Advanced practice toolkit

Advanced practice has been evolving across the four UK countries since the 1980s. Definitions, scope of practice and educational preparation have been refined over this time and are continuing to develop. More information about how advanced practice developed in the UK can be found in the Association of Advanced Practice Educators (AAPEUK) Student Handbook page 4.

Developing and increasing the number of advanced practitioners is a significant element of the Scottish Government strategy to develop and retain experienced clinicians within the workforce. Work began on the Transforming Roles programme in 2014/2015 and is now in the process of being revisited.

The Transforming Roles programme aims to provide strategic oversight, direction and governance through:

• Developing and transforming nursing, midwifery and allied health professions (NMAHP) roles to meet the current and future needs of Scotland’s health and care system.
• Ensuring nationally consistent, sustainable and progressive roles, education and career pathways across professions, services and Boards.
• Career structure and clarity around levels of practice.
• Clarity in understanding roles.
• Development of roles using a consistent process.

Since 2017 the education of advanced practitioners has experienced greater standardisation and clarity. In many cases a typical journey is now likely to involve:

• Application for a training post
• Specific training programme or module (a Master’s programme tied in with supervised practice and work-based learning)
• Assessed as competent for role
• Undertaking Advanced Practitioner role
• Continuing professional development within an Advanced Practitioner role

Currently the development of a national approach to advanced practice is a key strand of the new Workforce Transformation model featured in the diagram below, which underpins Transforming Roles.

The Scottish Government produced an Allied Health Professions (AHP) workforce and education review in Feb 2023 which will contribute to a national approach to advanced practice amongst different professions.

At present (Nov 2023) Advancing Midwifery Practice and Advanced Clinical Practitioners in Midwifery are being considered as part of the Midwifery Career and Education Framework for Scotland activity. Until now, the Transforming Roles Programme in Scotland has not had specific activity in the midwifery space and there is a need to understand both the service and educational needs for such developments. NHS Education for Scotland (NES) is working closely with the Chief Midwifery Officer in Scotland to develop a Midwifery Career and Education Framework for Scotland. The early focus may be on remote and rural practice.

Health Education England (HEE) have published the Advanced Clinical Practice in Midwifery Capabilities Framework in Nov 2022 to support the development of new midwifery roles.

The Royal College of Emergency Medicine and the Faculty of Intensive Care Medicine (RCEM) recognised the reduction of availability of medical staff in emergency and intensive care settings. They undertook extensive and robust work in considering the options to ensure the maintenance of safe and effective practice. This work led to staff development opportunities for nurses and allied health professionals culminating in the production of curriculum frameworks for Advanced Clinical Practitioners (ACPs). The title reflects a focus on clinical practice which was the key to this role development and practitioners can now apply for credential status with these organisations.

The Royal College of Emergency Medicine issued a statement in May 2022 affirming healthcare requires a diverse workforce and the role of the ACP is both welcomed and valued.

For further information on workforce development see the Workforce section.