Bass BM. Leadership and performance beyond expectations.New York, NY: Free Press; 1985

Coombes R. Dr Nurse will see you now. BMJ. 2008; 337

Evans C, Poku B, Pearce R Characterising the evidence base for advanced clinical practice in the UK: a scoping review protocol. BMJ Open. 2020; 10:(5)

Health Education England, NHS Improvement, NHS England. Multi-professional framework for advanced clinical practice in England. 2017.

Hill B, Mitchell A. Introducing advanced level practice and the scope of developing new roles. Br J Nurs. 2021; 30:(1)28-31

Hooks C, Walker S. An exploration of the role of advanced clinical practitioners in the East of England. Br J Nurs. 2020; 29:(15)864-869

Klastersky J, Paesmans M, Rubenstein EB The Multinational Association for Supportive Care in Cancer risk index: a multinational scoring system for identifying low-risk febrile neutropenic cancer patients. J Clin Oncol. 2000; 18:(16)3038-3051

Kumar A, Roberts D, Wood KE Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006; 34:(6)1589-1596

Leary A, MacLaine K. The evolution of advanced nursing practice: past, present and future. Nurs Times. 2019; 115:(10)18-19

Lumbers M. Approaches to leadership and managing change in the NHS. Br J Nurs. 2018; 27:(10)554-558

NHS England Sustainable Improvement Team. NHS change model. 2018. (accessed 21 June 2022)

NHS England. Commissioning for Quality and Innovation (CQUIN): Guidance for 2017–2019. 2018. (accessed 21 June 2022)

NHS England/NHS Improvement. NHS long term plan. 2019. (accessed 21 June 2022)

National Institute for Health and Care Excellence. Neutropenic sepsis: prevention and management in people with cancer. NICE clinical guideline CG151. 2012. (accessed 21 June 2022)

National Institute for Health and Care Excellence. Sepsis: recognition, diagnosis and early management. NICE guideline NG51. 2017a. (accessed 21 June 2022)

National Institute for Health and Care Excellence. Patient group directions. NICE medicines practice guideline MPG2. 2017b. (accessed 21 June 2022)

Stanford PE. How can a competency framework for advanced practice support care?. Br J Nurs. 2016; 25:(20)1117-1122

Assessing the impact of introducing trainee advanced clinical practitioners onto an acute oncology triage unit

07 July 2022
9 min read
Volume 31 · Issue 13


Advanced clinical practitioners (ACPs) have largely been based within acute emergency areas such as emergency departments (EDs) and acute medical units. At The Royal Wolverhampton NHS Trust, ACPs are a new element within oncology services. The acute oncology triage unit sees patients who have received systemic anti-cancer therapy (SACT) presenting with a variety of side effects and symptoms including oncological emergencies, reducing the need for ED attendance. The trainee ACPs identified the neutropenic sepsis pathway as an area requiring urgent change. Through the creation of a new neutropenic sepsis screening tool, as well delivering educational sessions to nursing staff on the unit, the trainee ACPs were able to significantly improve door-to-needle times for patients as well as increasing the use of patient group directions (PGDs), thus reducing delays in antibiotic administration.

Advanced practice roles have existed within nursing for many years, some since the 1970s (Leary and MacLaine, 2019), under various titles such as advanced nurse practitioner, nurse consultant, advanced practitioner and nurse practitioner. The first official advanced nurse practice course was developed in 1990 at the Royal College of Nursing Institute (Leary and MacLaine, 2019). It was a common misconception that advanced practice roles were a substitute for a shortfall in medical roles (Coombes, 2008), however, the role is now becoming more recognised and the idea of collaborative working between nurses, allied health professionals and doctors is more accepted. Advanced clinical practitioners (ACPs) have been largely based within acute emergency areas such as emergency departments (EDs) and acute medical units. More recently, ACP roles have expanded to include a multitude of healthcare backgrounds—including nurses, physiotherapists and pharmacists—in a variety of specialties (Evans et al, 2020). This has allowed many professionals to expand their skills and knowledge, often taking on roles traditionally recognised as that of a doctor such as advanced clinical assessment and prescribing (Health Education England (HEE) et al, 2017; Hooks and Walker, 2020).

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content