Advanced Practice

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Advanced Practice Achieving Consensus A Toolkit
Approach
Mike Sabin Nursing Officer CNO Directorate Scottis
h Govt.
www.advancedpractice.scot.nhs.uk
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Advanced Practice Achieving ConsensusA Toolkit
Approach
Mike Sabin Nursing Officer CNO Directorate Scottis
h Govt.
www.advancedpractice.scot.nhs.uk
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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 whove published, researched and
  developed in this area over the years

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Build it and they will come!
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Advanced Practice

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

www.advancedpractice.scot.nhs.uk
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Service Need Analysis
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Service Need Analysis
Workforce Skill-mix Analysis
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Non- Advanced Practice Roles
Service Need Analysis
Workforce Skill-mix Analysis
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Non- Advanced Practice Roles
Service Need Analysis
Workforce Skill-mix Analysis
Advanced Practice Role Expectations Agreed
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Non- Advanced Practice Roles
Service Need Analysis
Workforce Skill-mix Analysis
Advanced Practice Role Expectations Agreed
Existing Staff
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Non- Advanced Practice Roles
New Staff Recruitment
Service Need Analysis
Workforce Skill-mix Analysis
Advanced Practice Role Expectations Agreed
Existing Staff
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Non- Advanced Practice Roles
New Staff Recruitment
Service Need Analysis
Workforce Skill-mix Analysis
Advanced Practice Role Expectations Agreed
Development Need Analysis
Existing Staff
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Non- Advanced Practice Roles
New Staff Recruitment
Service Need Analysis
Workforce Skill-mix Analysis
Advanced Practice Role Expectations Agreed
Development Need Analysis
Existing Staff
Education/ Development
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Non- Advanced Practice Roles
New Staff Recruitment
Service Need Analysis
Workforce Skill-mix Analysis
Advanced Practice Role Expectations Agreed
Advanced Practice Post Established
Development Need Analysis
Existing Staff
Education/ Development
Competence Assessment
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Non- Advanced Practice Roles
New Staff Recruitment
Service Need Analysis
Workforce Skill-mix Analysis
Advanced Practice Role Expectations Agreed
Advanced Practice Post Established
Development Need Analysis
Existing Staff
Education/ Development
Competence Assessment
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Education/ Development
Competence Assessment
Non- Advanced Practice Roles
New Staff Recruitment
Service Need Analysis
Workforce Skill-mix Analysis
Advanced Practice Role Expectations Agreed
Advanced Practice Post Established
Development Need Analysis
Existing Staff
Education/ Development
Competence Assessment
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Education/ Development
Competence Assessment
Non- Advanced Practice Roles
New Staff Recruitment
Service Need Analysis
Workforce Skill-mix Analysis
Advanced Practice Role Expectations Agreed
Advanced Practice Post Established
Development Need Analysis
Existing Staff
Education/ Development
Competence Assessment
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Education/ Development
Competence Assessment
Non- Advanced Practice Roles
New Staff Recruitment
On-going Competence Review/ Revalidation Role
Evaluation
Service Need Analysis
Workforce Skill-mix Analysis
Advanced Practice Role Expectations Agreed
Advanced Practice Post Established
Development Need Analysis
Existing Staff
Education/ Development
Competence Assessment
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www.advancedpractice.scot.nhs.uk
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Consensus Definition
www.advancedpractice.scot.nhs.uk
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Consensus Definition
www.advancedpractice.scot.nhs.uk
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Consensus Definition
www.advancedpractice.scot.nhs.uk
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Advanced Practice

• A level of Practice, rather than a role or title
• Applicable across practice contexts
• Applicable across professional contexts
• Specialist practice is not above or below
  Advanced practice it is on a different
  continuum.

www.advancedpractice.scot.nhs.uk
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Expert Practice
Specialist Practice
Generalist Practice
Novice Practice
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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

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Job Profile KSF Outline
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Job Profile KSF Outline
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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/operationa
  l contexts Community, H_at_N, SCN, Mental Health,
  Children etc.

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Activity Analysis/Job Planning
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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

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Activity Analysis Measuring ANP impact
Identify type of indicator (Structure, process or
outcome)
Identify dimension of quality to be measured

• 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)

Set specific indicator
Develop clear operational definitions
Develop a data collection plan
Test and Refine
Data Collection
Analysis
Action
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Education Framework/DNAT
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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

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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

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Mapping outcomes from educational provision to AP
competencies

• HEIs map their programmes/courses against the
  Core Specific AP competencies
• Practitioners access web page and select their
  role profile and the courses they have undertaken
  from a pre-populated list
• Their AP profile/competency list is populated
  with the matched educational outcomes from the
  courses undertaken
• Missing competencies are identified so that
  practitioner/manager can arrange appropriate
  provision or seek other evidence of achievement.
• On going competence review is essential

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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

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Workforce Planning support
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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

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Regulatory Guidance
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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
  NMCs work on revalidation and establishing a
  robust system for how practitioners demonstrate
  continued fitness for practice.
• Common definition of Advanced Practice across
  professions

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More Senior Staff level 9
Consultant Practitioner level 8
Consultant NMAHPs
Clinical Academic Careers
Advanced Practice Toolkit
Advanced Practitioner level 7
SCN/CQI Project
Senior Practitioner level 6
Early Clinical Career Fellowships
Effective Practitioner
Registered Practitioner level 5
Flying Start NHS
Assistant Practitioner level 4
Senior Support Worker level 3
Support Worker - level 2
Support Worker level 1
Scottish initiatives to support the Nursing
Career Framework
www.advancedpractice.scot.nhs.uk