Feature
NURSING MANAGEMENT April 2009 | Volume 16 | Number 1 17
These roles are:
Clinical nurse specialists.
Lead clinical nurse specialists.
Senior charge nurses or team leaders.
Nurse consultants.
The scope of practice for the other seven framework
roles did not correlate with that of advanced nurse
practitioners, so they were excluded.
The roles on this list that can meet the necessary
criteria for advanced practice will be identified over
the next few months using a survey tool adapted from
an existing advanced practice role review method that
was developed at Greater Glasgow health Board, now
incorporated into NhS Greater Glasgow and Clyde.
In developing the advanced practice initiative,
a number of related issues, such as career level,
education level and development pathway, were
taken into consideration.
Career level Advanced nurse practitioners are on
Level 7 of the NhS Careers Framework (Skills for
health 2006) in recognition of their seniority and of
the advanced knowledge and skills they require.
There is no direct correlation between AfC and
the NhS Careers Framework, but advanced nurse
practitioners will be on one of three AfC bands:
Band 6: some district nurses, public health nurses
or clinical nurse specialists.
Band 7: some district nurse or public health team
leaders, or senior charge nurses.
Band 8: nurse consultants.
It is of greater importance, however, that practitioners
fulfil the advanced nurse practitioner criteria. In doing
so, some will meet other responsibilities such as
managing and leading teams.
Education level In addition to having registered,
all advanced nurse practitioners are expected to
have obtained specialist practitioner qualifications,
including those in independent prescribing, or to
have undertaken master's level study programmes
that are related to their clinical practice and that
include nurse prescribing.
Development pathway For some advanced
practice roles, there is no single development
pathway and practitioners must draw on
development opportunities in, for example,
clinical practice, clinical leadership, management,
education and research.
For such cases, the Advanced Nursing Practice
Toolkit includes an advanced practice succession
development pathway, developed by NhS Education
for Scotland (2007).
This pathway is based on individual needs
assessments and includes learning programmes
that can be tailored to meet advanced practice
requirements.
At NhS Lanarkshire, it is expected that anyone
designated an advanced nurse practitioner can
demonstrate evidence of:
Experience of clinical practice and clinical practice
development.
Experience of leadership and its development.
Experience of management, education or research
and their development.
NhS Lanarkshire has developed an understanding
of advanced practice in nursing and has made great
progress in translating this concept into practice.
Table 2 Nurse consultant domains
Expert clinical
practice
Nurse consultants must be able to deliver good care, enable
other practitioners to maintain professional expertise, and
exercise a high degree of autonomy. At least half of their jobs
must include direct or indirect patient contact.
Leadership
and
consultancy
Nurse consultants must demonstrate leadership skills, support
and motivate others to improve practice, care and health
continually, and act as a source of expertise in their fields.
Practice
and service
development
Nurse consultants must contribute to the development of
professional practice through the promotion of evidence-based
practice, audit and research. They must be influential in policy,
strategy and service development.
Education and
development
Nurse consultants must be able to contribute to the
education of others by establishing formal links with education
providers and contributing to the development of specialist
staff in their fields.
Adapted from Scottish Executive Health Department (2001)
Figure 2 The key components of specialist practice
Advanced practice
Nurseconsultants
Generalists
Breadth of practice
Specialists
Depthofpractice

Page 1Page 2Page 3Page 4Page 5Page 6Page 7Page 8Page 9Page 10Page 11Page 12Page 13Page 14Page 15Page 16Page 17Page 18Page 19Page 20Page 21Page 22Page 23Page 24Page 25Page 26Page 27Page 28Page 29Page 30Page 31Page 32Page 33Page 34Page 35Page 36Page 37Page 38Page 39Page 40Page 41Page 42Page 43Page 44 Produced by PageSuite