Advanced Practitioners

WT&E define advanced practice as:

‘Advanced practice is delivered by experienced, registered healthcare professionals. 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 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.’

Advanced practice is different from specialist and enhanced practice. Specialist and enhanced practitioners are experts in their chosen clinical area, working mainly in the clinical practice pillar (one of four mentioned in the quote above). For example a diabetic specialist nurse may have a depth of knowledge in the area of diabetes. Advanced practitioners have a breadth of knowledge across all four of the pillars of:

• Clinical practice
• Leadership and management
• Education
• Research

A short video on advanced practitioners is below.

What can advanced practitioners do in primary care?

The roles and responsibilities of the AP may vary by professional background. Below are some generic roles that APs might undertake (noting this list is not exhaustive):

• Triage patients
• Manage undifferentiated and undiagnosed conditions, including identifying red flags and underlying serious pathology
• High-level complex decision making to inform investigation, diagnosis and complete management of episodes of care
• Onward referral within scope of practice
• Provides multi-professional clinical supervision and education within scope of practice
• Leads audit and research projects
• Promotes, enables, facilitates and develops change across care pathways
• Provide teaching, education and verify to ARRs funded roles at both FCP and ACP level in order to complete the WT&E Roadmap requirements.

ACP role from a patient perspective:

---

Training and Supervision

Pre-requisites

ACPs require a minimum of 5 years postgraduate experience. The healthcare professional must be registered with the relevant organisation (HCPC or GPhC depending on background). ACPs are educated to master’s level in a relevant subject/area of expertise or  equivalent, demonstrating masters level across all 4 pillars.

Training

The WT&E roadmaps for practice detail the route towards FCP and AP by role. Links can be found above in the first section. Stage 1 and 2 of the roadmap relates to FCP and stage 3 relates to AP. FCP to AP career progression (under ARRs) can occur through the following routes:

• Complete e-learning modules (see roadmaps), portfolio of evidence against the domains of the Knowledge, Skills and Attributes (KSA) document and completed the outstanding domains referenced in the relevant Linking ACP to FCP- top-up required for AP documents.
• For the taught AP Master’s degree, primary care training will need to be completed if working in Primary Care, along with a portfolio of evidence against the appropriate AP profession specific framework.

For those who have undertaken an ACP MSc WT&E have stated: “If you have undertaken an ACP MSc, it is likely that you will have met the capabilities for stage 1 and stage 3.  You should map the learning outcomes of your MSc to the knowledge, skills and attributes to ensure this is the case.  Your outstanding requirement for roadmap verification is therefore the e-learning modules and stage 2.  (NB. If your MSc involved a placement in primary care, you may also have met stage 2).”

On completion of training a digital badge can be applied for to standardise recognition of the quality assurance of AP education, training and experience. More information can be found at: Digital badges – Advanced Practice (hee.nhs.uk).

Funding

WT&E provide some funding annually to support AP development for eligible individuals. More information can be found in the handbook at: South West Resources for Organisations – Advanced Practice (hee.nhs.uk). Please contact the training hub if you wish to consider applying and we can advise further.

Supervision

Supervisors for ACPs are usually expected to be at, as a minimum, an experienced advanced practitioner or specialist registrar. In Primary Care this is likely to be a GP or other experience ACP. The level of supervision will vary according to stage of training. To note once trained ACP/APs can provide significant supervision of other multi-professional learners and staff. See Advanced Practice Supervisor Capabilities – Advanced Practice (hee.nhs.uk) for further infomation.

A longer video below (37 mins) provides more information about supervision in advanced practice.

Recruitment

Job descriptions will vary by type of AP role. Job descriptions for paramedics, paramedics, physiotherapists, dieticians, clinical pharmacists and podiatrists can be found in the relevant section of the ARRs repository. Please note these JDs are aimed at a First Contact Practitioner (FCP) level (with the exception of clinical pharmacists who do not have an FCP level). The table below, taken from the WT&E roadmaps, shows the key differences between roles at an FCP and AP level, and may be useful to amend job descriptions as required to develop an FCP role into an AP role.

Further resources

NHS Multi-professional framework for advanced clinical practice can be found on the right of the page.

WT&E Roadmaps to practice (landing page): Roadmaps to Practice | Workforce Transformation and Education (hee.nhs.uk).

WT&E Advanced Practice site: Welcome – Advanced Practice (hee.nhs.uk).

ARRs FAQs for Advanced Practice ARRS FAQs – Advanced Practice (hee.nhs.uk)

Southwest faculty for Advanced Practice: Regional Faculty for Advancing Practice – South West – Advanced Practice (hee.nhs.uk)

South West Advanced Practice podcast series: South West Podcasts – Advanced Practice (hee.nhs.uk).

SW Advanced practice latest news and events: South West News and Events – Advanced Practice (hee.nhs.uk).