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Advanced Practice (AP)

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Role Description

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.

This definition, therefore, requires that health and care professionals working at the level of advanced clinical practice will exercise autonomy and decision making in a context of complexity, uncertainty and varying levels of risk, holding accountability for decisions made.

Practitioners working at an advanced level come from a range of professional backgrounds such as nursing, pharmacy, paramedics and occupational therapy. They are healthcare professionals educated to MSc level and have developed the skills and knowledge to allow them to take on expanded roles and scope of practice caring for patients. Click here to view the NHSE page explaining this role further.

Advanced practice roles are an integral part of the future NHS workforce as new models of care are transforming the way patients are treated. Advanced Practitioners work at level 7 across the four pillars of advanced practice – clinical, management and leadership, research and education, and offer multiple benefits to the health service and the population. They bring more holistic care to patients, support continuity of care and extend the scope of practice across traditional boundaries. This leads in turn to a greater focus on prevention, more personalised care, a more efficient team, a faster response to patient needs and better outcomes.

What can an Advanced Practitioner offer to patients in a Primary Care setting?

  • Independently manage complete clinical episodes of care for patients with undifferentiated and undiagnosed conditions.
  • Identify red flags and underlying serious pathology and take appropriate action.
  • Utilise complex decision making to inform diagnosis, investigation, and treatments within a broad scope of practice.
  • Actively take a personalised and population-centred approach to enable shared decision making with the patient.
  • They have a leadership role across Primary Care Networks (PCN) and in the Integrated Care Systems (ICS) around pathways and population health.

Becoming an Advanced Practitioner

Although becoming an Advanced Practitioner is a good opportunity for professional and career development, there must also be an identified workforce need for an Advanced Practice role in your clinical setting. Therefore, it is essential that employers are aware of  what service need will be met by developing a member of their staff into such a role and that a conversation has been had between employer and trainee with regards to this service need with a commitment from the employer to provide the necessary support throughout training and dedicated job role at the end of training.

The Muliti-professional Framework was designed to enable a consistent understanding of advanced clinical practice, articulating the core capabilities for health and care professionals at the level of advanced clinical practice across all advanced clinical practice roles, regardless of the health and care professional’s setting, subject area and job role.

Supervision for a trainee AP

The provision and delivery of high-quality workplace supervision for practitioners developing in advanced clinical practice is crucial for both professional and patient safety. It requires an integrated approach in which the developing advanced clinical practitioner (sometimes referred to as a trainee), is supported by multi-professional supervisors. The developing advanced clinical practitioner/ trainee should have a nominated ‘Coordinating Education Supervisor’ who supports the practitioner during the period of development and access to a variety of ‘Associate Workplace Supervisors’ who are matched to specified aspects of practitioner development across all the pillars of advanced clinical practice, (Clinical, Research, Leadership and Management or Education). This guidance for workplace supervision of advanced clinical practice development will be useful for supervisors, employers, those driving workforce development and educators. There are seven fundamental considerations, set out in the diagram opposite, which underpin workplace supervision and ensure that both patient and professional safety are maintained during the practitioner’s advanced clinical practice development.

Each NHSE Region now has a Faculty for Advancing Practice to support the work of the CfAP. Each Faculty has a Lead, a Supervision and Assessment Lead. More information about workplace supervision for trainee APs can be found here.

Applying to the Training Hub for NHSE funding

It is important that you check you have the necessary prerequisites for the course by looking at the University’s eligibility criteria.

If you would like to look into alternative HEIs, this can also be discussed. A Child-specific programme or Mental Health-specific programme would also be considered.

NHSE agrees to fund a certain number of places on these accredited courses each year and applicants in Primary Care can apply for a funded place via their Training Hub (they will also need to apply directly to the University for a place on the course still once their funding from NHSE has been confirmed).

Before applying to the Training Hub for a funded place, please read this guidance document carefully and please do reach out with any questions. Implementing and Funding Guide - Advanced Practice. If you wish to apply please see links to our application forms and accompanying documentation needed on this page here.

Although the commissioning window only opens each Spring for course start dates the following academic year, please do either express an interest or apply to the Training Hub at any point during the year. Interviews will then be held between Jan- Feb with final submissions to the AP Faculty in March for their funding decision and approval.

Advanced Practice supported ePortfolio route

NHSE are taking expressions of interest for the next cohort to undertake The ePortfolio (supported) Route. Click here to access the Expression of Interest Form. This route has been specifically designed to enable recognition with the Centre for Advancing Practice of existing, experienced advanced practitioners, who at the time of the expression of interest, are working clinically in advanced practitioner roles on a regular basis and who have already completed their advanced practice experiential and educational learning mostly before 2017 when HEE’s Multi-professional framework for advanced clinical practice in England was published. 

    Registrable Qualification

    An AP or ACP would have a registrable qualification from their initial graduate degree (profession specific):

    Examples and not limited to:

    • Registered General Nurse
    • Qualified Paramedic
    • Clinical Pharmacist
    • Physiotherapist

    What can the Training Hub offer you?

    • Access to full Advanced Practice pathway
    • CPD funding via your PCN Educator for Continued professional development
    • Best practice and guideline updates
    • Networking opportunities with peers and access to communications regarding latest events and opportunities via our Microsoft teams SharePoint Channel- please contact Surrey Traning Hub to be added to this
    • Access to the latest research and information through our Library Services

    Please click here to view the Community of Practice Flyer promoting online session organised by National Institute for Health and Care Research Kent, Surrey and Sussex Community Of Practice (NIHR KSS COP). Here is a link to the application.

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