Characterising the evidence base for advanced clinical practice in the UK: a scoping review protocol

Abstract

IntroductionA global health workforce crisis, coupled with ageing populations, wars and the rise of non-communicable diseases is prompting all countries to consider the optimal skill mix within their health workforce. The development of advanced clinical practice (ACP) roles for existing non-medical cadres is one potential strategy that is being pursued. In the UK, National Health Service (NHS) workforce transformation programmes are actively promoting the development of ACP roles across a wide range of non-medical professions. These efforts are currently hampered by a high level of variation in ACP role development, deployment, nomenclature, definition, governance and educational preparation across the professions and across different settings. This scoping review aims to support a more consistent approach to workforce development in the UK, by identifying and mapping the current evidence base underpinning multiprofessional advanced level practice in the UK from a workforce, clinical, service and patient perspective.Methods and analysisThis scoping review is registered with the Open Science Framework (https://osf.io/tzpe5). The review will follow Joanna Briggs Institute guidance and involves a multidisciplinary and multiprofessional team, including a public representative. A wide range of electronic databases and grey literature sources will be searched from 2005 to the present. The review will include primary data from any relevant research, audit or evaluation studies. All review steps will involve two or more reviewers. Data extraction, charting and summary will be guided by a template derived from an established framework used internationally to evaluate ACP (the Participatory Evidence-Informed Patient-Centred Process-Plus framework).DisseminationThe review will produce important new information on existing activity, outcomes, implementation challenges and key areas for future research around ACP in the UK, which, in the context of global workforce transformations, will be of international, as well as local, significance. The findings will be disseminated through professional and NHS bodies, employer organisations, conferences and research papers.

Advanced Clinical Practitioners in Primary Care in the UK: A Qualitative Study of Workforce Transformation

“…Working with Health Education England (HEE), a national non-departmental public body that supports NHS workforce development), the interim NHS People Plan aims to define sets of advanced skills to apply across a wide range of professional groups by developing advanced clinical practice (ACP) roles with primary and community services targeted for greater service and workforce expansion [ 15 ]. ACP roles are being developed across a range of professions in multiple sectors [ 19 ]. However, in primary care, by far the largest non-medical cadre is nursing [ 9 ].…”

Workforce experience of the implementation of an advanced clinical practice framework in England: a mixed methods evaluation

“…Other professional groups such as pharmacists and Allied Health Professionals undertake a role known as an Advanced Clinical Practitioner [4][5][6]. Many calls have been made for a consistent approach to the development of this workforce across all occupational groups [7]. Prior to this, there had been some ambiguity over this level of practice and in particular the differences between advanced clinical practice and clinical specialisms [8,9].…”

Impact of clinical leadership in advanced practice roles on outcomes in health care: A scoping review

“…The impact of clinical leadership on health care outcomes has gained increasing interest in health systems worldwide (Mianda & Voce, 2018), not least in the area of advanced practice (Lamb et al., 2018). In nursing and in other health professions, advanced practitioners (APs) are increasingly identified as clinical leaders who have progressed into areas of higher level practice improving care quality and outcomes (Evans et al., 2020; Leggat et al., 2015; Milner & Snaith, 2017; Thompson et al., 2019). While there is an established association between leadership traits of managers and a range of patient, staff and organisational outcomes within health services in general (Cummings et al., 2018; West et al., 2015), demonstrating the impact of clinical leadership on outcomes remains challenging.…”