New research shows more professionals in advanced practice roles

Published on 10 May 2023

But public understanding of advanced practice is unclear as NMC considers future regulation

Experienced nurses and midwives are increasingly taking on complex, autonomous and expert roles commonly referred to as ‘advanced practice’, according to independent research commissioned by the NMC. But it’s unclear whether people who use services and the public understand the advanced practitioner’s role and what it means for them.

This matters because delivery of the level of practice that advanced practitioners are undertaking can carry inherent risks to patients and people using services. However, people may not know what it means when their nurse or midwife describes themselves as an advanced practitioner – and even those who understand can’t necessarily expect the same level of knowledge, skill and experience from different advanced practitioners with similar roles and titles as this responsibility typically lies with employers.

The NMC commissioned The Nuffield Trust to look at the existing literature on regulation of advanced practice, and international approaches to regulating advanced practice. It also considered the advanced practice landscape in all four countries of the UK, in conversation with key senior/relevant stakeholders. The consensus from the interviews and focus groups was that some form of specific regulation was needed for advanced practice in nursing and midwifery.

The research found great variation in how professionals enter and practice in these roles across the UK. This means there’s no single definition of advanced practice, nor any consistent outcomes, or standards of education or proficiency.

For example, current routes to advanced practice status include higher education such as a masters’ degree. However, there’s substantial variation in courses, with some designed to meet different course outcomes than others and therefore including different content.

The Council will discuss the findings of this early research at its next meeting on 17 May. The research will then inform further lines of enquiry as the NMC continues its review of the advanced practice landscape, including engaging with the public and people who use services, before presenting Council with options to consider later this year.

Andrea Sutcliffe, NMC Chief Executive and Registrar, said:

“The independent research is clear that experienced nurses and midwives working in complex, autonomous advanced practice roles can have huge benefits for the care they provide for people.

“Yet people who use services may be unsure what it means when a professional describes themselves as an advanced practitioner. And where somebody works with multiple advanced practitioners, they might assume those professionals achieved their roles through shared knowledge and skills, which isn’t always the case.

“We’re asking the NMC Council to discuss these initial findings and how they’ll help inform our next steps. This will include further lines of enquiry before we come to any conclusions on options for the future. It’s vital that we work closely with our partners, professionals and the public to coproduce any changes we may make.”

Anyone interested in our ongoing review can join our community of interest on advanced practice for all the latest updates, including opportunities to get involved.


  • We also commissioned Britain Thinks to run discussion groups with professionals currently working in advanced practice roles. They’re currently concluding their analysis and will provide a final report shortly.

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