about nursing practice here in terms of indemnity,” Ms Kinnair told the conference.
The RCN’s advanced nurse practice credentialing scheme will be launched for testing in November by four pilot sites and will be fully introduced by May 2017.
Karen Lynas, the RCN’s associate consultant for leading the credentialing project, said: “The RCN recognises the huge commitment to personal practice, skills and competences associated with nurses becoming ANPs. It is only right that we should recognise and reward that level of practice through a robust process of credentialing.
“As a professional body, we are concerned with the continuing development of nursing practice and want to see that properly assured and recognised,” she told Nursing Times.
“If you currently work at that level, becoming recognised by your profession will provide assurance to you, your colleagues, employers and, of course, patients and the public about the level of independence and expertise you have,” she added.
She said the RCN would also in the future be launching credentialing for other nurse roles, in order to support recognised career pathways for nurses.