1. Modernising Nursing Careers Advanced and Specialist Practice Mike Sabin, SEHD MNCMNCMNCMNCMNCMNCMNCMNCMNCMNCMNC

2. UK Initiative The Modernising Nursing Careers (MNC) initiative was launched by the four UK Chief Nursing Officers in 2005/6 as part of the overarching Modernising Healthcare Careers strategy. The UK-wide nurse leaders group subsequently produced the report ‘Modernising Nursing Careers: Setting the Direction’ (DoH 2006). The report identified four priority actions: 1.Develop a competent and flexible nursing workforce 2.Update career pathways and career choices 3.Prepare nurses to lead in a changed healthcare system 4.Modernise the image of nursing and nursing careers MNCMNCMNCMNCMNCMNCMNCMNCMNCMNCMNC

3. Programme of work The programme is a UK wide initiative. However the context in each country will drive different approaches where required. Each country is responsible for communication, dissemination and stakeholder management; to that end, each country may establish its own national structures or projects. Synergy between this and the Modernising Medical Careers (MMC) and similar work with AHPs and the non-clinical workforce will take place via the wider Modernising Healthcare Careers (MHC) programme. The programme and related projects where appropriate will consider nursing at all levels (including assistant/associates) and in all sectors. Midwifery issues will be managed separately but will engage at all levels. MNCMNCMNCMNCMNCMNCMNCMNCMNCMNCMNC

4. Workstreams Pre-registration Education Careers Framework Competency Passport Specialist and Advanced Practice* Community Nursing Clinical Academic Roles Career Navigation Tools Independent sector Leading and coordinating care Fast-track Scheme for Nurse Leaders Image MNCMNCMNCMNCMNCMNCMNCMNCMNCMNCMNC

5. CodeWorkstreamLead AiPre-registration EducationNMC AiiCareers FrameworkAll AiiiCompetency PassportSkills for Health AivSpecialist and Advanced Practice & Early Clinical Career Fellowships Scotland BiCommunity NursingAll BiiClinical Academic Roles/ Clinical Education Careers England Scotland BiiiCareer Navigation ToolsSfH/England BivIndependent sectorEngland CiLeading and coordinating careN. Ireland CiiFast-track Scheme for Nurse LeadersWales DImageNHS Employers/All Communications and engagementAll MNCMNCMNCMNCMNCMNCMNCMNCMNCMNCMNC

6. Scottish MNC Group (Chaired by Margaret Smith) Provides a forum for dissemination of UK-wide developments and for generating data and focus for implementation or adaptation within the Scottish context. Provides stakeholder perspectives on each element to support SEHD decision-making, including option appraisal and risk analysis. Feed back to the MNC consortium to inform UK wide work. Provide support on the specific Scottish–led topic of Advanced/ Specialist Practice. MNCMNCMNCMNCMNCMNCMNCMNCMNCMNCMNC

7. Advanced/Specialist level practice – Scottish Lead Designated lead country for this MNC workstream, Opportunity to use MNC to support greater consistency in titles, roles and reward. Consultation event and HDL with outline framework for the development of this role within the Scottish context. New Roles Framework Cancer, OoH, Workload and Workforce, Educational models Crucially – an opportunity to build on existing work Initial invitation and subsequent work groups MNCMNCMNCMNCMNCMNCMNCMNCMNCMNCMNC

8. Advanced and Specialist Practice Overview and ideas

10. Expert Practice Specialist Practice Generalist Practice Novice Practice

11. Clinical

12. Educational Clinical

13. ManagementEducational Clinical

14. ManagementEducational Clinical Research

15. ManagementEducational Clinical Research LEVEL 5 Practitioner

16. LEVEL 5 Practitioner

17. LEVEL 5 Practitioner Clinical

18. LEVEL 5 Practitioner Clinical Educational

19. LEVEL 5 Practitioner Clinical EducationalManagement

20. LEVEL 5 Practitioner Clinical EducationalManagement Research

21. LEVEL 5 Practitioner LEVEL 6 Senior Practitioner

22. LEVEL 5 Practitioner LEVEL 6 Senior Practitioner

23. Clinical LEVEL 5 Practitioner Research Management

24. LEVEL 5 Practitioner LEVEL 6 Senior Practitioner Clinical

25. LEVEL 5 Practitioner LEVEL 6 Senior Practitioner LEVEL 7 Advanced Practitioner

26. LEVEL 5 Practitioner LEVEL 6 Senior Practitioner LEVEL 7 Advanced Practitioner LEVEL 8 Consultant Practitioner

27. Advanced Practice – The ‘Toolkit’ Create a model to explicitly link the regulated title, agreed national competencies, academic preparation and credit, the Career framework, the KSF and Agenda for Change. Articulation of clinical ‘ladder’ with research, education and management ladders. Development of ‘Toolkit’ which captures complexity/interaction in user friendly format. Establishment of Advanced Practice toolkit development group

28. Stakeholders Employers/Managers Linking competencies to KSF and AfC Link to PDPs and learning/development contract Skills Analysis/Needs analysis tools Outline of roles above and below AP Practitioners Mapping self to AP Competencies PDPs Needs analysis Portfolio development HEIs Mapping of Programme outcomes to AP competencies Assessment of competence - theory and practice guidance Links to Qualifications frameworks (SCQF/NQF/N.I. NQF/FHEQ) Links to regulatory frameworks (NMC, HPC)

29. Workload Analysis tool – what the service needs Workforce Analysis tool – what we already have (skills/compencies) Training Needs Analysis tool – what development is needed Recruitment Modelling tool – what skills we can bring in Workforce model – how this fits with national structures Governance, Policy and Regulation Guide – Supporting patient safety and staff governance AfC/KSF interface – what the rewards/expectations are Educational Framework – SCQF, Theory/Practice, Assessment and QA Service Workforce Planning Education Partnership Regulators Public Workload and Workforce Planning Project SCN Review and CQIs Cancer Framework Advanced/Specialist practice review Educational models KSF Mapping and Job Profiles

30. Advanced Practice - Actions Creation of ideal-type exemplars in key clinical areas: Cancer OoH/Unscheduled Care Critical Care/H@N Elderly care/ Long-standing Conditions Mental Health Public Health/Community Midwifery/AHPs Appointment of MNC Project Leader for work on Early Clinical Career Fellowship Programme, Advanced Practice Framework and Career Pathways. ECCF development model to target key areas and populate the framework MNCMNCMNCMNCMNCMNCMNCMNCMNCMNCMNC

33. Advanced Practice – Communication Strategy Engagement with NES and HEIs to support educational and assessment models. Engagement with service to ensure buy-in and integration in service redesign models. Engagement with Scottish Partnership forum and key UK partners Evaluation framework to explore numbers, core competencies, skills application service models and service impact. MNCMNCMNCMNCMNCMNCMNCMNCMNCMNCMNC