A new draft framework of core capabilities for advanced clinical practice, aimed at practice nurses working in general practice in England, has been published by Skills for Health.
The framework details a series of 13 capabilities that are expected of advanced nurse practitioners (ANP) working in general practice and using the ‘advanced’ title.
The core capabilities, which must be evidenced and maintained by the nurse, include critically engaging in research activity as well as networking with academic and clinical researchers.
ANPs must also consistently identify and act appropriately on red flags, appropriately manage and escalate medical emergencies such as sepsis, and manage medical complexity.
The capabilities are split into four domains: person-centered collaborative working (domain A); assessment, investigations and diagnosis (domain B); condition management, treatment and prevention (domain C); and leadership and management, education and research (domain D).
The core capabilities are required for both ANPs and practice nurses who see patients with undifferentiated and undiagnosed conditions. They are:
Communication and consultation skills
Working with colleagues and in teams
Maintaining and ethical approach and fitness to practice
Information gathering and interpretation
Clinical examination and procedural skills
Making a diagnosis
Managing medical and clinical complexity
Independent prescribing and pharmacotherapy
Leadership, management and organisation
Education and development
Research and evidence based practice
All nurses working at an advanced level or using the ‘advanced’ title will need to demonstrate these capabilities.
The Academy for Advancing Practice, which is under development, will provide an opportunity to evidence capability to work at an advanced level.
But the academy will not evidence the nurse’s ability to work within the specific setting or role – this will be down to local and regional employers and governance.
Examples of evidence that a portfolio should contain include records of modules completed at university and workplace assessments, a learning log and patient satisfaction questionnaires.
ANPs must have undertaked or be working towards a minimum of a postgraduate diploma (PG Dip) in advanced clinical practice or equivalent. They will also be an independent prescriber.
The draft framework has been published as part of the GPN 10-point plan, and builds on the multi-professional advanced clinical practice framework published by HEE in 2017.
On the need for a framework, Skills for Health said in the report: ‘The advanced nurse practitioner role, within general practice, has developed without a set standard and this has led to varying levels of attainment, resulting in much disparity. This has created confusion for employers, fellow healthcare staff and patients because of variation in titles, qualifications and competency.’