Workforce experience of the implementation of an advanced clinical practice framework in England: a mixed methods evalua
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RESEARCH
Workforce experience of the implementation of an advanced clinical practice framework in England: a mixed methods evaluation Jessica Lawler1, Katrina Maclaine1 and Alison Leary1,2*
Abstract Background: This study aims to understand how the implementation of the advanced clinical practice framework in England (2017) was experienced by the workforce to check assumptions for a national workforce modelling project. The advanced clinical practice framework was introduced in England in 2017 by Health Education England to clarify the role of advanced practice in the National Health Service. Methods: As part of a large-scale workforce modelling project, a self-completed questionnaire was distributed via the Association of Advanced Practice Educators UK aimed at those studying to be an Advanced Clinical Practitioner or who are practicing at this level in order to check assumptions. Semi-structured phone interviews were carried out with this same group. Questionnaires were summarised using descriptive statistics in Excel for categorical responses and interviews and survey free-text were analysed using thematic analysis in NVivo 10. Results: The questionnaire received over 500 respondents (ten times that expected) and 15 interviews were carried out. Advanced clinical practice was considered by many respondents the only viable clinical career progression. Respondents felt that employers were not clear about what practicing at this level involved or its future direction. 54% (287) thought that ‘ACP’ was the right job title for them. 19% (98) of respondents wanted their origin registered profession to be included in their title. Balancing advanced clinical practice education concurrently with a full-time role was challenging, participants underestimated the workload and expectations of employer’s training. There is an apparent dichotomy that has developed from the implementation of the 2017 framework: that of advanced clinical practice as an advanced level of practice within a profession, and that of Advanced Clinical Practitioner as a new generic role in the medical model. Conclusions: Efforts to establish further clarity and structure around advanced clinical practice are needed for both the individuals practising at this level and their employers. A robust evaluation of the introduction of this role should take place. Keywords: Health policy, Education and training, Health services administration and management
*Correspondence: [email protected] 1 School of Health and Social Care, London South Bank University, 103 Borough Road, London SE1 0AA, UK Full list of author information is available at the end of the article
Background Advanced practice roles have existed in healthcare for many years. In the UK they were more formally established in the early 1990s [1]. Such roles have tended to evolve rather than be part of strategic workforce planning [2]. In other countries there has been a long history of advanced practice nursing, for example in the US and
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