Advanced Clinical Practice

Advanced clinical practitioners come from a range of professional backgrounds such as nursing, pharmacy, physiotherapy, paramedics and occupational therapy. They are healthcare professionals educated to Master’s level and have developed the skills and knowledge to allow them to take on expanded roles and scope of practice caring for patients.

What is advanced clinical practice?

Advanced clinical practice (ACP) is a defined level of practice within clinical professions such as nursing, pharmacy, paramedics and occupational therapy. This level of practice is designed to transform and modernise pathways of care, enabling the safe and effective sharing of skills across traditional professional boundaries.

Advanced clinical practitioners (ACPs) are healthcare professionals, educated to Master’s level or equivalent, with the skills and knowledge to allow them to expand their scope of practice to better meet the needs of the people they care for. ACPs are deployed across all healthcare settings and work at a level of advanced clinical practice that pulls together the four ACP pillars of clinical practice, leadership and management, education and research.

A definition of ACP, its underpinning standards and governance, can be found in the Multi-professional framework for advanced clinical practice in England. The framework ensures there is national consistency in the level of practice across multi-professional roles that is clearly understood by the public, advanced clinical practitioners, their colleagues, education providers and employers.

The roles undertaken by advanced clinical practitioners are determined by the needs of the employer and how they require the level of practice to be deployed within their setting. This may fit with nationally understood roles, such as those within emergency departments or very bespoke roles based upon the needs of a specific population such as an advanced clinical practitioner dietitian running a complex enteral feeding (tube feeding) service for paediatric patients).

Definition

Health Education England (HEE), in association with its multi-disciplinary partners, has developed a definition of Advanced Clinical Practice.

Advanced clinical practice is delivered by experienced, registered health and care practitioners. It is a level of practice characterised by a high degree of autonomy and complex decision making. This is underpinned by a master’s level award or equivalent that encompasses the four pillars of clinical practice, leadership and management, education and research, with demonstration of core capabilities and area specific clinical competence.

Advanced clinical practice embodies the ability to manage clinical care in partnership with individuals, families and carers. It includes the analysis and synthesis of complex problems across a range of settings, enabling innovative solutions to enhance people’s experience and improve outcomes.

The ACP definition has been developed to provide clarity for employers, service leads, education providers and healthcare professionals, as well as potential ACPs practising at an advanced level. This is the first time a common multi-professional definition has been developed which can be applied across professional boundaries and clinical settings. The definition serves to support a consistent title and recognises the increasing use of such roles in England.

Project ECHO for Advanced Clinical Practitioners In-reaching Into Care Homes

The aim of these sessions is to:

- Increase knowledge and confidence in managing care home patients through formal teaching and case-based learning

- Create a community of practice within your region, and with other ACPs in other regions to share knowledge and good practice

5 ECHO sessions which consist of a 20-minute presentation followed by 2 case studies delivered by members of the community of practice

26th May 2022 1-2.30 ECHO session 1

9th June 2022 1-2.30 ECHO session 2

23rd June 2022 1-2.30 ECHO session 3

7th July 2022 1-2.30 ECHO session 4

21st July 2022 1-2.30 ECHO session 5

To express your interest, please complete the form: Microsoft Forms

For any further details about the ECHO programme, please contact the Project ECHO Team at echo@hospicesheffield.co.uk

NHS Leadership Academy Programmes

www.leadershipacademy.nhs.uk/programmes/

Extra Links:

Faculty for Advancing Practice (Midlands) Update Bulletin.pdf
https://advanced-practice.hee.nhs.uk/resources-news-and-events/

Availability of Supported e-Portfolio Route

The online application form for the Supported e-Portfolio Route will be available via the Centre for Advanced Practice website is now closed.

Further opportunities for this route are likely to be made available in due course.

To support prospective applications, the Centre for Advancing Practice has developed a guidance document, and accompanying FAQs.

Advanced Practice Week – hear from those involved with Advanced Practice in H&W

Charlotte Murphy

South Worcestershire, Redditch & Bromsgrove GPN Mentor Herefordshire & Worcestershire Training Hub

Since qualifying in 2002 I have had 16 years working in an emergency medical setting and critical care. I was lucky to spend two years working in a busy ED in Melbourne before returning to the UK. The last 5 years have been spent in primary care which has been a very interesting transition, giving me scope to transfer many of my acute skills. I have been lucky to be given funding from HEE to complete the MSc in Advanced Clinical Practice. With support from the GP’s I work for, I have embarked on moving into an ACP role. Since starting in September 2021 it had been very busy getting back into the academic style of thinking whilst balancing my clinical supervision hours and work. It’s early on in the course but I am thoroughly enjoying the learning curve and pushing my clinical knowledge further. Being on the 3 years masters with other nurses, pharmacists, physiotherapists and paramedics has been really interesting in looking at ways to challenge service delivery and case studies from a variety of health care settings. I am very excited about the skills and knowledge I will gain in the first year of advanced clinical practice and how my practice will advance in the future.

Katie Cowell
South Worcestershire, Redditch & Bromsgrove GPN Mentor Herefordshire & Worcestershire Training Hub

Now entering my final modules for the MSc in Advancing Practice, is a good time to reflect on how far I have come as a practitioner.

I am a training ACP in general practice, and as my role has grown over the past 3 years, not only my clinical skills, in health assessment, minor illness diagnosis, but the ability to treat, diagnose and prescribe are invaluable to my role.

However, the 4 pillars of advanced practice now underpin my role, in every aspect, enhancing my leadership skills, enabling me to look at the wider picture of clinical practice and the NHS, ensuring that my practice is evidence-based underpinned by research, being able to critically appraise and enable change has been of great benefit.

Although working full time and undertaking the MSc is by now means easy, learning and sharing new knowledge with others is incredibly rewarding, to see you grow as a professional, underpinned by key elements, and working within the four pillars offers not only the practitioner but the patients we care for the best service and care available.

I am proud to be on this journey and look forward to the personal reward and satisfaction of completing this, to ensure improved patient care and clinical excellence.

Meeraj Shah

Multi-professional GP Educator Herefordshire & Worcestershire Training Hub

I have had the privilege of working with Advanced Clinical Practitioners in primary care and teaching students undertaking their Masters in Advanced Clinical Practice at the University of Worcester. Advanced Clinical Practitioners have such a vital role in patient care and in helping shape how health care is delivered. I have learnt so much by working alongside Advanced Clinical Practitioners and can proudly say they bring something different to primary care. It is great the Advanced Clinical Practitioners all have different backgrounds (nurses, pharmacists, paramedics etc.) The feedback I have received from patients and colleagues regarding advanced clinical practitioners has been excellent. Locally, the PCNs in Herefordshire and Worcestershire, are finding Advanced Clinical Practitioners are having a huge impact in clinical areas such as frailty, palliative care and learning disabilities. If anyone is thinking about undertaking a Masters in Advanced Clinical Practice, I would highly recommend it.

PCN requirements and entitlements for Additional Roles

From 1 April 2023, new advanced practice roles have been included in the 23/24 update to Additional Roles Reimbursement Scheme (ARRS). These include;

including Advanced Clinical Practitioner Nurses in the roles eligible for reimbursement as Advanced Practitioners (APs), who must have gained the Centre for Advancing Practice ‘Advanced’ digital badge.
reimbursing PCNs for the time that First Contact Practitioners spend out of practice undertaking education and training to become Advanced Practitioners.

NHSE Primary Care team, in partnership with the Centre of Advancing Practice, have developed some FAQs in which to provide some clarity on the requirements and entitlements for these roles in order to support Training Hubs, PCNs and practices to understand and enable effective reimbursement of the appropriate primary care workforce.

Also included an information update on the e-portfolio (supported) route and the link to the form for any expressions of interest for appropriate practitioners.