Advancing advanced practice

The Royal College of Nursing (RCN) suggests that, for nurses to be able to work (this is the RCN's word ‘work’ as opposed to practise) at an advanced level, nurses need to meet a number of standards. The standards referred to are the RCN's standards (RCN, 2018), they are not mandatory. It requires universities that are collaborating with the RCN to demonstrate that programmes of study for advanced nursing practice have met these standards in order to receive RCN accreditation. There is, of course, a fee for accreditation.

It is acknowledged that anything to do with advanced practice is complex—and so it should be, as patient safety is at stake. Advanced practice is a rapidly moving policy space (Council of Deans of Health, 2018). The Council of Deans is working with Health Education England on advanced clinical practice across various health professions. It should also be noted that, across the four nations of the UK, advanced practice policy differs. The Council of Deans refers to ‘advanced clinical practice’, as a level of practice, as opposed to ‘advanced clinical practitioner’, as a role. The UK Central Council for Nursing, Midwifery and Health Visiting (UKCC) (now the Nursing and Midwifery Council (NMC)) defined specialist practice more than 18 years ago as the exercising of higher levels of judgement, discretion and decision-making in clinical care (UKCC, 2001).