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

Advanced clinical practice Advanced practitioner Allied health professionals Interprofessional working

Journal

Nurse education in practice
ISSN: 1873-5223
Titre abrégé: Nurse Educ Pract
Pays: Scotland
ID NLM: 101090848

Informations de publication

Date de publication:
Feb 2023
Historique:
received: 22 09 2022
revised: 06 12 2022
accepted: 17 12 2022
pubmed: 6 2 2023
medline: 25 2 2023
entrez: 5 2 2023
Statut: ppublish

Résumé

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. 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? A qualitative, exploratory study to explore perspectives on the ACP role in a range of clinical settings. 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. One-to-one semi-structured interviews throughout 2020, recorded and transcribed verbatim, anonymised and thematically analysed. 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. 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.

Sections du résumé

BACKGROUND 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 OBJECTIVE
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 METHODS
A qualitative, exploratory study to explore perspectives on the ACP role in a range of clinical settings.
PARTICIPANTS METHODS
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 METHODS
One-to-one semi-structured interviews throughout 2020, recorded and transcribed verbatim, anonymised and thematically analysed.
RESULTS 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 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.

Identifiants

pubmed: 36739736
pii: S1471-5953(23)00008-2
doi: 10.1016/j.nepr.2023.103546
pmc: PMC9872859
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103546

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

Claire Mann (C)

Centre for Health Improvement, Leadership and Learning, Nottingham University Business School, University of Nottingham, Jubilee Campus, Nottingham, NG8 1BB , UK. Electronic address: claire.mann@manchester.ac.uk.

Stephen Timmons (S)

Centre for Health Improvement, Leadership and Learning, Nottingham University Business School, University of Nottingham, NG7 2RD, UK. Electronic address: Stephen.timmons@nottingham.ac.uk.

Catrin Evans (C)

Health Sciences, QMC University of Nottingham, NG7 2RD, UK. Electronic address: Catrin.Evans@nottingham.ac.uk.

Ruth Pearce (R)

Allied Health Professions and Midwifery University Hospitals, Birmingham NHS Foundation Trust, UK. Electronic address: Ruth.Pearce@uhb.nhs.uk.

Charlotte Overton (C)

Health Sciences University of Leicester, UK. Electronic address: charlotte.overton@leicester.ac.uk.

Kathryn Hinsliff-Smith (K)

Health and Life Sciences, School of Nursing and Midwifery De Montfort University, UK. Electronic address: kathryn.hinsliff-smith@dmu.ac.uk.

Joy Conway (J)

Centre for Health, Medicine and Life Sciences Brunel University London, UK. Electronic address: joy.conway@brunel.ac.uk.

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Classifications MeSH