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NHS told to tighten up on use of ‘advanced’ in job titles

NHS organisations are being told to ensure that staff using job titles containing the word ‘advanced’ meet standards set out in new multi-professional guidance and do not compromise patient safety

NHS organisations are being told to ensure that staff using job titles containing the word ‘advanced’ meet standards set out in new multi-professional guidance and do not compromise patient safety.

National bodies have agreed on a definition for advanced clinical practice in the NHS, as well as the competencies and skills that should be met by advanced clinical practitioner (ACP) roles.

The new framework, published by Health Education England (HEE) today, lays out expectations for employers on governance arrangements for ACP roles, warning them against 'unconscious incompetence' if their policies and procedures are not modified to reflect these responsibilities.

Clarity for professionals, employers and the public

It also says ACPs will hold registration with their professional regulator, master’s level qualifications and be involved in leadership, management, education and research.

RCN head of nursing Wendy Preston said the framework may help to add clarity for professionals, employers and the public, but it would depend on how it was implemented and funded.

She said: 'The framework is just one element in a range of resources aimed at addressing the current issues in advanced practice, which include multiple and confusing job titles.'

Speaking to Nursing Standard, HEE director and dean of education and quality John Clark emphasised that the guidance was about a level of practice, not a specific role or area of practice.

Clear and consistent approach

Professor Clark said: 'The aim of the framework is to provide a clear and consistent approach to the development of advanced clinical practice across England.'

‘We have been doing advanced nursing practice for 30 plus years but not in any nationally agreed way.

‘This is a way of making sure advanced practitioners in the future work around a nationally agreed set of skills and competencies.’

He added: ‘My expectation is that this is a soft launch of standardising job titles.'

‘A really positive step forward’

In September, researchers found that hundreds of unregistered care staff had been given job titles containing words such as ‘advanced’ even though they lacked qualifications to merit them.

The study's author, Alison Leary, London South Bank University chair of healthcare and workforce modelling, said the guidance was ‘a really positive step forward’ for advanced practitioners in England.

Professor Leary said: ‘From employers, regulators and a legal point of view, in terms of employment law and litigation, there needs to be standardisation, to harmonise job titles with levels of education and experience.’

ACPs must meet 38 standards

The guidance says ACPs must meet 38 standards across clinical practice, leadership and management, education and research, which include being able to demonstrate:

  • A critical understanding of their broadened level of responsibility and autonomy and the limits their competence and professional scope of practice.
  • Team leadership, resilience and determination, managing situations that are unfamiliar, complex or unpredictable and seeking to build confidence in others.
  • Ability to act as a role model, educator, supervisor, coach and mentor – seeking to instil and develop confidence in others.
  • Critical engagement in research activity, so that evidence-based strategies are developed and applied to enhance quality, safety, productivity and value for money.

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