Realising their potential? Exploring interprofessional perceptions and potential of the advanced practitioner role: a qualitative analysis

Abstract

ObjectivesTo explore perceptions of the current practice and future potential of advanced practitioners (APs) from the perspectives of different professional groups in Wales UK.DesignA qualitative study consisting of nine focus group interviews.MethodsInitially verbatim transcriptions of each focus group interviews were analysed thematically before themes were merged to represent perceptions for the whole data set.ParticipantsData were gathered from a total of 67 stakeholders—including APs from a variety of professional groups (eg, nursing, physiotherapy, paramedics) as well as managers, workforce developers, educators and medical staff who have a role developing and supporting APs in practice.ResultsThe results are presented in four themes: (1) demand, policy context and future priorities, (2) role clarity and standardisation, (3) agreement and understanding of the role and (4) interprofessional working. The context within which current and future AP roles were considered was influenced by inexorable demands for healthcare and the requirements to meet health policy priorities. Developing AP roles were hampered currently by a lack of shared understanding and ‘joined-up’ working between different groups such as medical practitioners, managers, commissioners and educators.ConclusionsFor the AP role to flourish more ‘joined-up’ thinking, support and development opportunities are required between APs, managers, senior clinicians, commissioners and educators. Working together to plan and deliver education, innovation and service delivery is of prime importance to meeting ever increasing complex health needs. This will ensure that future APs are adequately prepared and supported to reach their full potential and help deliver necessary innovations in current models of care delivery.

Role definition is key—Rapid qualitative ethnography findings from a team‐based primary care transformation

“…Our observations suggest this was possibly a result of unclear role definition; even in internal implementation documents, the APP role was defined as “to be determined,” because stakeholders could not come to consensus on the functions of the APP role within this model. This lack of role definition may be a wider spread problem for APPs in traditionally physician‐led settings; other qualitative studies have documented role clarity as a barrier to successful integration of APPs across medical contexts . Future planned evaluation of this model includes a focused assessment of the APP role.…”

The education and training needs of advanced clinical practitioners: An exploratory, qualitative study

“…Data from a focus group study (n = 67) by Jones et al support this view, with authors highlighting the need for more 'joined-up' thinking, support and development opportunities. [5] There are, however, significant challenges to cross boundary working, with success frequently hampered by restrictive structures and processes. These problems have been described in literature related to achieving integrated care within the NHS [19] and across other large-scale organisations.…”

“…[5,16] New models of ACP education, such as the apprenticeship standard currently in development in England [20] also need to be critically reviewed to determine their benefits and the degree to which there is 'organisational readiness' for work based approaches. [21] In addition, consideration must be given to any stipulations with regard to potential future registration of some titles by different professional bodies (for example, the consultation on medical associate roles by the Department of Health & Social Care).…”

“…[1,2] The continuously extending scope and breadth of the ACP role means that practitioners have unique training and education needs, which may not be met by traditional academic programmes. [5] In addition, role expansion has left many current staff needing to extend their skills and knowledge. [2,3,6] However, despite a plethora of literature on AP and a National multidisciplinary framework published in England, [2] a scoping review undertaken by the authors identified only two previous small scale primary research studies, one conducted in Sweden [7] and one in Finland [8] specifically addressing the educational preparation of ACPs.…”

Advanced musculoskeletal physiotherapy practice in Ireland: A National Survey

“…Increased demands on health services, with growing waiting lists, staff and skill shortages, and need for cost containment (Jones, Powell, Watkins, & Kelly, ; McPherson et al, ), together with recognition of the wider clinical expertise and competence of various health disciplines, have driven the transformation of healthcare models with the development of advanced practice health professional roles. Physiotherapy is one such discipline which has broadened its practice remit in the UK, Canada, New Zealand, Australia, Sweden and, more recently, in Ireland (Fennelly, Blake, Desmeules, Stokes, & Cunningham, ).…”