Developing and implementing advanced clinical practitioner roles

Advanced Clinical Practitioner (ACP) posts have been introduced successfully across many professions at my trust, and the numbers continue to grow thanks to ever-increasing service needs and drivers.

Traditionally, ACP roles have been implemented as a reactive service response, rather than planned and co-ordinated. This lack of consistency has resulted in disparity between the roles across the organisation.

As vice-chair of the trust's Specialist Practitioner Forum, I was tasked with developing a governance document by the chief nurse. The purpose was to provide a more consistent approach to the overarching governance, development and management of current and aspiring ACPs, and enable effective workforce planning for all ACP roles.

The document draws on and consolidates existing frameworks relating to advanced practice across the UK, including national and professional guidelines such as the Multi-professional framework for advanced clinical practice in England, (NHS England, 2017)¹.

During its development, I worked closely with other ACPs and consultant practitioners to ensure it reflected the needs and requirements of all professions. Multiple drafts were circulated to the Senior Practitioner Forum, divisional operational managers, and development and educational leads.

It was imperative that the final document would not only provide a trust-wide governance structure for these posts, but also provide practical support, advice, and tools, easily accessible to all. The final document was approved by the trust board earlier this year and endorsed by the trust's chief nurse and the medical director.

The final document includes information and guidance about:

• Minimum core and clinical competencies and capabilities for all ACPs  
• Minimum educational requirements and clinical development
• Minimum clinical supervision requirements and appraisal guidelines
• CPD requirements and supporting portfolios, including information on non-medical prescribing, research, audit and quality improvement projects, professional leadership, and consultancy and clinical leadership 
• Competencies and increased scope of practice
• Workforce planning, sustainability and recruitment including business case development
• Job descriptions and job planning
• Trust regulation and accountability, roles and responsibilities
• Education and preparation of trainee ACPs, linking assessment and competence to pay banding
• Assessment and progress review for trainee ACPs, including work-based assessment tools

With the approval of the trust senior management team, we developed an Advanced Practice Oversight Group, which I currently chair. It is our responsibility to ensure the guidelines are implemented effectively. We will be reviewing all ACP and associated roles with ‘advanced’ in their title against the current framework, and provide support to ensure they achieve the new minimum standards.

We have already started to develop working parties for job planning and job descriptions to improve standardisation, and all new trainee ACP portfolios will be approved by the group.

To develop the document further, we are looking at including a progression framework, as well as minimum competencies and capabilities for practitioners working at consultant level. Our main aim is to provide oversight and strategic vision of the development, training and governance of all ACP roles. We shall feedback findings and recommendations to the trust board. 

Katie is happy to answer questions by emailabout the ACP document and the work at Norfolk and Norwich.