Advanced Practice: Achieving Consensus A Toolkit Approach

Advanced Practice: Achieving ConsensusA Toolkit Approach

Mike SabinNursing Officer

CNO DirectorateScottish Govt.

www.advancedpractice.scot.nhs.uk

Acknowledgements

Karen, Paul, Jean, Ros, Kathy & UK MNC Coalition Margaret Smith & Scottish MNC group Mark Cooper, Maggie Grundy, Gillian Knowles,

Caitrian Guthrie, Douglas Allan, Anne Campbell, Mairi Kellagher, Colette Ferguson, Janet Corcoran, Susan Aitkenhead, Katie Barnes, Michelle Mello, Donna Mead and many more….

Dave Barton and AANPE All those who’ve published, researched and developed

in this area over the years

Build it… and they will come!

Advanced Practice

What is it?Who is it?Where is it?Is it a good idea?How do we know we’ve got it? How do we develop/support it?How do we evidence it?


Service Need

Analysis

Service Need

Analysis

WorkforceSkill-mixAnalysis

Service Need

Analysis


Non- Advanced Practice Roles

Service Need

Analysis


Advanced Practice

Role Expectations

Agreed


Service Need

Analysis


Advanced Practice

Role Expectations

Agreed

Existing Staff


Service Need

Analysis

New StaffRecruitment


Advanced Practice

Role Expectations

Agreed

Existing Staff


Service Need

Analysis


Development Need

Analysis


Advanced Practice

Role Expectations

Agreed

Existing Staff


Service Need

Analysis

Education/Development


Development Need

Analysis


Advanced Practice

Role Expectations

Agreed

Existing Staff


Service Need

Analysis



Development Need

Analysis


CompetenceAssessment

Advanced Practice

Role Expectations

Agreed

AdvancedPractice

PostEstablished

Existing Staff


Service Need

Analysis



Development Need

Analysis



Advanced Practice

Role Expectations

Agreed

AdvancedPractice

PostEstablished



Existing Staff


Service Need

Analysis


On-goingCompetence

Review/ Revalidation

Role Evaluation


Development Need

Analysis



Advanced Practice

Role Expectations

Agreed

AdvancedPractice

PostEstablished



Existing Staff


Consensus Definition


Advanced Practice

A level of Practice, rather than a role or titleApplicable across practice contextsApplicable across professional contexts

‘Specialist’ practice is not above or below ‘Advanced’ practice – it is on a different continuum.


Expert Practice

Specialist Practice

Generalist Practice

Novice Practice

Key Themes & Principles

Leadership Facilitating Learning Research Advanced Clinical Practice

Autonomous practice, Critical Thinking, High Levels of Decision Making & Problem Solving Values-Based care Practice Improvement

Job Profile & KSF Outline

KSF Outlines/ Job Descriptors/Profiles

Development of a national job profile and KSF outline templates for ‘Advanced Nurse Practitioner’ roles.

Outline will support consistency across contexts with ‘Exemplars’ for different clinical/operational contexts – Community, H@N, SCN, Mental Health, Children etc.

Activity Analysis/Job Planning

Activity Analysis

Development of prototype data collection and analysis tools

Aim to support training needs analysis and good governance regarding matching client need to service delivery.

Job Profiling/Planning

Data capture Benchmarked AP characteristics

Activity Analysis & Measuring ANP impact

Benchmarking - National, Regional & Local level

Clinical Activity Data – National data, PANDORA or local systems

Developing Indicators (Lloyd 2004)

- McMaster University APN Toolkit

- ? Minimum clinical activity data set (Concept & Indicators)

Identify type of indicator(Structure, process or

outcome)

Identify dimension of quality to be measured

Data Collection

Test and Refine

Develop a data collection plan

Develop clear operational definitions

Set specific indicator

Analysis

Action

Education Framework/DNAT

Educational Framework

Role development requires Development Needs Analysis and educational support

Agreement across the sector regarding Masters level and ‘core’ and context specific’ requirements for Advanced Practice development programmes.

NHS Education for Scotland ‘Advanced Practice Succession Planning Pathway’

Model acknowledges existing education provision and the value of work-based learning and assessment

HEI - Electronic Proforma

University title Background and links to agenda (250 words) Advanced Clinical Practice focused programmes -

MSc,PgD, PgC Individual modules - Leadership/Management focused courses – Research focused courses – MPhil, PhD Education focused courses - PgCert Education Recognition of Prior Learning KSF, AP Competencies and other relevant mapping Application Download link Contact Details and email link

Mapping outcomes from educational provision to AP competencies

1. HEIs map their programmes/courses against the Core & Specific AP competencies

2. Practitioners access web page and select their role profile and the courses they have undertaken from a pre-populated list

3. Their AP profile/competency list is populated with the matched educational outcomes from the courses undertaken

4. ‘Missing’ competencies are identified so that practitioner/manager can arrange appropriate provision or seek other evidence of achievement.

On going competence review is essential

Masters level – CPD ?

Need to demonstrate Masters level thinking/practice.

HEIs and Service could develop limited credit Masters level CPD units.

Only available to individuals who have completed their initial ANP preparation, achieved competencies and have attained the minimum of a Degree.

Advantages to Practitioner Advantages to Service Advantages to Higher Education Possible issues

Workforce Planning support

Workload/ Workforce Analysis

Service Need – Service Design – Skill Mix

Workforce/Workload Planning tools for robust and standardised measures that support the efficient targeting of nursing resources towards areas of need - beyond merely ‘numbers of nurses’ towards determination of skill mix.

NHS National Workforce Projects ‘Six-steps’ Workforce Planning Process

Regulatory Guidance

Regulatory Guidance

Ensure that the regulatory position of advanced level practice roles is fully linked to devolved and UK-wide governance principles, processes and responsibilities.

ANP regulation is co-dependent on many other aspects of the White Paper and linked to the NMC’s work on revalidation and establishing a robust system for how practitioners demonstrate continued fitness for practice.

Common definition of ‘Advanced Practice’ across professions

Support Worker – level 1

Registered Practitioner – level 5

Assistant Practitioner – level 4

Senior Support Worker – level 3

Support Worker - level 2

More Senior Staff – level 9

Consultant Practitioner – level 8

Advanced Practitioner – level 7

Senior Practitioner – level 6

SCN/CQI Project

Advanced Practice Toolkit

Early Clinical Career

Fellowships

Consultant NMAHPs Clinical Academic

Careers

Scottish initiatives to support the Nursing Career Framework

‘Effective Practitioner’


Flying Start NHS

Advanced Practice: Achieving Consensus A Toolkit Approach

Documents

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