Update – DEVELOPING ADVANCED PRACTICE IN NHSSCOTLAND – Scottish Government report June 2016

Interesting developments within Scotland has seen a commitment from the Scottish Government CNO office to support the development of 500 Advanced Nurse Practitioners (ANPs). The report from the working group has set out a robust vision for ANPs education, key competencies and an agreement that MSc qualification will be the minimum to be considered an ANP. Governance structures within health boards will require collating numbers of existing ANPs and specialty (this is already done in some health boards) and standard job descriptions. Many of the recommendations are already being achieved and HEIs are covering the majority (if not all) of the core areas of education in their existing MSc programmes.

Clinical assessment

Clinical reasoning, judgement and diagnostic decision making

Anatomy and pathophysiology

Non medical prescribing- V300

Leading, delivering and evaluating care

Practice learning/transferable work based learning processes.

This pragmatic approach to ANP education focussing on the clinical pillar of advanced practice reflects the current service needs of the country. However, the report does stress the importance of all 4 pillars of AP.  How HEIs ensure that they are able to accommodate these increased numbers and how a standard approach on clinical pathways of MSc programmes is met is something that we at AAPE UK are aiming to address via our AAPE Scottish sub- group which should be discussing these developments with the working group. Interestingly, the focus here is on nursing whilst the rest of the UK appears to focusing on AP across disciplines. However, these are exciting times which could see the most coordinated approach to ANP education across the whole of Scotland. I recommend reading the whole report. transforming-roles-advanced-practice-paper-june-2016

Dr Evelyn McElhinney (UK Committee, AAPE Scotland sub-group lead)


AAPE UK response to announcement that RCN is to credential ANP’s.

AAPE UK have noted the announcement that the RCN is to credential Advanced Nurse Practitioners with the aim of improving the consistency related to the use of this title.

Demand for advanced level knowledge and skills is at an all time high in the UK as our health care systems face significant challenges.  Nevertheless, the public and employers are asking for clarity and assurance about the appropriate use of titles, underpinning education, rigour of assessment and governance framework needed for the burgeoning number of posts.

AAPE UK representatives are currently participating in top level discussions related to advanced clinical practice policy, standards and implementation strategies in England, Scotland, Wales and Northern Ireland.  Whilst the specific priorities vary in each country, there is a common recognition that advanced clinical practice roles have expanded beyond nursing to include allied health professionals and pharmacists.

AAPE UK hope that the production of standards for advanced practice by the professional colleges will support and facilitate the further expansion of advanced practice roles and not result in an incoherent, fragmented approach.

We look forward to hearing more of the RCN work at the launch in November.

Update on Health Education England Advanced Clinical Practice Project (August 2016)


In the latter part of 2015, Health Education England started a project in relation to Advanced Clinical Practice aiming to establish an agreed framework with a common definition and core principles with a multidisciplinary application.  A Steering Group was established.  The opportunity was taken to utilise an existing group of LETB representatives and advanced practice health professionals who had been already meeting for a year to share local advanced clinical practice frameworks and guidance.  This group has become the working reference group for the HEE project.

AAPE UK have representation on both groups:  Ruth Pearce (former Chair of AAPE UK) is a member of the Steering Group and Katrina Maclaine (Current Chair of AAPE UK) is on the working group.

Meetings of both groups are being held regularly with good attendance and enthusiastic participation.  The time line for the project has recently been extended from 1 year to 2 years in recognition of the scale of the project, however it is hoped that a definition with principles will be produced as on of the interim outputs.

Thoughts from Katrina Maclaine on themes from recent working group meetings:

The enthusiasm for this project has been high with lots of discussion and debate on issues that have vexed everyone involved in advanced practice for many many years.  As a result achieving a consensus has been challenging but a very interesting process.

For example is the intention to set a standard for advanced clinical practice as a level of practice or rather to define the role advanced clinical practitioner. We have agreed the former (using the reasoning already well articulated in the Welsh Advanced Practice policy) however anxiety in the practitioners in the group remains regarding how this will help the multitude of titles and consistency of terms for patients and colleagues.

Another key aspect that many of us have emphasised is the need to not reinvent the wheel, with high quality UK and international and profession specific work to draw on.   We undertook an exercise where multiple definitions of advanced practice were mapped and key common words highlighted.  This enabled us to synthesis a draft definition which will be put to the Steering group for consideration.  In this we particularly emphasised the importance of the four pillars, not only as separate key aspects of advanced practice but also as integral to and underpinning each other to ensure that the level of practice is significantly different from the standard of a newly qualified health professional.

The most contentious issue has been whether there should be a set standard for educational preparation and if so what this should be.   Some members want “masters level thinking” focusing on demonstrating experiential learning, while others of us are strongly pushing for a full MSc award with the curriculum based around all 4 pillars.

There was some email debate following the last meeting so I thought it might be worth sharing what I contributed (see below).  I would welcome your thoughts to enable Ruth and I to reflect your opinions as AAPE UK members in the group discussions. 

As I said at the meeting I strongly advocate a full MSc ACP for the future standard with agreed themes for content based around the 4 pillars that form part of our proposed definition.

This does not stifle creativity and can be outcome focussed with recognition of prior and experiential learning optimised.

I looked that some of the other Local office standards and also the Scottish, Welsh and Northern Ireland, RCEM and international work.

MSc Advanced Practice is now the common proposed standard and I think any suggestions for England not to act similarly would be a serious mistake in terms of reputation and its impact on reducing inter-country barriers for a mobile global workforce.

Their rationale does refer to international comparisons, however they also importantly emphasise:

  1. The need to establish consistency to sustain the future of advanced clinical practice with a single framework to support employers, service leads and senior clinicians to articulate the role, its function and the education requirements.
  2. Recognition of the level of practitioner that will result from a full MSc with a specific curriculum designed to fully optimise the knowledge, skills and competencies that are characteristic of advanced clinical practice, will be higher than that for a lower masters level award such as a module, PgCert or PgDip.   This is key for delivering the future policy agenda nationally and locally in England.

I know there may be a perception that as an HEI we have a vested interest in advocating for a full MSc, however my experience from the being on the UKCC Higher Level Steering Group (1994) piloted a standard for trying to regulate advanced nursing, subsequently as part of the NMC working group on regulating Advanced Nurse Practitioners (2004), and then on the Department of Health group to define Advanced Nursing (2010) has demonstrated to me that “masters level thinking” is not sufficient to provide a the single standard needed to enable us to move on from the constant debate about the standards needed for preparation of health professionals for advanced practice.

The issue of affordability came up last Thursday.  This is a challenging one but I don’t think we should modify our goals based on this.

I realise there are other views but wanted to share my thoughts so they could be included in information for the Steering group to consider.

Katrina’s contact email is 

We will provide further updates on this work.  

Our conference in March 2017 will also include a presentation from Mark Radford who is co-chairing the Steering Group for this important project. 

Nuffield Trust release Reshaping the Workforce

The Nuffield Trust have released their report titled: Reshaping the workforce to support new models of care. Their executive summary states it ‘is a huge opportunity, but
also a huge organisational development challenge – particularly with regard to the
non-medical workforce. We argue that organisations need to begin with a deep
understanding of patient needs, and then train, recruit and skill the workforce to
meet those needs. This report explores how organisations can do this, and the benefits
that would result.’

Click on the link to access the report

For HEI’s it state that advanced practice roles should ‘typically’ have a two year Masters qualification. The Health Education England National Framework also gets a mention and the need for ring fenced funding. See below:

The report states there are a number of important areas where national support is needed. Based on
their research they would recommend the following:
– the Health Education England budget and specialist workforce planning expertise
should be protected by ring-fencing monies to support local workforce redesign
– national competence frameworks are needed for staff in extended and advanced
– there should be a dialogue between the professional regulators and system
regulators to ensure that there is no ‘regulatory gap’ and that new and extended
roles have safe governance arrangements
– Health Education England should work with NHS Improvement and the Care
Quality Commission to ensure that planning assumptions, new workforce models
and inspection requirements are aligned and clearly communicated
– the Department of Health should review the current legal indemnity
arrangements for primary care staff with new and extended roles to find ways to
make legal indemnity easier to obtain and more affordable
– the underlying needs analysis for, and impact of, workforce redesign should be
a national research priority
– Health Education England should consider how it can support the dissemination
of good practice examples.

As Chris Inman from Birmingham City University points out there are parts of the report that read is if the Nuffield Trust has just come up with these roles and rather typically, when AP is mentioned, there is scant attention paid to regulation. However, it’s good to see a call for the DH to review legal indemnity for primary care staff.

AAPE UK Conference 2016 programme

 AAPE UK Annual Conference 2016

 “The Impact of Inter-Professional Advanced Practitioners on Service Design and Health and Social Care” 

 Friday 4th March 2016, 9am – 4:00pm

The Old Fire Station, University of Salford,

Council Chamber G05, The Crescent, Salford, M5 4WT

 Location: Visit

Nearest train station – Salford Crescent Station (3 minute walk – turn left out of the station and cross at the pedestrian crossing – venue is facing you)

Call for posters submission date extended until 12th February

You can still submit your poster to the annual AAPE-UK conference! The deadline has been extended until 12th February 2016. You may have prepared a poster in the past as part of your course work or have an element of advanced practice you’d like to share. Please consider submitting your poster to our conference.

Call for posters AAPE Conference 2016 – submission

Abstract submission form for poster session

The impact of Inter professional Advanced Practitioners on Service Design and Health and Social Care

The Association for Advanced Practice Educators UK (AAPE) National Conference

 4th March 2016

University of Salford


Preparing your abstract

1.      The abstract must not exceed 300 words (excluding authors’ names and affiliations).

2.      Please structure your abstract as follows:

a.       Put the title of the abstract in bold (Please use sentence case for the title);

b.      Provide the names and affiliation(s) of all authors, with the name of the presenting author in bold;

c.       Use the following headings in your abstract: Introduction, Aims/Objectives, Details of project, Results/Outcomes, Conclusions/Impact.

3.      Please attach your abstract document in Microsoft Word format and email it together with the form below to  by 12th February 2016.

Corresponding author name:  
Email address:
Presenting author name (if different to corresponding author):
Job title:
AAPE member Yes/ No


Terms and conditions

By submitting this abstract, the authors consent to it being published in conference programme and on the association of Advanced Practice Educators website. Presenting authors also acknowledge that they will need to register and pay to attend the conference.


RCN Scotland ‘Nurse Innovators – clinical decision making in action’

RCN Scotland have published a report outlining how advanced nurse practitioners work as innovators. Theresa Fyffe, the director of RCN Scotland states the report has been compiled due to ‘frustration at the lack of recognition at all levels of the health service and within Government of the key contribution that senior nurses in clinical decision-making roles currently make to our health service.’ the report contains case studies outlining the work advanced nurse practitioners do to enhance practice.