Advanced clinical practice

The Nursing and Midwifery Council (NMC) has acknowledged a growing debate concerning whether advanced practice requires regulation. There are various approaches to advanced practice across the four countries of the UK, and all are at odds with each other. The NMC 2020-2025 strategy (NMC, 2020) noted a plan to undertake a comprehensive review of advanced nurse practice, including consideration of whether regulation is needed.

As the ways in which health care is delivered change, there is an opportunity to restructure healthcare roles to meet future needs. The increasing number of people with long-term or complex multiple conditions, for example, would benefit from receiving services from an advanced clinical practitioner (ACP). Advanced clinical practice over the years has expanded beyond nurses and now advanced-level practitioners come from a range of professional backgrounds including nursing, pharmacy, paramedics, occupational therapy, healthcare science and midwifery. Leary and MacLaine (2019) noted that, although this does much to highlight the importance of recognising advanced practice as a level of care that comes with common core characteristics across professions, it has also added to the complexity. In 2017 Health Education England (HEE) produced a multidisciplinary framework for advanced clinical practice. The framework aims to ensure that there is uniformity across England as well as enhance understanding of the ACP role. Advanced clinical practice requires practitioners (and those who aspire to the role) to understand how to communicate effectively, working with patients and carers as they aim to enhance patient outcomes and improve patient satisfaction, generate an ability to self-manage healthcare needs and to collaborate with care planning. Those health and care professionals working at the level of advanced clinical practice are required to have developed their skills and knowledge aligned to the standards outlined in the HEE framework and the four pillars that underpin it: clinical practice, leadership and management, education, and research.