Rural Workplace Advanced Practice Supervision Hub

Often working in isolation, Rural Advanced Practitioners are extended generalists. They work autonomously and collaboratively to promote health and well-being and contribute to addressing inequality in health outcomes. Based on identified community needs and strengths, they work with statutory, private, and voluntary providers to help build community strengths, assets, resilience and mitigate against health inequality, to prevent disease and improve health outcomes.  

When required, they advocate and lobby to address gaps in local remote and rural service provision to promote and support community health and wellbeing. 

As champions of technology-enabled care, they provide person-centred holistic care and support effective multi-disciplinary and multi-site care provision. They have enhanced decision-making skills to provide safe, effective, and autonomous person-centred care, often in isolation from other healthcare professionals. 

Rural Advanced Practitioners stem from a range of professional backgrounds for example nurses, paramedics, physiotherapists and pharmacists and have advanced level capabilities across the four pillars of clinical, leadership, education and research and are now working beyond the scope of their original disciplines. They manage episodes of care in partnership with patients and their families. They combine an in-depth knowledge of the health care needs in their community and natural environmental hazards with advanced health and social care knowledge, enhanced decision-making skills, diagnostic reasoning, and evidence-based therapeutic knowledge to provide person-centred care across the age spectrum (0 – 80+).  

Rural Advanced Practitioners assess, diagnose, and manage patients with emergencies, minor injuries/ailments, long-term and complex health conditions. They have the authority to order and interpret diagnostic laboratory tests and prescribe medicines within their areas of competence.   

They develop effective professional networks with primary, secondary, tertiary, statutory, retrieval and voluntary services that enable safe, seamless patient care at, or as near a patient’s home as possible. As leaders, they implement evidence-based practice using audit, improvement methodology and research skills. Rural Advanced Practitioners facilitate continuous service improvement while maintaining and developing their own knowledge and skills. They support learning within and out-with their multidisciplinary team and remote and rural community. Rural Advanced Practitioners are meeting service demands and patient needs traditionally associated with other professions.   

There will be overlap with other roles, but multi-professional rural advanced practitioners are registered professionals, working within their qualifying professional registration, to meet rural advanced clinical practice demands. 

The Multidisciplinary Rural Advanced Practice (RAP) Educational Pathway identifies the knowledge and skills needed to become a Rural Advanced Practitioner. It illustrates how multidisciplinary team members can progress their clinical careers in rural areas by accessing education that meets the needs of the remote and rural health and social care workforce. It utilises one of the key findings from the international research programme, ‘Making it Work’ (2019), by creating a Rural career framework to provide support with recruitment and retention of rural staff.

Rural Advanced Practitioners must demonstrate capability, competence, confidence, and ability in rural practice using the The Multidisciplinary Rural Advanced Practice Capability Framework - Primary and Community Care.

The Multidisciplinary Rural Advanced Practice Capability Framework and related competencies outlines the knowledge, skills and attitudes required of Rural Advanced Practitioners. The framework:

• Aligns with the NHS Education for Scotland’s (NES) Nursing Midwifery & Allied Health Professionals (NMAHP) Post Registration Career Development Framework (Level 7) and expands upon the current NES advanced practice competencies
• Applies across multidisciplinary remote, rural and island professional roles
• Defines and shows the scope of practice and capabilities required of those working in a Rural Advanced Practitioner role
• Provides suitable guidance so that modules delivered by education providers can be aligned and quality assured
• Supplies an outline against which the skills set of a practitioner can be assessed in remote, rural and island practice
• Informs rural community members and other health and social care staff about the role