Introduction
Advanced clinical practice has been an important topic in the NHS because it is key in helping to transform service delivery through improved productivity, capability, efficiency, and capacity in multi-professional teams. The advanced clinical practitioner role was introduced due to a UK NHS workforce shortage (Fothergill et al., 2022).
The NHS defines Advanced clinical practitioners as healthcare professionals who have a high level of education to a master’s degree or equivalent and have the knowledge and skills that allow them to work outside their scope to meet the needs of the patients they care for (Evans et al., 2020). Advanced clinical practitioners are deployed at all levels of care to bring together the four pillars of clinical practice, including management, leadership, research, and education (Evans et al., 2021). This study will evaluate the benefits of advanced clinical practitioners’ role to patients and services and provide a rational judgment of its usefulness.
Discussion
Benefits of the ACP role
The UK’s ACP role has led to various benefits such as being advanced, career pathways and influencing change in healthcare. The importance of being advanced has been attributed to expert practice and collaboration (Stewart-Lord et al., 2020). The role of ACP leads to the acquisition of skills that make healthcare professionals gain expert practice in leadership, autonomous practice, expert decision-making, and specialist clinical gains. ACP allows healthcare professionals to gain advanced knowledge in one part of the job, such as radiography, film reading, etc. (Woo, Lee, and Tam, 2017). These skills provide the ACP with specialist skills to handle complex cases and make critical clinical decisions on managing severe illnesses.
ACP also uses teamwork and collaboration to enhance safety and quality in its practice (Htay and Whitehead, 2021). They act as role models and mentors to the junior teams, which helps them to realize their full potential. In a study conducted by Lawler, Maclaine, and Leary (2020), a psychotherapist states that as advanced practitioners, they are expected to support and mentor junior staff, and therefore, they have to do extensive coaching even for new graduates. This enables them to retain their professional specialty.
The other benefit of the ACP role is based on career pathways. The ACP has led to diversified career paths, opportunities, and titles (Evans et al., 2021). ACP leads to evolved roles and structured career pathways in an organization. This enables to revolutionalize of healthcare by having several specialized posts that cater to rising patient care needs (Sánchez-Gómez et al., 2019). However, some career paths, such as art and drama therapists, were difficult to improve because they were misunderstood and not recognized by other professionals (Wallis et al., 2022).
ACPs have a significant role in influencing change in healthcare, and therefore they use these opportunities to improve service delivery. ACP also led to service developments and quality improvements whereby the professionals used the knowledge gained to innovate more creative ways of solving patient problems and transforming lives (Nadaf, 2018). Most ACPs have developed educational programs for their juniors and carried out different research, which helps in improving lives.
In a study by Evans et al. (2020), one radiographer states, “I have written up protocols, referral pathways and manuals for training as well.” Another physiotherapist states that he is running a local scoping study, and using that data, he has been able to apply and successfully got a doctoral fellowship from NIHR as a clinical academic (Nursing Times, 2022). This shows that the role of ACP is helping to influence and transform healthcare through quality improvement, research, and education.
How the Introduction of ACP Role Fits with Healthcare
ACP was officially introduced in 2017 in the UK by Health Education England, an NHS workforce development. The UK healthcare service is applied in four countries, including Wales, Scotland, England, and Northern Ireland, through the NHS (Hill, 2017). The NHS’s long-term plan is to have new integrated models that cut across traditional primary and secondary care boundaries (Lawler, Maclaine, and Leary, 2020). This plan calls for the utilization and investment in non-medical clinical roles with advanced skills to expand the workforce. This led Health Education England to plan and define a wide range of advanced skills by introducing Advanced Clinical Practice (Drennan et al., 2021). The national policy does not guide ACP development in the UK, but it is locally driven depending on the patient’s needs, responding to the specific employer needs, and lacks standardization in role specification, educational background, and role title (Evans, Pearce, Greaves and Blake, 2020).
Benefits of ACP to the Service
One of the main benefits of ACP is that it helps curb the problem of medical staff shortages. By introducing this new role, the NHS has accommodated more healthcare practitioners with varying job titles based on patient needs, which has helped reduce medical staff shortages (Oliver, 2022). This has ensured better service delivery in the UK healthcare system.
ACP has also improved the clinical decision-making process. The new role of ACP has significantly helped in clinical decision-making and enhanced the ability to deal with undifferentiated diagnostics (Hooks and Walker, 2020). The increased specialization brought by the ACP gives them enough experience, which makes it easy to make clinical decisions.
How Patients Benefit from ACP
ACP provides new models of offering care to patients. They have brought the emergence of a “one-stop-shop” in healthcare whereby patients can get all the services they need by seeing one professional (Lopes-Júnior, 2021). This helps patients receive specialized services, save time, financial benefits, and improved-patient experience (Wood, 2021).
As identified by the international physiotherapy literature, ACPs have been providing new models of care, such as in the emergency setting, musculoskeletal services, and primary care (Black et al., 2015). For instance, ACPs are capable of physiotherapy assessment and treatment instead of referring patients to medical practitioners, making the process lengthy and expensive (Lowe, Plummer, O’Brien, and Boyd, 2017). This has led to a higher quality of care, wider strategies, and increased accessibility to specialized services.
ACP has also led to better health outcomes. ACPs have been significant pillars in managing patients with chronic conditions. A study by Barratt (2018) showed that ACP had improved diabetes, hypertension management, and associated risk factors. Respiratory diseases like asthma are more manageable under ACP, and the disease symptoms are highly controlled (Stewart-Lord et al., 2020). ACP has also helped to identify fragile patients who require special attention and focus on them to achieve better healthcare outcomes.
ACP has also made healthcare affordable through cost-effectiveness. ACPs meet the system demands, such as referrals and quality of outcomes, compared to traditional family physicians (Abou Hashish and Alsayed, 2020). ACPs provide significantly high-quality service compared to that provided by family practitioners (HealthIT.Gov, 2022). This is because they use individualized attention, spend more time with their clients, and have a high awareness of patient information. This improved model used by healthcare organizations has helped improve patient access to healthcare by developing diverse entry points that reduce healthcare expenditure and increase efficiency. According to Kemppainen, Tossavainen, and Turunen (2012), ACP can detect health problems earlier, leading to shorter hospital stays and less treatment costs.
ACPs also help patients to achieve high-quality life in the healthcare setting. According to Harvey and Leary (2021), there is a significant decrease in emergency case demand due to the introduction of ACP. Additionally, the role of ACP has increased the rate of consultation demand by patients with chronic and respiratory diseases. This is because of the ability of ACP to detect and treat potentially complicated diseases. Wood et al. (2020) suggest that patients were more satisfied with the healthcare service and attention from ACPs. This shows that ACPs lead to a higher quality of life.
Conclusion
The ACP role was introduced in the UK due to a shortage of medical staff. It mainly involves expanding the skills of nurses, pharmacists, and other healthcare professionals to take more advanced roles in their field. ACP has improved various services, including advanced career pathways, better patient outcomes, and influencing and transforming. ACP has also had its advantages to the services, including curbing the problem of staff shortage and improved clinical decision-making. ACP has brought new models to offer care to the patients, led to better outcomes, and made healthcare affordable and a higher quality of life. This shows that ACP has had a tremendous impact on the UK healthcare system despite having different challenges, such as job titles, salary expectations for advanced practitioners, and high costs involved in the education of the healthcare practitioners.
Reference List
Abou Hashish, E. and Alsayed, S., 2020. Evidence-Based Practice and its Relationship to Quality Improvement: A Cross-Sectional Study among Egyptian Nurses. The Open Nursing Journal, 14(1), pp.254-262.
Barratt, J., 2018. Collaborative communication: learning from advanced clinical practice patient consultations. Nursing Standard, 33(1), pp.27-32.
Black, A., Balneaves, L., Garossino, C., Puyat, J. and Qian, H., 2015. Promoting Evidence-Based Practice Through a Research Training Program for Point-of-Care Clinicians. JONA: The Journal of Nursing Administration, 45(1), pp.14-20.
Drennan, V., Collins, L., Allan, H., Brimblecombe, N., Halter, M. and Taylor, F., 2021. Are advanced clinical practice roles in England’s National Health Service a remedy for workforce problems? A qualitative study of senior staff perspectives. Journal of Health Services Research & Policy, p.135581962110367.
Evans, C., Pearce, R., Greaves, S. and Blake, H., 2020. Advanced Clinical Practitioners in Primary Care in the UK: A Qualitative Study of Workforce Transformation. International Journal of Environmental Research and Public Health, 17(12), p.4500.
Evans, C., Pearce, R., Greaves, S. and Blake, H., 2020. Advanced Clinical Practitioners in Primary Care in the UK: A Qualitative Study of Workforce Transformation. International Journal of Environmental Research and Public Health, 17(12), p.4500.
Evans, C., Poku, B., Pearce, R., Eldridge, J., Hendrick, P., Knaggs, R., Blake, H., Yogeswaran, G., McLuskey, J., Tomczak, P., Thow, R., Harris, P., Conway, J. and Collier, R., 2021. Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review. BMJ Open, 11(8), p.e048171.
Evans, C., Poku, B., Pearce, R., Eldridge, J., Hendrick, P., Knaggs, R., McLuskey, J., Tomczak, P., Thow, R., Harris, P., Conway, J. and Collier, R., 2020. Characterizing the evidence base for advanced clinical practice in the UK: a scoping review protocol. BMJ Open, 10(5), p.e036192.
Fothergill, L., Al-Oraibi, A., Houdmont, J., Conway, J., Evans, C., Timmons, S., Pearce, R. and Blake, H., 2022. Nationwide evaluation of the advanced clinical practitioner role in England: a cross-sectional survey. BMJ Open, 12(1), p.e055475.
Harvey, M. and Leary, A., 2021. Do advanced clinical practitioners have the theoretical knowledge to authorize blood components for transfusion? A cross-sectional survey Study. Journal of Clinical Nursing, 30(19-20), pp.2968-2977.
HealthIT.Gov, 2022. Improved Diagnostics & Patient Outcomes | HealthIT.gov. [online] Healthit.gov. Web.
Hill, B., 2017. Exploring the development and identity of advanced practice nursing in the UK. Nursing Management, 24(5), pp.36-40.
Hooks, C. and Walker, S., 2020. An exploration of the role of advanced clinical practitioners in the East of England. British Journal of Nursing, 29(15), pp.864-869.
Htay, M. and Whitehead, D., 2021. The effectiveness of the role of advanced nurse practitioners compared to physician-led or usual care: A systematic review. International Journal of Nursing Studies Advances, 3, p.100034.
Kemppainen, V., Tossavainen, K. and Turunen, H., 2012. Nurses’ roles in health promotion practice: an integrative review. Health Promotion International, 28(4), pp.490-501.
Lawler, J., Maclaine, K. and Leary, A., 2020. Workforce experience of the implementation of an advanced clinical practice framework in England: a mixed methods evaluation. Human Resources for Health, 18(1).
Lopes-Júnior, L., 2021. Advanced Practice Nursing and the Expansion of the Role of Nurses in Primary Health Care in the Americas. SAGE Open Nursing, 7, p.237796082110194.
Lowe, G., Plummer, V., O’Brien, A. and Boyd, L., 2017. Time to clarify – the value of advanced practice nursing roles in health care. Journal of Advanced Nursing, 68(3), pp.677-685.
Nadaf, C., 2018. Perspectives: Reflections on a debate: When does Advanced Clinical Practice stop being nursing?. Journal of Research in Nursing, 23(1), pp.91-97.
Nursing Times, N., 2022. Role of advanced practitioners in primary care – a literature review | Nursing Times. [online] Nursing Times. Web.
Oliver, E., 2022. Advanced practitioners improve efficiency and patient satisfaction. [online] Independentnurse.co.uk. Web.
Sánchez-Gómez, M., Ramos-Santana, S., Gómez-Salgado, J., Sánchez-Nicolás, F., Moreno-Garriga, C. and Duarte-Clíments, G., 2019. Benefits of Advanced Practice Nursing for Its Expansion in the Spanish Context. International Journal of Environmental Research and Public Health, 16(5), p.680.
Stewart-Lord, A., Beanlands, C., Khine, R., Shamah, S., Sinclair, N., Woods, S., Woznitza, N. and Baillie, L., 2020.
The Role and Development of Advanced Clinical Practice Within Allied Health Professions: A Mixed Method Study. Journal of Multidisciplinary Healthcare, Volume 13, pp.1705-1715.
Stewart-Lord, A., Beanlands, C., Khine, R., Shamah, S., Sinclair, N., Woods, S., Woznitza, N. and Baillie, L., 2020.
The Role and Development of Advanced Clinical Practice Within Allied Health Professions: A Mixed Method Study. Journal of Multidisciplinary Healthcare, Volume 13, pp.1705-1715.
Wallis, L., Locke, R., Sutherland, C. and Harden, B., 2022. Assessment of advanced clinical practitioners. Journal of Interprofessional Care, pp.1-5.
Woo, B., Lee, J. and Tam, W., 2017. The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human Resources for Health, 15(1).
Wood, C., 2021. Leadership and management for nurses working at an advanced level. British Journal of Nursing, 30(5), pp.282-286.
Wood, E., King, R., Robertson, S., Allmark, P., Senek, M., Tod, A. and Ryan, T., 2020. Advanced practice nurses’ experiences and well‐being: Baseline demographics from a cohort study. Journal of Nursing Management, 28(4), pp.959-967.