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College to pilot accreditation standards for advanced practice

  • 5 Comments

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”

Donna Kinnair

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”

Karen Lynas

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.

Donna Kinnair

Dame Donna Kinnair

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

Karen Lynas

Karen Lynas

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.

  • 5 Comments

Readers' comments (5)

  • Fully support this.
    Have a Bsc Hons Nurse Practitioner with Independent prescribing. This maps closely to the RCN's competence for advanced practice. My practice is specialised and I would challenge any post grad student nurse to work to the level I currently do. Which includes complete undifferentiated diagnosis consultations, management plans and discharge.

    I would concede though that a Masters should be standard.

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  • Thank you for the insight of the Training of ANP with differences in training programes. The BSc Level prepares the nurse to practice as a Nurse Practitioner as do other programs in other countries at a certificate level or Accreditation from another entity.
    As RCN is a modeled for Preparing Nurses at any level, your approach to the credentialing this area of nursing is critical.

    I agree that Accreditation and credentialing of this level of nursing is needed to ensure that credit and recognition is given to this cadre of nursing and also advance the profession.

    However, if I may, I would support, as I know RCN (International Pace setter in Nursing) will do, ANP training programs should be based on Common agreed Competencies which will indicate a better acceptance of a program completed at any level whether it be at a Certificate, Bachelors, Masters or higher level.

    What is important is that, Nursing must be able to clearly articulate, across the world, what it is that each cadre of nurses can do. This I believe may be a reason contributing to the status of Nursing world wide at this junction in our history.

    My support will be for APN Training any level as long as the Program is competency based and meet the needs of the country where the nurse is credentialed and registered to practice.

    Professionally,

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  • I would like to see the evidence regarding the numbers of ANPs that face FTP proceedings and are struck off - this is anecdotal scaremongering . I would agree that the NMC don't know how to fairly judge the competence of ANPs in FTP proceedings and they even admitted to me once that any ANP would be judged in line with the ordinary registrant which is most unfair but I would take issue with Donna Kinnair saying there appears to be an inordinate amount of ANPs struck off as a result of the lack of regulation

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  • I can not help but wonder, is the RCN charging for this service? Should it not be something the RCN puts pressure on the NMC to introduce? Most accreditation schemes I have come across usuall charge a fee for people to join. Do they charge the Uni's to be members of their accreditation and will they also charge nurses? It would be interesting to find out. The NMC should be comparing nurses like for like rather than an average of nurses. They should compare a nurse with similar levels of experiance and education for that role or at least take that into consideration.

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  • This is an excellent plan and a very helpful start. Advanced nurses have been lobbying the NMC for the past 15 years to regulate the ANP role. Good on you RCN for starting the process.
    Yes, it should be Masters level as all nurses are now attaining a BSc at age 21 so will need to study at a higher level to achieve advanced status.
    I have sadly seen nurses given the title ANP without the appropriate skills, experience or qualifications - resulting in those others within the team 'carrying' them which is unsafe and unacceptable.
    GP's are renowned for employing 'ANPs' in a hurry to fill gaps within their team, they're a whole lot cheaper than a locum GP! After all, it is flattering to be offered an ANP 'title' and often nurses don't think through the potential implications of what they are taking on.
    This move by the RCN will hopefully stop both nurses taking these roles and employers filling them with inappropriately qualified individuals.
    If you want an advanced title then go and do the study to earn it. GP's have to train for 3 years... why do nurses walk straight into advanced roles unprepared?

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