1. The future’s bright.. The Future’s ACP Prof Mark Radford CNO & Exec Lead HEEWM for ACP

2. NHS Drivers : Why now? FYFV Quality Reform Patient choice Future models of care Economic urgency in relation to patient safety, productivity & efficiency

3. ‘Liberating the NHS’ to ‘Five Year Forward view Continued operational and financial challenges. Foundation Trust status. Social & community care reorganisation – closer to home. Building relationships with emergent CCG and Clusters. High public expectation. Re-focussing on care quality (post Mid-Staffs).

4. Professional Drivers for N, M and AHP’s –Enhanced professional education models (Diploma to Degree) –Academic autonomy and knowledge development –Advanced Education & research requirements –Professional advanced & development

5. What's changed for healthcare workers ? The workplace context –Specialisation (medical, Nursing and AHP) –Finance and productivity agenda –Policy support for professional expansion –Challenge to medical dominance in healthcare Multi-professional relationships at ward and board The status and experience of nurse, doctors and AHPs Patients expectation Training and education

6. Pushing Nursing & AHPs to the front Accelerated Policy Drivers have been in place to support.. Has this been maximised ? Key reports from the Department of Health (DH) –NHS Modern and Dependable (1997) –Keeping our NHS local (2003) –Our Health our Say (2006) –Modernising Nursing/Scientific careers (2006)

7. What does this mean for Advanced Clinical Practioners? How does Advanced Practitioner fit into this model; ▫ New models of care ▫ Clinical leadership and development ▫ Social entrepreneurship ▫ Can this be achieved without a consensus across professions and clinical environments ?

8. Vision – to enable a skilled and knowledgeable Advanced Practice workforce to be used effectively to enhance the capacity of the existing health workforce to ensure a quality service for patients, now and in the future Academic Framework Curriculum diversity Competenc e diversity Competenc e diversity Academic and Profession al uncertainty of ACP Role Diversity Deployment challenges Regulation and managemen t

9. Deliverables for Regional Advanced Practice Programme 5 key themes a)Creation of Baseline Survey Results 2014 Workforce Plans 2014 Summary b)Curriculum Standardised Modules for Advanced Practitioners c)Competencies Core Competencies for Disciplines Specialist Competencies for Disciplines d)Communication Communication Strategy e)Deployment Draft Contents & Timetable for Creating Toolkit for Deployment of Advanced Practitioners This workstream requires influence/negotiation at a senior level in trusts

10. Curriculum and Competence Consensus across all HEI’s Clear outlined model and framework Defined 80% core curriculum Covers Primary, Secondary, (Nurse, Midwife and AHP) MH and LD 20% local academic and speciality variation

11. Professional issues and Deployment Agreed model Alignment of educational and professional educational standards Requirements and training portfolio CPD requirements Nomenclature

12. Product development –HE (WM) – Regional Advanced Practice model and framework –HE (WM) – Curriculum framework –HE (WM) – Cross discipline competency framework –HE (WM) – Deployment toolkit (End of Jan)

13. National Alignment –Synergy with other Regional programs –Ahead in concept and product development –Initial Alignment and agreement with HE (EM) –HE (WM) – sponsored national meeting in Feb to create consensus for National model

14. Future development (15/16 > 16/17) –Deployment of the standardised curriculum offer in WM –Refinement of specialists models –Coordinate LETC ACP commissioning arrangements –ACP education and outcome tracker –Exploration and development of WM voluntary Register –Development of CPD network –Research evaluation of standardised curriculum and competency –Explore and determine revalidation and professional leadership models for ACP

16. Round Table Event – 8 th January 2016 There are multiple definitions of advanced practitioner There are various established roles, across all specialties and professions working as advanced clinical practitioners There are practitioners using advanced skills but not in recognised ACP roles There is a general lack of recognition of the role Education level / qualification variation Need agreement nationally to ensure parity Need to distinguish between the range of titles and accompanying meanings Key stakeholder to provide multi-disciplinary representation to agree a common definition

17. Workshops Definition for Advanced Clinical Practice –What is an advanced clinical practitioner –Recognise the range of professional backgrounds where ACPs originate (multi- professional) –Level of skills, theoretical knowledge, leadership and decision making ability –Agree on one definition – that is nationally recognised Core principles for Advanced Clinical Practice –What are the core principles for ACP to include academic level i.e. Masters –An ACP will …… –What are the generic competencies to include in each job description –Highlight the ‘advanced’ functions required to undertake to be classed as ACP Generalist, specialist and transferability –Terminology and definition of generalist and specialist –Clarity and differences of other roles compared to ACP (i.e. Physician Associate) –Shared understanding of specialist role and title –Specialist does not mean advanced level practice –Is transferability being limited (across speciality areas/professions)

18. Definition……..work in progress Advanced practitioners: are experienced professionals have developed expert knowledge base use and build the evidence base demonstrate complex clinical decision-making skills manage risk continually learn and facilitate learning for others innovate to deliver sustainable improvements in patient care exhibit proactive leadership to transform services understand local and national contexts of healthcare work across boundaries

19. Advanced……….extended roles Advanced –“…acquisition of additional expertise to achieve a higher performance level.” Extended –“…..additional expertise sufficient to provide services or perform tasks that are outside the usual scope of practice of the profession.” Source – Jackson, J et al, Understanding advanced and extended professional practice, Australian Pharmacist, (April 2015) Pharmaceutical Society of Australia Ltd.

20. Transformational change

21. Advanced Clinical Practice: defining the future forward role – 29 th January 2016 Representatives with an interest in Advanced Clinical Practice from healthcare, higher education institutes, senior leaders and advanced practitioners (multi- professional) Share and discuss the innovative work currently underway on Advanced Clinical Practice across Health Education England Highlight how Advanced Clinical Practice across the multi-professional workforce can be used effectively to enhance and provide capability within teams as part of the continuing drive to provide safe, accessible and high quality care for patients Share and learn about the important Advanced Clinical Practice work being carried out locally and nationally including frameworks, competencies and role development Synergy with other Regional programs and product development (frameworks) Alignment and agreement with HEE area teams

22. Advanced Clinical Practice 200 delegates from across the Country and professional groups Valuable event and good use of time HEE engagement with local area teams and ACP work Opportunity to understand the ACP journey from Trainee to Qualified professional including student experience Hear about work been undertaken in other parts of the Country Not in isolation – different models developed across the Country Highlighted ACP is Multi-professional Expectations are changing and therefore workforce needs to change to meet the demands – transformation and support of new roles Patient focused and flexible workforce with the right skills Opportunity to debate with Peers and ACPs Took plenty away to think about!

23. Questions