NMC affirms advanced practice nursing is ‘not a doctor substitute’

Advanced nurse practitioners (ANPs) are ‘not a substitute for medical practitioners’ but a ‘welcome and vital role’, the nursing regulator has said.

The Nursing and Midwifery Council (NMC) has published a statement this week after the British Medical Association (BMA) called for views and reports on medical substitution after concerns were raised about the ‘blurring of the distinction between doctors and non-medically qualified staff’.

Claims were also made by the BMA that patient safety concerns had been raised around non-medical clinicians working outside of their competency or without sufficient supervision.

In response, the NMC has clarified the ‘welcome and vital’ role of ANPs and reiterated that they are ‘not a substitute for medical practitioners’.

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‘A registered nurse or midwife working at an advanced level is an expert professional with additional post-graduate education and experience,’ the regulator said.

‘They use their evidence-informed knowledge, skills and capability to influence, shape, deliver and lead safe and effective care, while managing risk, uncertainty and complexity.’

The response comes following the regulator setting out principles for advanced practice last year, clarifying its expectations for advanced level practitioners including practising within their individual scope of practice and in line with their level of knowledge, experience, qualifications, training and employment role.

It also revealed a definition of advanced practice nursing and midwifery, focusing on the extra post-qualification education nurses and midwives complete to ‘increase their knowledge and skills allowing them to give expert, higher-level care’.

Professor Donna O’Boyle, acting executive director of professional practice, said: ‘Advanced practice is a clearly distinguished role achieved by highly skilled, knowledgeable and experienced nursing and midwifery professionals.’

‘The publication of our Principles for Advanced Practice was a major milestone in the history of nursing and midwifery.

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‘They provide clarity and transparency around what the public can expect from advanced practitioners, and they support employers to harness the benefits of advanced practice safely and effectively.

‘We’re clear that advanced practitioners should be valued as highly skilled members of multi-disciplinary teams, working alongside doctors – not as a substitute for them.’

Last month, the Royal College of Nursing (RCN) also addressed the BMA’s concerns,  stating that nurses working at an advanced level are autonomous professionals and are ‘not substitutes for any other profession’.

‘The RCN position is clear. Advanced level nursing describes a level of practice which can only be delivered by registered nurses with additional knowledge and expertise,’ the college said.

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The NMC added that it will continue working towards ‘additional regulation’ for advanced level practitioners by developing new Standards of Proficiency and Advanced Practice Education Programme Standards.

Through this work, the regulator aims to ‘bring clarity to the role of advanced level practitioners, providing assurance’ to the public through standardisation of the role and addressing the variability’.