NMC calls on employers and professionals to adopt new advanced practice principles

The transformative principles set out, for the first time, what’s expected of registered nurses and midwives who are taking on complex, autonomous and expert roles commonly referred to as ‘advanced practice’.

According to recent research, there is a lack of clarity around advanced practice and what it means. That is why the principles include new regulatory definitions tailored both for the public – to better understand advanced practice – and for professionals to guide their roles and responsibilities.

Developed through extensive UK-wide engagement with professionals and the public, the principles were approved by our governing council in March 2025 and are now available in full.

We’ve published a short video featuring members of the public, professionals and system leaders discussing how the principles will strengthen advanced practice care. We strongly recommend and encourage their widespread use across workforce planning, education and governance.

The principles will form the foundation of a wider set of regulatory measures that will support the best possible advanced practice care in the future.
  
In Spring 2027, we’ll begin work to develop standards of proficiency and associated advanced practice programme standards. Nurses and midwives already practising at an advanced level will be supported through tailored transitional arrangements, while robust quality assurance processes will ensure approval of new advanced practice programme that meet our standards. 

This phased approach gives employers, educators and practitioners the clarity and time they need to embed the principles into daily practice, enabling safer, more consistent, and truly person-centred advanced level nursing and midwifery care across the UK. 

Prof Donna O’Boyle, Acting Executive Director of Professional Practice at the NMC, said: 

"Across the UK, we’ve heard a clear message that advanced practice needs greater clarity, consistency and support. For too long, there has been a wide variation in how these roles are defined, deployed and supported. These principles offer a clear foundation that sets out what advanced level practice looks like and the benefits they would bring if supported by employers across all health and social care settings."

“These principles are designed to support the transformation and delivery of care, to help meet the increasingly complex needs of those we care for, harnessing new technologies and changing ways of working. Nurses and midwives working at advanced levels of practice bring expert knowledge, complex decision-making skills and strong clinical leadership closer to the people receiving care."

“We’re encouraging professionals, employers and educators to start using the principles now to shape workforce planning, education and day-to-day decisions. By doing so, we can help advanced practice thrive, and most importantly, to help ensure that people receive safer, consistent and person-centred care when they need it most.”

The UK’s chief nursing and midwifery officers said:

“The NMC’s principles for advanced practice will provide welcomed clarity for professionals, employers and the public by clearly setting out for the first time a consistent definition across the UK of what’s expected of nurses and midwives practising at an advanced level."

“The principles are aligned to the existing advanced practice frameworks in each of our four countries of the UK; we strongly encourage professionals and their employers to use them to design and deliver services across all health and care settings."

“These transformational principles mark an important first step towards the NMC setting standards for advanced practice. We look forward to continuing to work with the NMC and colleagues across the four nations of the UK as this work continues towards additional regulation of advanced practice.”

Duncan Burton, Chief Nursing Officer (England)

Kate Brintworth, Chief Midwifery Officer (England)

Deborah Sturdy, Chief Adult Social Care Nurse (England)

Maria McIlgorm, Chief Nursing Officer (Northern Ireland)

Caroline Keown, Chief Midwifery Officer (Northern Ireland)

Anne Armstrong, Interim Chief Nursing Officer (Scotland)

Justine Craig, Chief Midwifery Officer (Scotland)

Sue Tranka, Chief Nursing Officer (Wales)

Karen Jewell, Chief Midwifery Officer (Wales)

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