1. Advanced Practice: Achieving Consensus A Toolkit Approach Mike Sabin Nursing Officer CNO Directorate Scottish Govt. www.advancedpractice.scot.nhs.uk

2. Advanced Practice: Achieving Consensus A Toolkit Approach Mike Sabin Nursing Officer CNO Directorate Scottish Govt. www.advancedpractice.scot.nhs.uk

3. Acknowledgements Karen, Paul, Jean, Ros, Kathy & UK MNC Coalition Margaret Smith & Scottish MNC group Mark Cooper, Maggie Grundy, Gillian Knowles, Caitrian Guthrie, Douglas Allan, Anne Campbell, Mairi Kellagher, Colette Ferguson, Janet Corcoran, Susan Aitkenhead, Katie Barnes, Michelle Mello, Donna Mead and many more…. Dave Barton and AANPE All those who’ve published, researched and developed in this area over the years

6. Build it… and they will come!

7. Advanced Practice What is it? Who is it? Where is it? Is it a good idea? How do we know we’ve got it? How do we develop/support it? How do we evidence it? www.advancedpractice.scot.nhs.uk

8. Service Need Analysis

9. Service Need Analysis Workforce Skill-mix Analysis

10. Service Need Analysis Workforce Skill-mix Analysis Non- Advanced Practice Roles

11. Service Need Analysis Workforce Skill-mix Analysis Advanced Practice Role Expectations Agreed Non- Advanced Practice Roles

12. Service Need Analysis Workforce Skill-mix Analysis Advanced Practice Role Expectations Agreed Existing Staff Non- Advanced Practice Roles

13. Service Need Analysis New Staff Recruitment Workforce Skill-mix Analysis Advanced Practice Role Expectations Agreed Existing Staff Non- Advanced Practice Roles

14. Service Need Analysis New Staff Recruitment Development Need Analysis Workforce Skill-mix Analysis Advanced Practice Role Expectations Agreed Existing Staff Non- Advanced Practice Roles

15. Service Need Analysis Education/ Development New Staff Recruitment Development Need Analysis Workforce Skill-mix Analysis Advanced Practice Role Expectations Agreed Existing Staff Non- Advanced Practice Roles

16. Service Need Analysis Education/ Development New Staff Recruitment Development Need Analysis Workforce Skill-mix Analysis Competence Assessment Advanced Practice Role Expectations Agreed Advanced Practice Post Established Existing Staff Non- Advanced Practice Roles

17. Service Need Analysis Education/ Development New Staff Recruitment Development Need Analysis Workforce Skill-mix Analysis Competence Assessment Advanced Practice Role Expectations Agreed Advanced Practice Post Established Existing Staff Non- Advanced Practice Roles

18. Service Need Analysis Education/ Development New Staff Recruitment Development Need Analysis Workforce Skill-mix Analysis Competence Assessment Advanced Practice Role Expectations Agreed Advanced Practice Post Established Education/ Development Competence Assessment Existing Staff Non- Advanced Practice Roles

19. Service Need Analysis Education/ Development New Staff Recruitment Development Need Analysis Workforce Skill-mix Analysis Competence Assessment Advanced Practice Role Expectations Agreed Advanced Practice Post Established Education/ Development Competence Assessment Existing Staff Non- Advanced Practice Roles

20. Service Need Analysis Education/ Development On-going Competence Review/ Revalidation Role Evaluation New Staff Recruitment Development Need Analysis Workforce Skill-mix Analysis Competence Assessment Advanced Practice Role Expectations Agreed Advanced Practice Post Established Education/ Development Competence Assessment Existing Staff Non- Advanced Practice Roles

21. www.advancedpractice.scot.nhs.uk

22. Consensus Definition www.advancedpractice.scot.nhs.uk

23. Consensus Definition www.advancedpractice.scot.nhs.uk

24. Consensus Definition www.advancedpractice.scot.nhs.uk

25. Advanced Practice A level of Practice, rather than a role or title Applicable across practice contexts Applicable across professional contexts ‘Specialist’ practice is not above or below ‘Advanced’ practice – it is on a different continuum. www.advancedpractice.scot.nhs.uk

26. Expert Practice Specialist Practice Generalist Practice Novice Practice

27. Key Themes & Principles Leadership Facilitating Learning Research Advanced Clinical Practice Autonomous practice, Critical Thinking, High Levels of Decision Making & Problem Solving Values-Based care Practice Improvement

28. Job Profile & KSF Outline

30. KSF Outlines/ Job Descriptors/Profiles Development of a national job profile and KSF outline templates for ‘Advanced Nurse Practitioner’ roles. Outline will support consistency across contexts with ‘Exemplars’ for different clinical/operational contexts – Community, H@N, SCN, Mental Health, Children etc.

31. Activity Analysis/Job Planning

32. Activity Analysis Development of prototype data collection and analysis tools Aim to support training needs analysis and good governance regarding matching client need to service delivery. Job Profiling/Planning Data capture Benchmarked AP characteristics

33. Activity Analysis & Measuring ANP impact Benchmarking - National, Regional & Local level Clinical Activity Data – National data, PANDORA or local systems Developing Indicators (Lloyd 2004) - McMaster University APN Toolkit - ? Minimum clinical activity data set (Concept & Indicators) Identify type of indicator (Structure, process or outcome) Identify dimension of quality to be measured Data Collection Test and Refine Develop a data collection plan Develop clear operational definitions Set specific indicator Analysis Action

34. Education Framework/DNAT

35. Educational Framework Role development requires Development Needs Analysis and educational support Agreement across the sector regarding Masters level and ‘core’ and context specific’ requirements for Advanced Practice development programmes. NHS Education for Scotland ‘Advanced Practice Succession Planning Pathway’ Model acknowledges existing education provision and the value of work-based learning and assessment

36. HEI - Electronic Proforma University title Background and links to agenda (250 words) Advanced Clinical Practice focused programmes - MSc,PgD, PgC Individual modules - Leadership/Management focused courses – Research focused courses – MPhil, PhD Education focused courses - PgCert Education Recognition of Prior Learning KSF, AP Competencies and other relevant mapping Application Download link Contact Details and email link

37. Mapping outcomes from educational provision to AP competencies 1. HEIs map their programmes/courses against the Core & Specific AP competencies 2. Practitioners access web page and select their role profile and the courses they have undertaken from a pre-populated list 3. Their AP profile/competency list is populated with the matched educational outcomes from the courses undertaken 4. ‘Missing’ competencies are identified so that practitioner/manager can arrange appropriate provision or seek other evidence of achievement. On going competence review is essential

38. Masters level – CPD ? Need to demonstrate Masters level thinking/practice. HEIs and Service could develop limited credit Masters level CPD units. Only available to individuals who have completed their initial ANP preparation, achieved competencies and have attained the minimum of a Degree. Advantages to Practitioner Advantages to Service Advantages to Higher Education Possible issues

39. Workforce Planning support

40. Workload/ Workforce Analysis Service Need – Service Design – Skill Mix Workforce/Workload Planning tools for robust and standardised measures that support the efficient targeting of nursing resources towards areas of need - beyond merely ‘numbers of nurses’ towards determination of skill mix. NHS National Workforce Projects ‘Six-steps’ Workforce Planning Process

41. Regulatory Guidance

42. Ensure that the regulatory position of advanced level practice roles is fully linked to devolved and UK-wide governance principles, processes and responsibilities. ANP regulation is co-dependent on many other aspects of the White Paper and linked to the NMC’s work on revalidation and establishing a robust system for how practitioners demonstrate continued fitness for practice. Common definition of ‘Advanced Practice’ across professions

43. Support Worker – level 1 Registered Practitioner – level 5 Assistant Practitioner – level 4 Senior Support Worker – level 3 Support Worker - level 2 More Senior Staff – level 9 Consultant Practitioner – level 8 Advanced Practitioner – level 7 Senior Practitioner – level 6 SCN/CQI Project Advanced Practice Toolkit Early Clinical Career Fellowships Consultant NMAHPs Clinical Academic Careers Scottish initiatives to support the Nursing Career Framework ‘Effective Practitioner’ www.advancedpractice.scot.nhs.uk Flying Start NHS