What can we learn from our recent advanced clinical practice survey? (England)

11 July 2018

Background

The Council of Deans of Health ran a simple survey in June to test members’ attitudes to developments in advanced clinical practice (ACP) education. The survey was created to provide a benchmark for the Council’s current project work on advanced clinical practice in England, which has been funded by Health Education England (HEE). It was cascaded to deans, heads of school and course leads in England through the Council’s news bulletin and through the Association of Advanced Clinical Practice Educators (AAPE) network. The Council received 68 responses. Respondents’ free text comments added depth and context to the answers given to our questions.

Survey results

Survey results indicate a good level of awareness of the national 2017 ACP framework (67% felt they were extremely or very familiar with it). Respondents felt somewhat less familiar with the new advanced clinical practitioner apprenticeship. Nevertheless, results suggest that these two policy developments are already impacting on education provision. 70% of respondents had made or were planning changes to their ACP curricula in light of the framework and almost 80% had made or were planning changes to curricula in light of the apprenticeship, particularly to accommodate the requirement for End Point Assessment.

Over 90% of respondents said they are discussing delivery of the apprenticeship with local employers. Comments suggest extensive engagement locally, with universities working hard to respond to employers’ requirements, despite some perceived constraints around workplace support, supervision and study time.

Policy developments nationally are likely to require ACP programmes increasingly tailored to the individual or area specific clinical needs of students. Over 60% of survey respondents said that their ACP students in 2018/19 would take both generic clinical modules and clinical modules relevant to their own area of clinical work and 15% said modules would be relevant to students’ own areas of work. 23% said they were providing generic clinical modules. Comments indicate that respondents perceive an increasing demand for advanced specialist clinical skills. Respondents said that specialist content was more readily available for certain specialties than others and that there are challenges in delivering specialist modules for smaller specialties.

Just over 50% of respondents were optimistic about the future of advanced clinical practice. More respondents felt there was a clear vision for ACP nationally than locally and more respondents felt there was a clear vision for advanced practice for certain disciplines at national and local level than for others.

Respondents’ comments referred to ongoing ambiguity around the future of ACP across the professions. Our survey did not ask about professional identify but this topic came up in many comments. Some respondents felt that ACP should be a protected title with role standardisation and regulation. There were also concerns expressed about the involvement of medical Royal Colleges and the impact this could have on fragmentation of the future workforce, professional identity and representation.

What next?

The Council’s ACP conference on 14 September (now fully booked) will provide an opportunity for members to discuss the opportunities and challenges of ACP policy development. We want to challenge members to examine their current provision and think creatively about how educators will need to respond to future workforce demands. Our ACP project will continue beyond September with an ACP workshop at our full Council meeting in October and further activity and engagement over the Autumn and Spring. The Council is fully engaged with HEE’s work on advanced practice, working closely with professional organisations and NHS Employers to help shape the future of ACP.

Fleur Nielsen, Head of Policy

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