Advanced Clinical Practitioners (ACP) come from a variety of professional backgrounds including nursing, physiotherapy, pharmacy, paramedics and occupational therapy. They are experienced healthcare professionals with a Masters level award or equivalent who have developed their skills and knowledge to take on expanded roles and scopes of patient care.

People often assume that Advanced Clinical Practitioner are all nurses as the title of Advanced Nurse Practitioner (ANP) is well known in the NHS. However, as the number of different professionals grows within this role, it will change and become the norm to have a Multidisciplinary Team (MDT) of Advanced Clinical Practitioners supporting the rest of the medical team.

What Is An Advanced Clinical Practitioner?

As noted earlier, there is some confusion around defining Advanced Clinical Practitioners until now. Health Education England (HEE) along with its multi-disciplinary partners define Advanced Clinical Practice as follows:

“Advanced clinical practice is delivered by experienced, registered health and care practitioners. It is a level of practice characterised by a high degree of autonomy and complex decision making. This is underpinned by a master’s level award or equivalent that encompasses the four pillars of clinical practice, leadership and management, education and research, with a demonstration of core capabilities and area-specific clinical competence.” (Source: HEE)

What Role Does An Advanced Clinical Practitioner Play?

Advanced clinical practitioners eventually work at the level of a middle grade doctor. They support existing and clinical care to enhance the capacity and capability within multi-professional teams. Their primary roles include improving clinical continuity, providing more patient-focused care. They also helps provide safe, accessible and high-quality patient care.

As stated in the formal definition: “Advanced clinical practice embodies the ability to manage clinical care in partnership with individuals, families and carers. It includes the analysis and synthesis of complex problems across a range of settings, enabling innovative solutions to enhance people’s experience and improve outcomes.” (Source: HEE)

ACPs must develop skills across patient pathways in a range of clinical areas on top of their core clinical specialty. They will have expertise in a specific area but need clinical examination skills and know various diagnostics and treatment options. This will enable them to identify and act upon issues across a range of clinical systems.

Health Education England’s Competencies Framework

To ensure consistency across the scope of the role and to ensure that everyone clearly understands it, HEE developed a competency framework. The framework clearly outlines a path into, and through the profession which sets the standard of an ACP’s work expectations. Both Wales and Scotland have advanced clinical practice tool kits and Northern Ireland has a framework. All four resources are broadly similar and should be used to facilitate the transformation of the workforce and support these advanced roles.

Download the PDF here

How Can ACP Roles Benefit Patients With Neurological Conditions?

ACP roles are continuing to emerge within neurology with an increasing number of physiotherapists and AHPs taking up the posts. Neuro-physiotherapists hold skills and experience in all four pillars of advanced practice, they know about the patient journey and can assess and treat patients holistically.

Neuro-physiotherapists already hold some of the clinical examination skills required in neurology and musculoskeletal practice but to work as an ACP they must further develop these specialist skills and gain additional generic examination, diagnostic and treatment skills in cardiology, respiratory medicine, abdominal examination and mental health to complement their existing knowledge.

Physiotherapists in these roles can champion the role of rehabilitation using their own skills within every patient interaction, providing a one-stop-shop to enhance the patient experience.

What Does It Take To Become An Advanced Clinical Practitioner?

All registered healthcare professionals are eligible, but most trusts and universities require around five years of clinical experience and a prerequisite of previous masters level study.

An MSc in Advanced Clinical Practice requires the completion of 180 credits amd may consist of modules that include pathophysiology, clinical examination, project management, non-medical prescribing, clinical reasoning, practitioner competence, research and education modules.

The variety of modules demonstrate the skills required within the four pillars of advanced practice (Health Education England, 2017) and provide a general base of knowledge to create a generic ACP. The specialty skills are learnt within the post.

The four pillars are clinical practice, leadership and management, education and research with the advanced practice framework demonstrating a clinician’s ability to work at an advanced practice level.

What Are The Benefits Of Becoming An Advanced Clinical Practitioner?

ACPs can bridge gaps within the MDT, bringing professions together as they have the necessary knowledge, skills, training and qualifications. Other than a pay increase and more responsibilities, the benefits across the board include the following:

• improved patient journey, better-informed patients and patient-focused care
• improvements in the continuity of patient care and in standards of service
• better communication between patients and the multi-disciplinary team
• increasing job satisfaction, assisting recruitment and retention and addressing the potential skills gap
• more flexibility within the team

A Journey to Advanced Practice In Stroke (Author, Lorraine Azam)

I am an ACPIN board member and have gone through the process of becoming an ACP. In order to assist anyone interested in doing the same, I decided to share a part of my journey with you.

I started out as a physiotherapist back in 1999 and spent most of my career working within neurology. More recently, my focus shifted primarily to stroke and in early 2017, I applied for a position as a qualified advanced clinical practitioner in neurosciences. The requirements were at least five years of clinical experience and some form of Masters level education which, for me, was the Older Persons Fellowship, Postgraduate Diploma in Advanced Practice.

In September 2017, I joined a different stroke service and embarked on an MSc in Advanced Practice. Health Education England funded my MSc and I was employed as a full-time trainee maintaining my previous salary.

What Am I Doing Now?

Having completed my MSc I am now on the junior clinical fellow rota within the stroke service. I work within a team of five other ACPs who work at both a junior and senior clinical fellow level dependent on experience.

I work within the medical team and as an ACP I work flexibly across the service and can work on the hyperacute, acute and rehab wards, in the TIA clinic or in the emergency department. It is a challenging role and I regularly use my physiotherapy skills as well as my new medical skills to enhance both the medical and non-medical care of patients within my service.

Final Thoughts

For more information on how to become an Advanced Clinical Practitioner and guidance from the CSP, refer to the links below.

• NHS Employers link
• CSP guidance
• Health Education England – Advanced Clinical Practice Multi-Professional Framework link

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