In the UK and around the world health care systems are evolving to deliver models of care which are fit for purpose. Needs are changing, the population is changing and professional skills are improving. The growing consensus is that if high quality patient care is to be sustained in the future, new and emerging roles will need to play a crucial part.
This is always going to be a contentious topic with different professions encroaching onto others. Take prescribing physios working in respiratory care as an example. The role they take up is encroaching upon some junior doctors as well as advanced nurse practitioners. This creates tension and a lack of clarity for both parties as professional boundaries are blurred, sadly this often leads to quashing of new and emerging roles.
This lack of clarity of what advanced practice is, and what you need to be working at an advanced level, has also led to many of these ‘advanced roles’ being unregulated and unequal in banding, role and individual expectation. This puts services and employers and risk but it also puts our patients in an uneasy position. Do they understand who is treating them, do they lose out by seeing a nurse or physio instead of a doctor? A lot of these questions remain unanswered.
What is Advanced Practice?
A couple of months ago HEE published the Multi-professional framework for advanced clinical practice in England which outlined what advanced practice is and if you were working at the required level. In summary there are 4 pillars of advanced practice; clinical practice, leadership and management, education and research. These may be manifested /demonstrated in different ways depending on the profession, role, population group, setting and sector in which an individual is practising.
What Next?
To answer many of the uncertainties around advanced practice there is a consultation which is currently underway in the UK. Health Education England has set up and is currently running an online workshop to help create some equity between profession, jobs and educational needs. The workshop is anonymous and free to register and use.
The aims of the workshop are to:
- Develop a better understanding of what advanced practice is
- How advanced practice benefits patients
- Identify needs and challenges of working at this level in the workplace
- To help employers understand the need for advanced practice
- Consider what the supporting infrastructure needs to look like to develop advanced practice further.