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Nuffield Research Supports Regulation of Advanced Practice Nursing

According to the NMC, the Nuffield Trust has completed an independent report on behalf of the Nursing andMidwifery Council, looking into advanced practice nursing as part of their 2020-25 corporate strategy.

There is currently no specific framework or regulation for anyone practicing at an advanced level, and the public often do not understand the roles of advanced practice nurses.

The NMC have stated on their website that they requested the Nuffield Trust to: “look at the existing literature on regulation of advanced practice, and international approaches to regulating advanced practice. It also considered the advanced practice landscape in all four countries of the UK, in conversation with key senior/relevant stakeholders. “

They also turned to Britain Thinks to “run discussion groups with professionals currently working in advanced practice roles. Britain Thinks is currently concluding its analysis and will provide a final report shortly.”

The Nuffield Trust report has suggested there is significant variation in the experience required and the content of advanced practice courses. It also stated that more nurses and midwives are undertaking “more complex, autonomous and expert roles” which are considered to be advanced practice.

It suggested that there is no consistent definition of what advanced practice actually is, and therefore it is impossible to know the extent of professionals practising at advanced levels. Advanced roles have been increasing due to myriad factors, including clinical, operational, and professional.

Due to a lack of NMC regulations, anyone practising at an advanced level is responsible for ensuring they work within the current regulatory guidelines. Though there has been discussion in the past about additional regulation, with the report acknowledging the NMC previously considering the possibility, it pointed out that no changes were made.

The Nuffield Trust said: “The consensus from the interviews and focus groups was that some form specific regulation was needed for advanced practice in nursing and midwifery and that the status quo was not satisfactory.”

The experience, skill and knowledge of an advanced practitioner is inconsistent, and the route to advanced practice is commonly via a masters’ degree, but the course content can vary wildly. An increasing number of NMC registered nurses are international, meaning there is further diversity in advanced practice qualifications, skills and knowledge.

There are concerns that the public’s lack of understanding about the roles means that they do not know what to expect from advanced practice nursing and midwifery.

The NMC said: “The research found variation in how professionals enter and practice in these roles across the UK. This means there’s no single definition of advanced practice, nor any consistent outcomes, or standards of education or proficiency.”

They also acknowledged that the general consensus, based on focus groups and interviews, is that specific regulation is needed for advanced practice within both nursing and midwifery.

At a meeting on 17 May, the council discussed steps for the future, based on the outcome of the report, and they have stated that it will, “inform further key lines of enquiry as we continue our review of the advanced practice landscape, including engaging with the public and people who use services, before presenting Council with options to consider later this year.

“We’ll work closely with our stakeholders as we consider our key lines of enquiry and any future changes to how we regulate advanced practice.”

You can read the full Nuffield Trust Report here:

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