Resources and guidance for managers developing advanced nurse practice.
In this section we have put together information, resources and sign posting to aid organisations in understanding the employer responsibility in providing effective governance for advanced practitioners and clinical nurse specialists.
NHS Boards should ensure that all advanced level roles are embedded into governance structures, with clear lines of responsibility and accountability leading through all professional lines. The Transforming Roles papers 2 and 7 provide an outline of the recommendations.
This is a governance example from the West of Scotland Advanced Practice Academy Leadership Group for advanced nurse practitioners. This approach could be adapted to fit other advanced level practice roles.
West of Scotland Advanced Academy Governance Example
Competence Frameworks
Sign off
In line with the triangle of capability principle, competence should be assessed and signed off by a lead clinician in the area of practice, a peer and line manager.
You can find out more here: Support resources | Career Framework (scot.nhs.uk)
Maintaining Competence
Education
Each advanced practitioner should complete a training needs analysis on a yearly basis to ensure that individual training needs are being met.
Academic Education
Continuous Professional Development
Supervision
Line Manager Supervision
Peer Supervision/Support
Clinical Supervision
You can find out more about supervision requirements for specific advanced level practice roles here Supervision | Turas | Learn (nhs.scot) and in the Facilitation of Learning pillar.
Record Keeping
It is recommended that all advanced practitioners collate evidence to support their level of practice. It is helpful to have one portfolio that can support with all the different requirements.
Links to access the Turas portfolio for your profession are below and for more information go to the Professional Development section.
Nursing https://www.nes.scot.nhs.uk/our-work/professional-portfolio-nursing-and-midwifery/
AHP Professional Portfolio AHP professional portfolio | NHS Education for Scotland
Pharmacy
To register for E-portfolio follow this link RPS core advanced curriculum overview and select ‘access E-portfolio'.
For more information on professional portfolios please go to the Professional Portfolios section.
Advanced Practice Data
NHS Boards need to maintain appropriate records of all advanced practitioners, and these should be linked to the Scottish Workforce Information Standard System (SWISS).
A key requirement from TNR paper 7 is the development of benchmarking indicators focused on outcomes that can be applied across all established and new roles.
Metrics
As per Transforming Roles Paper 7 advanced practice metrics should developed that relate to both quality of care and patient outcomes. A number of underpinning principles have been highlighted for consideration:
Principle 1: Metrics should be both qualitative and quantitative and triangulated to demonstrate effectiveness.
Principle 2: Metrics that measure effectiveness of practice must be based on key result areas/ outcomes and align with service needs.
Principle 3: Where possible, metrics should be based upon existing data sources and systems to support a Once for Scotland approach and minimise additional work required for data collection.
Principle 4: There must be clear methods for displaying outcomes of ANP practice through time (scorecards/dashboards etc.). These should be aligned to the national nursing assurance framework, Excellence in Care.
Service level impact
NHS Boards are expected to collect baseline data before implementing a new advanced practice role, with follow up and review post service change.
Quality assurance
NHS Boards are expected to evaluate the impact and quality of care delivery.