Exploring the role of advanced clinical practitioners (ACPs) and their contribution to health services in England: A qualitative exploratory study

Mann, Claire; Timmons, Stephen; Evans, Catrin; Pearce, Ruth; Overton, Charlotte; Hinsliff-Smith, Kathryn; Conway, Joy

Abstract

BACKGROUND: An extended role being explored globally is the advanced clinical practitioner (ACP). In England this is an extended role for allied health professions, nurses and midwives in a range of settings. OBJECTIVES: This paper focuses on three 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? DESIGN/SETTING: A qualitative, exploratory study to explore perspectives on the ACP role in a range of clinical settings. PARTICIPANTS: We recruited 63 stakeholders, including 34 nurses, working in a ACP role or ACP education. A purposive snowball sampling technique identified participants meeting inclusion criteria. METHODS: One-to-one semi-structured interviews throughout 2020, recorded and transcribed verbatim, anonymised and thematically analysed. RESULTS: The ACP role in England was undertaken in a broad range of clinical contexts. 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. Facilitators to the implementation process included training and education, clinical supervision and organisational support. Lack of protection for the role and variances in experience were barriers. Employer support facilitated development of the ACP role, however where support was limited, at either an individual or organisation level, this was a barrier. Our study highlighted the wide range of ways the ACP role benefitted patient outcomes and workforce development. CONCLUSIONS: This study outlines the contribution that ACPs can make to health services, contributing factors and key barriers and facilitators to implementing this role. The work showed the positive contribution ACPs can make to service redesign, workforce development and patient outcomes, whilst accepting there is much work to do to ensure protected status and parity across all professions and clinical contexts.

Citation

Mann, C., Timmons, S., Evans, C., Pearce, R., Overton, C., Hinsliff-Smith, K., & Conway, J. (2023). Exploring the role of advanced clinical practitioners (ACPs) and their contribution to health services in England: A qualitative exploratory study. Nurse Education in Practice, 67, Article 103546. https://doi.org/10.1016/j.nepr.2023.103546

• Journal Article Type: Article
• Acceptance Date: Jan 11, 2023
• Online Publication Date: Jan 24, 2023
• Publication Date: 2023-02
• Deposit Date: Jan 12, 2023
• Publicly Available Date: Jan 25, 2024
• Journal: Nurse Education in Practice
• Print ISSN: 1471-5953
• Electronic ISSN: 1873-5223
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 67
• Article Number: 103546
• DOI: https://doi.org/10.1016/j.nepr.2023.103546
• Keywords: Education; General Medicine; General Nursing
• Public URL: https://nottingham-repository.worktribe.com/output/15935959
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1471595323000082?via%3Dihub
• Additional Information: This article is maintained by: Elsevier; Article Title: Exploring the role of advanced clinical practitioners (ACPs) and their contribution to health services in England: A qualitative exploratory study; Journal Title: Nurse Education in Practice; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.nepr.2023.103546; Content Type: article; Copyright: © 2023 The Authors. Published by Elsevier Ltd.