Dr. Peter Carter (General Secretary RCN), Christine Beasely (CNO England), Roz Moore (NO England), Rosemary Kennedy (CNO Wales), Jean White (NO Wales), Paul Martin (CNO Scotland), Mike Sabin (NO Scotland), Martin Bradley (CNO Northern Ireland), Gavin Larner (Head of Implementation Professional Regulation Dept. of Health.)

Dr. David Barton
Chair (and on behalf) of the Association of Advanced Nursing Practice Educators

Dear Colleagues

I write to you as the Chair of Association of Advanced Nursing Practice Educators UK (AAPE) to discuss some of our associations concerns regarding the current and emerging situation on Advanced Nursing Practice in the UK.

AAPE is a collaboration of over forty Universities (and some 160 academics) representing the UK Universities interest in the development of, and educational preparation for, advanced nursing practice. Every member institution is involved in the educational provision of advanced nursing practice – and our key aims are:

Encouraging collaborative curriculum development and standard setting across the 4 countries of the UK
Consultation and advising with other professions, professional and statutory bodies, commissioners, employers and relevant government bodies
Promotion of international links

AAPE is today an influential national lobby that has advised in key strategic developments; the proposed Advanced Practice Register, the Modernising Nursing Careers initiative, and most recently the extending Professional Regulation initiative.

In AAPE’s view, the world of Advanced Nursing Practice has currently never been more topical, or more at risk, as multiple agencies, initiatives, specialities and professions involve themselves in this fundamental development. For example, whilst AAPE has lobbied positively for the introduction of a professional register and a nationally agreed advanced practice competency framework, we have become increasingly frustrated over the prolonged delays that have arisen regarding this initiative at the NMC. We have also noted the recent organisation difficulties that have arisen within the NMC. In the light of those wider problems we of course acknowledge that a crucial first task will be to assure the continuing regulation of the Nursing profession as a whole. Nevertheless, the potential impact of these problems on the development and regulation of Advanced Nursing Practice (and its significant contribution to healthcare) are hampering us, as educators, when trying to provide consistent and measurable educational and clinical standards. We cannot lose sight of the fact that Advanced Nursing Practice in the UK is not professionally regulated, and that we as educators need to be able to properly assure and monitor the demand for this clinical education in terms of outcome and best patient care.

AAPE has contributed, with others, to the Modernising Nursing Careers initiative and its promising and encouraging development of the Advanced Practice Toolkit, but we are now conscious that the four country perspective may differ on how this toolkit may, or may not, be implemented. Coupled with this are the multiple competency frameworks that are proliferating at this time from diverse professions, specialist groups, specialist forums, and from the more extensive and far reaching Department of Health, KSF and Skills for Health initiatives. For example, we are aware that the RCN Forums are discussing how advanced practice standards and definitions may be brought together more coherently in the light of their varied and multiple specialisms. Whilst many of these developments are laudable, from an educationalist perspective they are to all intents contrasting and uncoordinated developments, and this is making effective curricular design and programme delivery increasing complex and evermore difficult.

Finally, we are particularly concerned over the multitude of ongoing but disparate developments and initiatives throughout the UK in service provider organisations as they grapple to make some form of sense of Advanced Nursing Practice and its place in clinical practice.

Naturally, as senior educators, we are keen that all these developments should be coordinated and advised with appropriate representation from the Universities; as ultimately they are the institutions that will be called on to deliver such education in conjunction and collaboration with service providers. Issues of curricular design, commissioning, evidence base and strategic educational planning for advanced nursing practice cannot be properly undertaken without involvement and sensible collaboration with the Universities and their educational expertise and resource.

We would be grateful to have your views in these issues, and indications on how you see that these may be resolved. I would like to note that ANNPE is willing and able to provide representation and guidance to any of the developments that are arising from this complex situation.

Many Regards

Dr. David Barton – Ph.D. M.Phil. B.Ed. Dip.N. RN RNT
Chair AAPE