1. Lynn Turner Workforce Modernisation Manager NLIAH
Framework for Advanced Nursing, Midwifery and Allied Health Professional Practice in Wales
Lynn Turner
Workforce Modernisation Manager
NLIAH

2. Overview Purpose and development Policy drivers
Terminology and Definition
Pillars of Advanced Practice
Education
Workforce Planning
Governance

3. Purpose of the Framework
Clarity on the role of Advanced Practice for Nursing, Midwifery and Allied Health Professional Practive
Guide the successful development, implementation and evaluation of advanced practice roles within NHS Wales
Ensure consistency in NHS Wales
Ensure appropriate governance arrangements are in place
To be launched on 22nd September 2010

4. Development Multidisciplinary professional group
Drawn on previously published resources:
- Scottish Advanced Practice Toolkit
- Modernising Nursing Careers
- Modernising Medical Careers
- Midwifery 2020
- Modernising Allied Health Professionals

5. Policy Drivers
Strategic Service, Workforce and Financial Framework for NHS Wales;
Setting the Direction;
Rural Health Plan;
Annual Operating Framework;
Flexible and Sustainable Workforce;
1,000 Lives plus Campaign;
Healthcare Standards;
Workforce Modernisation Agenda

6. Terminology and Definition
Specialist – Generalist continuum
Specialist practice relates to a specific context, e.g. client group, skill set or an organisational context
Advanced Practice relates to the Novice to Expert continuum
Advanced Practice characterised by high levels of clinical skill, competence and autonomous decision-making
Widespread debate on definitions of Specialist and Advanced Practice

7. Advanced Practice Definition
Registered Practitioner
Expert knowledge base
Complex decision-making skills and clinical competences for expanded scope of practice
Demonstrable, relevant Master’s level education

8. Workforce Development
Existing Advanced Practice Roles
New Advanced Practice Roles
Identification of roles meeting the Advanced Practice Framework
Personal Development Planning and KSF process to meet the requirements of Advanced Practice
Identified through the Integrated Workforce Planning Process
Role development considered as part of service development and not in professional isolation
Organisational Approval Process linked to existing systems

9. Pillars of Advanced Practice
Advanced Practice clinical role with strong education/ research elements
Advanced Practice clinical role with a large management element

10. Education
Masters/CQFW level 7 education must underpin all Advanced Practitioner role developments in Wales
Other frameworks to consider
A Strategy for the Development of a Flexible and Sustainable Workforce (May 2008)
Post Registration Career Framework for Nurses in
Wales (September 2009)
The NHS Career Framework
Partnership working between NHS Organisations and Education Providers

11. Planning for Evaluation
Key questions
What objective outcomes are expected and when?
When will these outcomes be achieved?
What are the facilitators and barriers?
Strategies to maximise role facilitators
and minimise role barriers?
What resource and support is required
for role development?

12. Role Impact Analysis
Robust metrics to measure the impact and benefits within the 4 domains
Outcome focus on
safety and efficiency
organisational impact
acceptance and satisfaction
costs

13. Governance Arrangements
Achieved through:
Advanced Practice Framework
Personal Development Planning and KSF
Performance Management
Educational development
Evaluation

14. Summary
Advanced practice is a ‘level of practice’ rather than a specific role
Consistent approach in level of skills, theoretical knowledge (Masters CQFW Level 7) and decision making ability
Applicable across all areas of practice
All pillars must be present but focus may vary
Approval process for new developments
Evaluation of the role is essential