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Perceptions of competency in advanced clinical practice

22 July 2021
Volume 30 · Issue 14



Historically, there has been limited research carried out on the competency of individuals undertaking advanced clinical roles.


To research advanced clinical practitioner (ACP) perceptions of the term competency, and how they evidence their competency in practice.


A cross-sectional, qualitative study used semi-structured interviews, which were analysed by content analysis. Six participants were recruited to the study.


There is disparity in the definitions of ‘trainee’ and ‘qualified’ ACP in clinical practice as well as disparity and ambiguity regarding being able to work in a supernumerary capacity during training and master's level study. There is a lack of agreement over the benchmark for qualified ACP status and the road to getting there.


ACPs should be employed in a supernumerary capacity while training and work towards a full MSc in advanced clinical practice. They should maintain a portfolio of their competency. Work must also be carried out nationally to identify both generic and specialist curricula for ACPs to benchmark against.

In recent years, the NHS has clearly experienced complex challenges to its ability to provide safe and efficient care to patients. For the NHS to overcome these, the workforce has been overhauled several times, and this has included the introduction of roles such as advanced clinical practitioner (ACP) and advanced nurse practitioner (ANP).

In 2017, Health Education England (HEE, 2017a) produced a multiprofessional framework for advanced clinical practice in England. This explains that advanced practice is a level rather than a type of practice.

ACPs are educated to master's level in clinical practice and have been assessed as competent in practice, using their expert clinical knowledge and skills to practise at an advanced level. They have the freedom and authority to act, making autonomous decisions in the assessment, diagnosis and treatment of patients. ANPs are nurses who are working in an advanced practice capacity and, while this title is still widely used nationally, ANPs are in effect part of the wider multiprofessional term ACP.

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