NMC clarifies role of Advanced Practitioners as BMA calls for views on medical substitution

A registered nurse or midwife working at an advanced level is an expert professional with additional post-graduate education and experience. They use their evidence-informed knowledge, skills and capability to influence, shape, deliver and lead safe and effective care, while managing risk, uncertainty and complexity.

The BMA says it has heard concerns about the blurring of the distinction between doctors and non-medically qualified staff – including patient safety concerns resulting from non-medical clinicians being supported by their employers to work outside of their competency, or in ways that negatively impact the education and training of medical students and doctors.

The NMC is clear that Advanced Practitioners are not a substitute for medical practitioners as they continue to draw extensively on their nursing and midwifery person-centred practice. They work as part of multi-disciplinary teams, helping to enhance skill mix within teams and enable other health and care professionals to reprioritise.

Last June, the NMC unveiled its Principles for Advanced Practice. These set out its expectations for advanced level practitioners across the range of roles and settings – including practising within their individual scope of practice and in line with their level of knowledge, experience, qualifications, training and employment role.

The NMC will continue working towards additional regulation for advanced level practitioners – by developing new Standards of Proficiency, and Advanced Practice Education Programme Standards, in collaboration with key stakeholders and members of the public.
Through this work, the regulator will bring clarity to the role of advanced level practitioners, providing assurance to the public through standardisation of the role and addressing the variability currently seen across preparation, qualifications and governance processes.

Prof Donna O’Boyle MBE, Acting Executive Director of Professional Practice, said:

“Advanced practice is a clearly distinguished role achieved by highly skilled, knowledgeable and experienced nursing and midwifery professionals.

“The publication of our Principles for Advanced Practice was a major milestone in the history of nursing and midwifery. They provide clarity and transparency around what the public can expect from Advanced Practitioners, and they support employers to harness the benefits of Advanced Practice safely and effectively.

“We’re clear that Advanced Practitioners should be valued as highly skilled members of multi-disciplinary teams, working alongside doctors – not as a substitute for them.”

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