Nationwide evaluation of the advanced clinical practitioner role in England: a cross-sectional survey

Abstract

Background and study objectiveIn response to growing pressures on healthcare systems, the advanced clinical practice (ACP) role has been implemented widely in the UK and internationally. In England, ACP is a level of practice applicable across various healthcare professions, who exercise a level of autonomy across four domains, referred to as the four pillars of practice (education, leadership, research and clinical practice). A national framework for ACP was established in 2017 to ensure consistency across the ACP role, however current ACP governance, education and support is yet to be evaluated. This study aimed to analyse data from a national survey of the ACP role to inform the development and improvement of policies relating to ACP in the National Health Service (NHS) in England.DesignA cross-sectional survey with free-text comments.SettingThe survey was distributed across primary and secondary levels of care to three distinct groups in England, including individual ACPs, NHS provider organisations and Trusts and primary care settings.ParticipantsA total of 4365 surveys were returned, from ACP staff (n=4013), NHS provider organisations and Trusts (n=166) and primary care organisations (n=186).ResultsConsiderable variation was found in role titles, scope of practice, job descriptions and educational backgrounds of ACPs. Differing approaches to governance were noted, which led to inconsistent ACP frameworks in some organisations. A further challenge highlighted included committing time to work across the four pillars of advanced practice, particularly the research pillar. ACPs called for improvements in supervision and continuing professional development alongside further support in navigating career pathways.ConclusionsA standardised approach may support ACP workforce development in England and enable ACPs to work across the four pillars of practice. Due to the wide uptake of ACP roles internationally, this study has relevance across professions for global healthcare workforce transformation

Understanding the roles and work of paramedics in primary care: a national cross-sectional survey

“…However, there was no correlation regarding undertaking research activities and job title. This indicates that research activities are less accessible to paramedics in primary care, despite being a pillar of advanced practice, matching previous research findings 25…”

“…This indicates that research activities are less accessible to paramedics in primary care, despite being a pillar of advanced practice, matching previous research findings. 25 …”

“…This indicates that research activities are less accessible to paramedics in primary care, despite being a pillar of advanced practice, matching previous research findings. 25 Strengths and weaknesses of the study This is the first national survey of the paramedic role in primary care within the UK. It has international relevance for primary care workforce transformation in countries where paramedics operate in a similar way to in the UK, such as in Australasia and Canada.…”

Nurse and pharmacist systemic anti‐cancer therapy review clinics and their impact on patient experience and care: A systematic review

“…and is yet to improve standardization (Fothergill et al, 2022). Also, despite the level of regulation in some countries and acknowledgement that advanced practice roles can support the management of future demand, role ambiguity persists (Jones et al, 2015).…”

The Collaborative Care Model: Realizing healthcare values and increasing responsiveness in the pharmacy workforce

“…Other healthcare professional groups are also currently on their own difficult journey with the implementation of competence-based four 'pillar' workforce models, and, therefore, this paper may be widely applicable across many different professional groups. [168][169][170]…”