Advanced Clinical Practice
Advanced practice is a level of practice, rather than a specific role or title and has four pillars of practice.
Advanced Practice
Within the clinical practice pillar practitioners working at advanced level must demonstrate competence in:
- Comprehensive history taking
- Clinical Assessment
- Differential Diagnosis
- Investigations
- Treatment
- Admission, discharge and referral (Chief Nursing Officer Directorate, Transforming Roles Paper 2 (2017).
The Nursing, Midwifery and Allied Health Professions Development Framework provides details of generic knowledge, skills, and behaviours (KSBs) that all clinicians working at an advanced level of practice should possess. In addition, the development framework recommends that these generic KSBs are supplemented by role specific/speciality specific KSBs to fully describe the full complement of KSBs under the given pillar (ie in this instance the clinical pillar).
For example, an MSK Advanced Practice Physiotherapist would be required to develop and evidence their ability to fulfil the requirements of the generic KSBs within the development framework (clinical pillar) together with the role speciality specific KSBs identified within the UK MSK AP standards.
Clinical skills
Many clinical skills which were once considered to be extended or advanced skills are now core across roles and not viewed as higher level or advanced. Within advanced clinical practice there are many procedures undertaken which, due to the associated risks of harm, are generally considered to be advanced for example arterial stabs, lumbar puncture, insertion of central/arterial lines, abdominal paracentesis, various surgical procedures, confirmation of death and authorisation of blood products.
It is vital that robust training and competency assessment is in place if such procedures are to be undertaken and that appropriate clinical and professional governance is in place.
Within mental health nursing clinical interventions may include therapies, medicines, lifestyle advice and care as per Advanced Practice Mental Health Curriculum and Capabilities Framework (hee.nhs.uk).
Useful Resources
Please note this is not an exhaustive list, it is a collated selection of resources suggested by advanced practitioners that we hope you will find helpful.
BASICS (2023) Paediatric Tele-education
Blood tests
- Understanding Blood Results for Physiotherapists - Allied Health Professionals - M&K Update (mkupdate.co.uk)
- Demystifying Blood Tests in MSK Health (macpweb.org)
Confirmation of Death: Confirmation of death policy (NES)
Clinical Skills Managed Educational Network (CSMEN)
Communication
- Communication | Turas | Learn (nhs.scot)
- Effective Communication Training For NHS And Healthcare (difficultconversations.org.uk)
eBook by Skills you Need on advanced communication skills
Clinical Knowledge Summaries
e-Learning for Healthcare
- Home - elearning for healthcare (e-lfh.org.uk)
- BMJ Learning: Online Courses for Healthcare Professionals
- BASICS Scotland
- BMJ Best Practice
- Geeky Medics | free medical student revision notes, OSCE guides & MCQs
- MDCalc - Medical calculators, equations, scores, and guidelines
- Red Whale GP Update Homepage (gp-update.co.uk)
Fitnote training
- Fit note certification | Turas | Learn (nhs.scot)
- The Fit Note - elearning for healthcare (e-lfh.org.uk)
Guidelines
Joint and Soft Tissue Injection Information
- Injection therapy for physiotherapists | The Chartered Society of Physiotherapy (csp.org.uk)
- Corticosteroids, inflammatory disorders | Treatment summaries | BNF | NICE
Lymes Disease
Right Decisions for Health and Care
The Right Decision Service is a 'Once for Scotland' source of digital tools that enable people to make safe decisions quickly ‘on the go’, based on validated evidence. It provides health and social care organisations with tools to build decision-ready guidance, pathways, risk scoring tools, shared decision aids and other decision support resources. These tools are all delivered through this Right Decision Service website and mobile app.
Shared decision making
Realistic Medicine is an approach to healthcare that aims to put the patient at the centre of decisions made about their care. It also aims to reduce harm, waste and unwarranted variation, whilst acknowledging and managing the inherent risks associated with all healthcare, and championing innovation and improvement.
The Mastery Skills Pathway
The NHS Lothian Mastery Skills Pathway is an educational, quality assurance and patient safety initiative to promote high-quality training and safe, effective patient care for high-risk procedural skills. Can be accessed via this link The Mastery Skills Pathway (scot.nhs.uk)
Values-based care
Turas Learn page with eLearning module Value Based Health and Care | Turas | Learn
Values Based Reflective Practice Values based reflective practice (VBRP®) | Turas | Learn (nhs.scot)
- Delivering value based health and care: a vision for Scotland - gov.scot (www.gov.scot)
- A strategy for supporting better care in Scotland: 2022-2027 (healthcareimprovementscotland.org)
- New approaches to value in health and care - The Health Foundation
- Value Based Health & Care – Realistic Medicine
- NHS NSS Strategy 2019 - 2024
- Defining Value-based Healthcare in the NHS (cebm.net)
Profession Specific Links
