Advanced clinical practitioners (ACPs) are healthcare professionals, educated to Master's level or equivalent (for example the Centre for Advancing Practice ‘Advanced’ digital badge), with the skills and knowledge to allow them to expand their scope of practice to better meet the needs of the people they care for. Practitioners working at an advanced level come from a range of professional backgrounds such as nursing, pharmacy, paramedics, and physiotherapy.

In 2017 Health Education England (HEE) produced the HEE Multi Professional Framework for Advanced Clinical Practice in England. This framework provides a clear definition and specifies the capabilities for clinicians using the ‘Advanced’ title. This is the first time a common multi-professional definition has been developed which can be applied across professional boundaries and clinical settings. 

The framework supports a level of practice and clinicians who use the term ‘advanced’ in their title need to have Masters level education and be able to evidence capability across the four pillars of advanced practice as outline in the HEE Multi Professional Framework for Advanced Clinical Practice in England. 

The advanced practice role is integral part of the future NHS workforce as new models of care transform the way patients are treated and managed. Working at an advanced level across the four pillars of advanced practice – clinical, management and leadership, research and education, advanced practitioners offer multiple benefits to the health service and the population. They bring a more holistic approach to patient care, exercise autonomy and decision making in a context of complexity, uncertainty, and varying levels of risk. Each practitioner must work within their scope of competency and hold accountability for decisions made.

Health Education England (HEE) definition of Advanced Clinical Practice.

Advanced clinical practice is delivered by experienced, registered health and care practitioners. It is a level of practice characterised by a high degree of autonomy and complex decision making. This is underpinned by a master’s level award or equivalent that encompasses the four pillars of clinical practice, leadership and management, education and research, with demonstration of core capabilities and area specific clinical competence.

Advanced clinical practice embodies the ability to manage clinical care in partnership with individuals, families and carers. It includes the analysis and synthesis of complex problems across a range of settings, enabling innovative solutions to enhance people’s experience and improve outcomes.

PCN Requirements and Entitlements for Additional Roles Reimbursement Scheme (ARRS)

Advanced Practitioners are designated to the Network Contract DES roles for Clinical Pharmacists, First Contact Physiotherapists, Dietitians, Podiatrists, Occupational Therapists, Paramedics and Advanced Clinical Practitioner Nurses.

From 1 April 2023, new advanced practice roles have been included in the 23/24 update to Additional Roles Reimbursement Scheme (ARRS). These include;

• Advanced Clinical Practitioner Nurses in the roles eligible for reimbursement as Advanced Practitioners (APs), who must have gained the Centre for Advancing Practice ‘Advanced’ digital badge.
• Reimbursing PCNs for the time that First Contact Practitioners spend out of practice undertaking education and training to become Advanced Practitioners. 

NHSE Primary Care team, in partnership with the Centre of Advancing Practice, have developed some FAQs in which to provide some clarity on the requirements and entitlements for these roles in order to support PCNs and practices to understand and enable effective reimbursement of the appropriate primary care workforce (the link can be found in useful links).