Advanced clinical practice core capabilities for nurses working within general practice settings in England


NHS England Ten Point Plan Team has commissioned the development of a new core capabilities framework for nurses working in general practice settings. The framework will describe the required skills, knowledge and behaviours relevant to advanced clinical practice and will align with the Multi-Professional Framework for Advanced Clinical Practice in England (HEE 2017).

  • Background

    As defined in the HEE Multi-Professional Framework, a nurse working at an advanced clinical level will exercise autonomy and use clinical reasoning to make complex decisions in the context of uncertainty and varying levels of risk. They are accountable for their decisions.

    Over the past 15-20 years the role of the advanced nurse, often known as an advanced nurse practitioner (ANP), has evolved within both general practice and secondary care. Within general practice, nurses have played a key part in developing roles in response to practice and workforce need. Therefore, there now exists a variety of titles, varying levels of qualification/training and a wide range of competency. As such this has created confusion for nurses, fellow healthcare staff, employers, clinical supervisors and patients and this framework aims to address these concerns.

  • Purpose and scope of the framework

    A key purpose of the framework is to support development and planning of the advanced clinical level workforce, and to inform the design and delivery of education and training programmes. With a growing shortage of GPs, more complex care being delivered in primary care and an increasing patient demand, there is a huge need for more clinicians. The General Practice Forward View (2016) highlighted the need for workforce development to combat these issues. This framework is also in accordance with the NHS England ten-point action plan for General Practice Nursing and in particular, the deliverable to “Actively promote advanced clinical practice in order to increase the numbers of nurses in general practice working in these roles”.

    The framework will provide a standard and greater clarity on the scope of practice for nurses working at the advanced clinical practice level, within general practice settings. This will be particularly relevant to employers such as GPs and Practice Managers (e.g. for workforce planning), education providers (e.g. to inform the design and delivery of curricula) and to patients, nurses and colleagues in multi-disciplinary teams.

Development of the framework

Skills for Health has been commissioned to provide project management and lead on development of the framework. A steering group comprising key stakeholders will guide the development process.

The first stage of the project will focus on desk research to review existing source documents and develop the framework structure. It is anticipated that a draft framework will be developed by the end of March, which will then be available for review as part of a wider consultation process during April.

The framework is due for completion by the end of June 2019.

Register to be involved: To register your interest, please complete the form below. You will then be invited to take part in an online survey as part of the consultation process (expected April 2019).