Advanced Nurse Practitioner (Level 7)

Advanced Practice is a level of practice, rather than a specific role or title (Transforming Nursing Roles Paper 2 CNOD 2017)and  has four pillars of practice, which the ANP must have as part of their core role and function. These  are:-

• Clinical practice

• Leadership

• Facilitation of learning

• Evidence research and development

” An Advanced Nurse Practitioner (ANP) is an experienced and highly educated Registered Nurse who manages the complete clinical care for their patient, not solely any specific condition. Advanced practice is a level of practice, rather than a type of speciality of practice.

ANPs are educated at Masters Level in advanced practice and are assessed as competent in this level of practice. As a clinical leader they have the freedom and authority to act and accept the responsibility and accountability for those actions. This level of practice is characterised by high level autonomous decision-making, including assessment, diagnosis, treatment including prescribing, of patients with complex multi-dimensional problems. Decisions are made using high level expert, knowledge and skills. This includes the authority to refer, admit and discharge within appropriate clinical areas.

Working as part of the multidisciplinary team ANPs can work in or across all clinical settings, dependent on their area of expertise.”

(Scottish Government 2017)

“The Advanced Nurse Practitioner role has a specific focus on the clinical pillar, but must demonstrate competence within all four pillars of advanced practice. With regard to the clinical pillar all ANPs must be able to demonstrate competence in:

a) Comprehensive history-taking
b) Clinical assessment 
c) Differential diagnosis 
d) Investigations 
e) Treatment 
f) Admission, discharge and referral.” (Chief Nursing Officer Directorate, Transforming Nursing Roles Paper 2, 2017)

Transforming roles ANP competency frameworks are available here NHSGGC : Key Documents

ANPs are paid at a minimum of Band 7, and within NHSGGC the generic ANP Job Description should be used for any new Band 7 ANP roles.

Advanced Nurse Practitioners who work within General Practice and are not directly employed by NHSGGC but work within the Board area, are encouraged to join the Board held list of ANPs in General Practice. The benefits of joining this list are:

• On-going access to specific ANP education and information

The process to join is exactly the same as for those who are Board employed, but with the following grandfathering arrangements for those employed before 2010 or between 2011 and 2017.

Advanced Nurse Practitioners in General Practice Guidance Document

Employed as an ANP prior to 2010

Expected to demonstrate that they:

• meet all the appropriate competencies for their area of practice,
• can evidence the formal learning undertaken relevant to the role which may have been below master’s level (commonly degree level modules)
• provide evidence of recent workplace based assessments (within last 5 years)
• provide satisfactory feedback from others (minimum of 4 within the last year)
• provide a satisfactory supervision report
• provide evidence of reflection and a broad range of patients seen
• evidence continuing professional development

Employed as an ANP between 2011 and 2017

In addition to the above, ANPs employed between these years should demonstrate master’s level  learning. This could be done, for example, through having completed a module at master’s level.

Employed as an ANP after 2018

Expected to demonstrate that they meet all the appropriate competencies for their area of practice, a master’s level qualification in advanced practice, workplace based assessments, reflection, feedback from others, and a satisfactory final supervisors report (see Final Sign-off).

Recording General Practice ANPs

There are two stages to the process.

                Stage 1: Involves the Post being recognised as an ANP post (please note that posts which utilise the Board’s generic ANP job description automatically meet this requirement)

                Stage 2: Final Sign-off (see Final Sign off)

A completed ‘Final Sign-off’ form and the poster-holder’s Job description should be submitted to the Consultant Nurse for Advanced Practice (AdvancedPractice@ggc.scot.nhs.uk) . Following the moderation process the following will occur.

• The individuals name, NMC number, NHS email address and place of work will be recorded on the Board held list of GP ANPs
• The individual will receive written confirmation that their name has been recorded (a copy will be sent to their line manager and practice supervisor)
• Access will be given to the NHSGGC ANP Continuing Professional Development Moodle site so that ANPs can be kept up-to-date with news and resources relevant to ANPs including West of Scotland Advanced Practice Academy CPD days
• Annually the ANP will receive an email asking them for confirmation that they remain in their ANP post (a nil response will be taken to mean that the individual has left the post and their name will be removed from the list).
• Annually, ANPs will be requested to submit an updated ‘share pack’ from their ePortfolio evidencing continuing professional development and reflection on practice to their line manager.

[1] Set out in Chief Nursing Officer’s Directorate (2017) Transforming Nursing, Midwifery and Health Professions’ (NMaHP) Roles: Paper 2 Advanced nursing practice. Edinburgh: Scottish Government

An ANP who moves from one broad area to another, for example from acute care to primary care, is still regarded as an ANP while they transition. In this example, the ANP can be viewed as an Acute Care ANP practising within Primary/Community Care until they have met all the Primary/Community Care competencies.

Transitioning ANPs will need a Practice Supervisor and Practice Assessor to help them meet any learning needs and assess that they’ve met all appropriate competencies for their new role.

Transitioning ANPs may choose to undertake additional courses to help with transition.

Evidence of meeting additional competencies will need to be uploaded into the ANP’s Professional portfolio, a transitioning ANP sign-off form, should be completed by the Practice Assessor and line manager and emailed to advancedpractice@ggc.scot.nhs.uk along with the portfolio sharepack link. A sample of transitioning portfolios will be moderated

The ANP will then be recorded on the Board’s Advanced Practice database under the new broad area as well as their previous area.