20th January 2020

Image: ACP Nursing Framework.In November 2017 Health Education England (HEE) published the Multi-professional Framework for Advanced Clinical Practice in England. This provides a clear definition and specified the capabilities for clinicians using the 'advanced' title. The framework supports a level of practice and as such encompassed both those working in 'advanced specialist' and 'advanced generalist' roles.

Clinicians who use the term ‘advanced’ in their title need to have Masters level education and be able to evidence competency across the four pillars of advanced practice; clinical, management & leadership, education and research. This requires that health and care professionals working at the level of advanced clinical practice will exercise autonomy and decision making in a context of complexity, uncertainty and varying levels of risk, holding accountability for decisions made. Each clinician needs to work within their scope of competency.

The above work by HEE has led to the development of more detailed guidance for specific clinical areas/professions and today sees the launch of a national capabilities framework for nurses working at an advanced level of clinical practice in general practice and primary care in England.

Skills for Health, together with a steering group of key stake holders, were commissioned to develop this framework by NHS England & NHS Improvement General Practice Nursing 10 Point Plan Team, which provides clarity about advanced level practice in primary care/general practice for nurses.

Over a number of years, the role of the nurse has evolved within primary, community and secondary care. Nurses have in many ways been the pioneers of enhanced and advanced roles within many clinical settings. The NHS needs a workforce that is fit for the future and nurses with advanced clinical practice knowledge and skills will be able to both lead and work within and across teams to provide excellent care for people.

This framework sets a standard regarding the academic knowledge, skills and behaviours required to enable the highest standards of practice within primary care and general practice. It will support nurses working at an advanced level to demonstrate and evidence their capabilities to service commissioners, employers, people utilising health care and the public.

Nurses are employed in a variety of roles which require advanced level clinical practice. They and their employers can use this framework to agree the scope/content of their role within the multi-professional team. Nurses may have differing starting points, and this will help them and their employers to identify and address any educational/training needs and can be used as part of the appraisal process.

The Academy for Advancing Practice (presently under development) will provide an opportunity for practitioners working to evidence their ability to work at an advanced level. This may be supported by regional and local governance structures. Work is now underway to look at how best to support commissioners, employers and nurses to implement it.

The framework launched today provides clarity around the core capabilities required by advanced level nurses working in primary care/general practice and will promote a high standard of care for those utilising the services. It will allow nurses to showcase their advanced level knowledge, skills and behaviours which will be essential in the development of the multi-professional teams to provide excellent prevention and care for people accessing their services.

The Core Capabilities Framework for Advanced Clinical Practice (Nurses) Working in General Practice/Primary Care in England has now been published online from Skills for Health and is available to view and download here.

By Julia Taylor - ACP (Primary Care) GP Training Programme Director

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