Exploring The Role of Advanced Clinical Practitioners (ACPs) and Their Contribution To Health Services in England.

Abstract

Background An extended role being explored globally is that of the advanced clinical practitioner (ACP). In England this is an extended role for allied health professions, nurses and midwives. ACP education is organised by Health Education England (HEE) who organise an accredited training programme for ACPs alongside a multi-professional framework. This paper draws on research commissioned to evaluate the national implementation of the ACP role to inform the development of a Centre for Advancing Practice in the UK but has implications for others considering their ACP provision. This paper focuses on three key research questions: 1) What is the role of ACPs in England? 2) What are the barriers and facilitators to implementing the role? and 3) What is the contribution of ACPs to health services in England? Methods Semi-structured interviews were conducted in 2020 with 63 participants across a range of stakeholder groups and clinical areas. A purposive snowball sampling technique was used to identify participants meeting the inclusion criteria. Interviews were recorded and transcribed verbatim, anonymised and thematically analysed. Results We report on three aspects as highlighted from the data (1) The role of ACPs, (2) Barriers to and facilitators of the ACP role implementation (3) Contribution of ACPs to health services in England. The ACP role in England was undertaken in a broad range of clinical contexts. ACPs worked towards being an autonomous practitioner and most were independent prescribers. In England ‘advanced clinical practitioner’ was not a protected title. There were high levels of variability and ambiguity of understanding and deployment of the ACP role in England. Conclusions This study outlines the contribution that ACPs make to health services and contributing factors to the success of the ACP role in England. We demonstrated the range in which the role is successful in England. We identified key barriers and facilitators to implementing this role. Finally, the work showed the positive contribution that ACPs can make to service redesign and workforce development as well as patient outcomes, whilst accepting that there is much work to do to ensure protected status and parity across all professions and clinical contexts.