Government to develop ‘advanced practice nurse models’, says NHS 10-year plan

The government has committed to developing ‘advanced practice models’ for nurses that align to its three big shifts for the NHS, as part of its long-awaited 10-year plan.

The 168-page blueprint published today outlines several ways the government hopes to radically reform the NHS and introduce a Neighbourhood Health Service.

As part of this, the government has said it will introduce advanced practice models to better reflect the ‘essential leadership’ roles of nurses, midwives and allied health professionals (AHPs).

‘In the past few decades, the range of clinical tasks done by nurses has increased to include prescribing, some diagnosis and assessment, management of complex wounds and administration of intravenous therapies,’ the plan said.

‘Beyond that, nursing has evolved into a more autonomous role. Advanced nursing and midwifery practitioners provide clinical leadership across the multi-disciplinary team, making independent and complex decisions.’

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The government said it would ‘build on these foundations’ by developing new advanced practice models, which will be aligned to the government’s three shifts from analogue to digital, hospital to community and sickness to prevention, according to the plan.

The models will aim to give greater autonomy for advanced practice nurses working across a range of heath settings, with a focus on community and public health services.

The government will ‘work closely with the Nursing and Midwifery Council (NMC), the professions, and employers to ensure that effective systems of accreditation and regulation for advanced practice roles are introduced as quickly as possible’, the plan states.

As part of this, the government will support the NMC to consult on its planned advanced practice standards due in 2027-2028.

‘This regulatory framework will provide clarity for patients and the public, enhance patient safety, and strengthen career pathways thereby enabling nurses, midwives, and AHPs to continue delivering direct patient care with increased autonomy,’ the plan said.

The Queen’s Institute of Community Nursing chief executive, Steph Lawrence, explained that advanced roles already exist across community services in nurses who complete specialist practice qualifications (SPQ), including in district and general practice nursing. 

SPQ qualifications are designed to provide nurses with advanced skills and knowledge to provide specialized care within specific community health areas. 

‘In addition, advanced practitioners already exist outside of these SPQ roles in numerous nursing and AHP roles in community and primary care, and have done for a long time,’ she said. 

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But she warned that recent changes to Level 7 apprenticeships, with the government’s decision to remove funding for Level 7 apprenticeships for people aged 22 and over, could jeopardise the future of these roles. 

‘The QICN would reiterate that for nurses to undertake this training, be it SPQ or advanced clinical practice, it is very much reliant on the soon to be abolished level 7 apprenticeship funding. 

‘Therefore without an alternative or a change of direction on this, it is hard to see where additional staff with advanced practice qualifications will come from,’ Ms Lawrence added. 

In March, the NMC  was given the greenlight on its definition and principles of advanced practice, following several months of delay.

While the definitions are advisory, the NMC had said it would ‘strongly encourage professionals and employers to use them to ensure people receive the best possible care’.

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Last month, the regulator called on professionals and employers to implement the principles and said it would ‘strongly encourage professionals and employers to use them to ensure people receive the best possible care’.

The principles recognise the established principles of advanced practice which are aligned to the advanced practice frameworks of all four nations:

• Clinical practice
• Education
• Research
• Leadership
• Management

As part of its advanced practice work, the NMC has committed to developing advanced practice standards of proficiency and associated programme standards in the 2027–2028 financial year (April to March). This will include public consultation.