Enhanced practice is a level of practice within the healthcare workforce. It covers the graduate professional workforce delivering most of the clinical activity, those who have moved beyond novice/competent and who are not working at the level of advanced practice. (NHSE, 2024)
Enhanced level nursing describes a level that can only be delivered by registered nurses who have gained additional post-registration education and experiential learning in a relevant subject area. This level can be applied to the full range of registered nurse careers. The enhanced level is differentiated from other levels by a registered nurse’s expertise in applying specific knowledge and skills to a designated area. For example, this could be a client group, skill set or in an organisational context (RCN,2024).
SCOPE OF PRACTICE
Role Responsibilities:
Registered nurses working at an enhanced level are expected to be able to manage discrete activities in complex, challenging and changing situations and environments. They should also be confident to seek further guidance when they reach the boundaries of their competence.
An enhanced practice nurse has the following key responsibilities in relation to delivering health services:
- Works as a part of a multi-disciplinary team within the PCN
- Consults with patients, their family, and the multi-professional team to undertake assessment of patient needs and devise and evaluate complex plans.
- Utilises clinical knowledge to critically analyse problems to seek out evidence to apply, utilise enhanced techniques, intervention, and equipment to make clinical decisions.
- Delivers enhanced Clinical care in the context of continual change, challenging environments, different models of care delivery, innovation and rapidly evolving technologies using analysis and their underpinning knowledge to manage complex interventions.
- Teaches and advises patient and their families on how to manage their condition or support the multi-disciplinary team (MDT) to do so.
- Participates in clinical audits and research projects and implements changes as required, including the development, and updating of practice protocols/guidelines and procedures locally.
- Works within, and recognises own scope of practice, understanding when and to whom patients should be referred using the principles of delegation, delegates work to other members of the MDT and take responsibility for the delegated activity as appropriate.
- Demonstrates initiative and are creative in finding solutions to problems.
- Holds responsibility for team performance and service delivery
- Provides supervision to student nurse associate, nurse associate, Registered Nurse Degree Apprentices and General Practice Nurses
‘NHSE 2024: Network Contract DES: Contract specification 2024/25’
ENTRY REQUIREMENTS
- Has completed a nursing degree or Registered Nursing Degree Apprenticeship (RNDA)
- Registered with the NMC
- Has a post graduate qualification at level 7 or above RELEVANT to the area of enhanced practice, for example in wound care, diabetes, respiratory, CVD, Dementia, Women’s Health, Public health, and Population Health Management.
- Is working at an enhanced level of practice as described in the primary care and General Practice nursing Career and Core Capabilities Framework: HERE
‘NHSE 2024: Network Contract DES: Contract Specification 2024/25’
SUPERVISION REQUIREMENTS
Supervision is a process of professional learning and development that enables individuals to reflect on and develop their knowledge, skill, and competence, through regular support from another professional.
Supervision can have different forms and functions and several terms are used to describe these. For this guidance we use the below terms and define them as follows:
- Clinic/practice supervision: day-to- day support provided by a named/duty senior/more experienced clinician for issues arising in the practice.
- Clinical/professional supervision: regular support from a named senior/ experienced clinician/practitioner to promote high clinical standards and develop professional expertise.
- Educational supervision: supports learning and enables learners to achieve proficiency.
Supervision Guidance for primary care network multidisciplinary teams (NHSE,2023); HERE
RECRUITMENT INFORMATION
Where a PCN employs or engages a Enhanced practice Nurse under ARRS Scheme, the PCN must ensure that the enhanced practice nurse meets the ‘minimum Role Requirements stipulated in Annex B of the Network DES: HERE
Additional Resources
Enhanced practice NHSE landing page