Advancing Clinical Practice
What is advancing practice?
Advancing practice is a suite of levels of practice beyond initial registration and encompasses the following levels:
Enhanced clinical practice
This is the level of practice after initial registration, and before advanced clinical practice. Working at an enhanced clinical practice level is a career destination in itself, as well as being a stepping stone for some to advanced clinical practice. ECP provide a high standard of complex specialist care for patients, using enhanced levels of clinical judgement, skills and knowledge and working within national and local protocols.
Enhanced Clinical Practice is underpinned by a minimum of an undergraduate degree and professional qualifications in integrated sexual health and HIV.
Advanced clinical practice
Advanced clinical practice is delivered by experienced, registered health and care practitioners. It is a level of practice characterised by a high degree of autonomy and complex decision making. This is underpinned by a master’s level award or equivalent that encompasses the four pillars of clinical practice, leadership and management, education and research, with demonstration of core capabilities and area specific clinical competence.
Advanced Clinical Practice is underpinned by a master’s level award (minimum PGDip), independent non-medical prescribing, and advanced assessment skills, supplemented with advanced professional qualifications in integrated sexual health and HIV.
Consultant clinical practice
Consultant practitioner can be defined as the pinnacle of the clinical career ladder for all health and social care disciplines in the UK. They provide expert clinical practice and exercise their authority in complex cases that carry a high risk and are unpredictable, alongside clinical service development and strong clinical leadership. To play a pivotal role in the integration of clinical, education and research findings in providing practice and defining clinical practice. The consultant practitioner is able to initiate clinical service developments and deliver improved patient outcomes through the implementation of the findings of clinical research clinical audit, clinical governance and clinical risk assessment. They have the freedom to act and have the autonomy and authority to make changes within clinical and service development within their organisation.
Consultant level practice is underpinned by a minimum of Master’s level education, however CCPs often have professionally recognised teaching qualifications and a doctoral level award.
Types of professionals who become ECPs, ACP, and CCPs
Across the levels of practice, practitioners can come from any regulated healthcare profession, although generally in integrated sexual health and HIV they tend to come primarily from nursing, pharmacy, dietetics, and physiotherapy.
Developments in advancing practice
National developments
- The launch of the Health Education England National Centre for Advancing Practice
- The creation of a HEE national directory of ACPs
- HEE accreditation of MSc Advanced Clinical Practice programmes
Enhanced clinical practice
- The launch of the apprenticeship standard for enhanced clinical practitioners
- The creation of a multi-professional framework for enhanced clinical practitioners
Advanced clinical practice
- The piloting of credentialing of ACP in Integrated Sexual Health and HIV
- The piloting of the alternative route to the HEE directory for ACPs for existing ACPs
Consultant clinical practice
- The creation of a multi-professional framework for enhanced clinical practitioners
For further information about advancing clinical practice
Institute for apprentices
ECP apprenticeship standard
ACP apprenticeship standard
England - Health Education England
https://www.hee.nhs.uk/our-work/advanced-clinical-practice
Scotland - NHS Education for Scotland
Northern Ireland - Department of Health, Social Services and Public Safety
Wales - National Leadership and Innovation Agency for Healthcare
https://weds.heiw.wales/assets/Uploads/35f7cc70ad/NLIAH-Advanced-Practice-Framework.pdf
The Advanced Clinical Practitioner (ACP) Integrated Sexual Health and HIV Specialty Training Curriculum 2019 (revised 2021)
The ACP curriculum has been developed as a joint project between the British Association for Sexual Health and HIV (BASHH), the Faculty of Sexual and Reproductive Healthcare (FSRH) and the National HIV Nurses Association (NHIVNA) as a Health Education England (HEE)-supported project to standardise practice in integrated sexual health and HIV services. The curriculum has just received endorsement from the Royal College of Nursing and the British HIV Association.
The aim of the ACP Integrated Sexual Health and HIV curriculum is to provide a clear and comprehensive guide to the expected level and breadth of practice for advanced clinical practitioners working in integrated sexual health and HIV. It has been designed to support practitioners, managers, higher education institutions and commissioners.
In addition to having a masters level award, ACPs will be independent non-medical prescribers, and be able to undertake advanced clinical assessments. For ACPs in Integrated Sexual Health area specific clinical training is likely to include STIFAdvanced competency for STI and related conditions, Diploma of the Faculty of Sexual & Reproductive Healthcare, and Letters of Competence in Sub Dermal Implants and Intrauterine techniques for contraception. While for ACPs working in HIV, NHIVNA-STIF HIV Advanced competencies.
There are three clinical pathways:
- Integrated Sexual health
- HIV
- Integrated Sexual Health & HIV
What does the curriculum cover?
The curriculum provides clear, comprehensive guidance on the knowledge, skills and attributes needed for practitioners working within integrated sexual health and HIV services. It is based on the medical curricula for GUM/HIV and Sexual & Reproductive Health, and has been mapped to the four pillars of advanced clinical practice (clinical practice, leadership & management, education, and research) core capabilities as outlined in the HEE multi-professional framework for advanced clinical practice.
It will help practitioners, managers, employers, Higher Education Institutions and commissioners, to better understand the role of nurses working in specialist integrated sexual health services.
What are the core ACP curriculum learning outcomes?
As part of the requirements for the curriculum, all Advanced Clinical Practitioners will be expected to complete the following four pillars and associated knowledge, skills and behaviours:
- Leadership and management
- Education research
- Clinical practice: basis for practice / HIV (part 1)
Then there are specific learning outcomes depending on which clinical pathway you undertake:
- STIs and related conditions
- Contraception and gynaecology
- HIV part 2
How do I access the curriculum?
The curriculum is free to access and endorsed by Health Education England.
Download the curriculum here