Advanced Practice: Achieving ConsensusA Toolkit Approach
Mike SabinNursing Officer
CNO DirectorateScottish Govt.
www.advancedpractice.scot.nhs.uk
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?
www.advancedpractice.scot.nhs.uk
Service Need
Analysis
Service Need
Analysis
WorkforceSkill-mixAnalysis
Service Need
Analysis
WorkforceSkill-mixAnalysis
Non- Advanced Practice Roles
Service Need
Analysis
WorkforceSkill-mixAnalysis
Advanced Practice
Role Expectations
Agreed
Non- Advanced Practice Roles
Service Need
Analysis
WorkforceSkill-mixAnalysis
Advanced Practice
Role Expectations
Agreed
Existing Staff
Non- Advanced Practice Roles
Service Need
Analysis
New StaffRecruitment
WorkforceSkill-mixAnalysis
Advanced Practice
Role Expectations
Agreed
Existing Staff
Non- Advanced Practice Roles
Service Need
Analysis
New StaffRecruitment
Development Need
Analysis
WorkforceSkill-mixAnalysis
Advanced Practice
Role Expectations
Agreed
Existing Staff
Non- Advanced Practice Roles
Service Need
Analysis
Education/Development
New StaffRecruitment
Development Need
Analysis
WorkforceSkill-mixAnalysis
Advanced Practice
Role Expectations
Agreed
Existing Staff
Non- Advanced Practice Roles
Service Need
Analysis
Education/Development
New StaffRecruitment
Development Need
Analysis
WorkforceSkill-mixAnalysis
CompetenceAssessment
Advanced Practice
Role Expectations
Agreed
AdvancedPractice
PostEstablished
Existing Staff
Non- Advanced Practice Roles
Service Need
Analysis
Education/Development
New StaffRecruitment
Development Need
Analysis
WorkforceSkill-mixAnalysis
CompetenceAssessment
Advanced Practice
Role Expectations
Agreed
AdvancedPractice
PostEstablished
Existing Staff
Non- Advanced Practice Roles
Service Need
Analysis
Education/Development
New StaffRecruitment
Development Need
Analysis
WorkforceSkill-mixAnalysis
CompetenceAssessment
Advanced Practice
Role Expectations
Agreed
AdvancedPractice
PostEstablished
Education/Development
CompetenceAssessment
Existing Staff
Non- Advanced Practice Roles
Service Need
Analysis
Education/Development
New StaffRecruitment
Development Need
Analysis
WorkforceSkill-mixAnalysis
CompetenceAssessment
Advanced Practice
Role Expectations
Agreed
AdvancedPractice
PostEstablished
Education/Development
CompetenceAssessment
Existing Staff
Non- Advanced Practice Roles
Service Need
Analysis
Education/Development
On-goingCompetence
Review/ Revalidation
Role Evaluation
New StaffRecruitment
Development Need
Analysis
WorkforceSkill-mixAnalysis
CompetenceAssessment
Advanced Practice
Role Expectations
Agreed
AdvancedPractice
PostEstablished
Education/Development
CompetenceAssessment
Existing Staff
Non- Advanced Practice Roles
www.advancedpractice.scot.nhs.uk
Consensus Definition
www.advancedpractice.scot.nhs.uk
Consensus Definition
www.advancedpractice.scot.nhs.uk
Consensus Definition
www.advancedpractice.scot.nhs.uk
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.
www.advancedpractice.scot.nhs.uk
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
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’
www.advancedpractice.scot.nhs.uk
Flying Start NHS
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