Advanced practice embodies the ability to manage clinical care in partnership with individuals, families and carers.
Advanced 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 practice embodies the ability to manage clinical care in partnership with individuals, families and carers. It includes the analysis and synthesis of complex problems across a range of settings, enabling innovative solutions to enhance people’s experience and improve outcomes.
This animation provides a brief overview of the role of advanced practitioners and the contribution they make to the workforce.
Multi professional roles in advanced practice
Advanced practitioners can be found across a range of professional backgrounds and settings including but not limited to nursing, pharmacy, paramedics, other allied health professions, and midwifery. The term advanced practitioner is used as a consensus umbrella term to encompass the wide range of health care professional registrants who work in advanced practice roles.
These roles can support multi-disciplinary teams, both traditional and more specialist teams, across a range of care settings including primary and secondary care. Please see
Multi-professional framework for advanced clinical practice in England for more information and career pathway into and within advanced practice across professions.
Case Study one
"My name is Paula Silva, and I am a dedicated nurse trained internationally. Since joining West Hertfordshire Teaching Hospitals NHS Trust in 2016, I have advanced my career significantly and developed a deep passion for elderly care.
In 2022, I committed to the Advanced Clinical Practice (ACP) program to enhance my skills further. My objective was to expand my knowledge and cultivate the expertise needed to address the complex needs of my patients effectively. Transitioning from a leadership role as a ward manager, I integrated my leadership skills into my position as an Advanced Clinical Practitioner, fully embracing the four pillars of advanced practice.
As an ACP, I have developed advanced skills in health assessments and clinical examinations tailored for elderly patients. This expertise has empowered me to play a vital role in preventing hospital admissions, facilitating early discharges, and accurately identifying patient needs. I also collect and analyse data monthly, contributing directly to service development and broader organisational strategies. Additionally, I am actively training and educating staff, fostering continuous professional growth across the Trust.
Throughout this journey, I have gained confidence in delivering high-quality care with considerable autonomy and making complex clinical decisions that significantly enhance patient outcomes."
Case Study two
I am a Trainee Advanced Practitioner with a background in Occupational Therapy currently working within Hospital at Home Service under the Hertfordshire and West Essex ICB. Whilst AP has been well established in bed-based units, it is new to community in this area and, as such has been an emerging role in a changing organisational environment. It has been both exciting and challenging to be part of its development.
As a trainee I have been privileged to be able to engage with further learning in each of the 4 pillars of practice such as: completing a module in management of chronic heart failure within the clinical pillar, coaching and mentoring training to support leadership pillar, and using some of the acquired research skills to inform involvement in service improvement projects. However, filling an emerging role has had its challenges. I have needed to work very flexibly, become highly responsive to external pressures, and get very familiar with both change and ambiguity. The learning curve is steep but its opportunities for application will be broad.
Caroline, trainee advanced practitioner
Those working at an enhanced level of practice can work as part of a multi-disciplinary team across a wide range of health and care settings, including secondary care, primary care, social care, and dentistry and as with advanced practice come from all multi-professional backgrounds. This level of working is highly valued and a career destination in itself. Training can come via an apprenticeship or traditional academic route.
What is consultant practice? Expertise in four domains necessary for enabling quality care from micro, to meso and macro levels of the system The key skill set for systems leadership and systems transformation aided by clinical credibility in own professional field Clinical academic role as an embedded researcher.
The Academy is part of the Hertfordshire and west Essex Integrated Care System where NHS organisations, in partnership with local councils and others, take collective responsibility for managing resources, delivering NHS standards, and improving the health of the population they serve.
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