Earlier this year, the Nursing and Midwifery Council (NMC) clarified its stance on advanced practice with the approval of its Principles for Advanced Practice. While the principles have not yet been published – a launch date has been proposed for late May 2025 – a draft version is available via the NMC Council Papers (NMC, 2025).
The concept of advanced practice, what it entails and its significance, has been debated and discussed for decades. The Department of Health, representing all four UK Health Departments, commissioned the Council for Healthcare Regulatory Excellence to provide guidance on how regulatory bodies manage developments in professional practice following initial registration. The findings from the commissioned activity concluded that implementing statutory regulation would not provide a substantial enhancement to public protection. Instead, alternative approaches to oversight and professional accountability may be more effective in ensuring safe and competent practice.
Discussions continued regarding additional regulation within the existing legal framework. In England, a formal definition of ‘advanced practice’ was established, while the other UK nations worked on expanding and refining various frameworks. There has been a strong commitment across all four nations to developing and growing the advanced practitioner workforce.
The issue of advanced practice extends beyond nursing and has significant implications for a wide range of health and care professions. The Health and Care Professions Council, which regulates 15 distinct health and care professions, has a vested interest in how advanced practice evolves. However, the NMC and other professional regulators are progressing at different stages in their approach to advanced practice.
Unfortunately, this fragmented approach may have resulted in a missed opportunity to establish a consistent and unified framework across the UK and wider professions. A more coordinated strategy for advanced practice regulation could have helped reduce variability, promote consistency and enhance public trust and confidence in advanced practitioners. A unified framework would also have provided much-needed clarity across the sector, ensuring that professionals receive structured support in developing and delivering advanced practice roles nationwide. For the public, those who rely on the expertise of advanced practitioners, such an approach would have provided assurance that all advanced practitioners meet the same rigorous standards, are assessed as competent and capable and deliver safe, high-quality care regardless of their professional background or their location.
The NMC's position statement represents a significant and progressive shift in its approach to advanced nursing roles. This evolution is both timely and necessary, as advanced practice nurses play an increasingly important role in contemporary healthcare. Their expertise is essential in managing the growing complexity of patient care, addressing workforce challenges, and responding effectively to the evolving needs of health and care systems.
By formally recognising and refining its stance on advanced practice, the NMC acknowledges the expanding scope and responsibilities of these roles. This development is a positive step towards providing greater clarity, consistency and regulatory support for advanced practitioners. It also reinforces the importance of ensuring that those in advanced roles are equipped with the necessary skills, knowledge and professional accountability to deliver high-quality, safe and effective care.
As healthcare continues to evolve, the role of advanced nursing practice will become even more pivotal. The NMC's position statement marks an important ambition in shaping the future of advanced practice.