The role of advanced nurse practitioner (ANP) was introduced to the NHS in the 1990s and is now an established part of the healthcare team, both in general practice and in hospital settings. Despite this, there remains a lack of clarity about the role.
So what is an advanced nurse practitioner?
Also known as advanced practitioners or nursing practitioners – among other things – ANPs are usually nurses with a depth of post-registration experience and an education to masters level.
They can serve as a patient’s primary healthcare provider and are able to diagnose disease via history taking, physical examination and the ordering and interpretation of diagnostic tests. They can make onward referrals and may provide appropriate treatment for their patients, including prescribing most medications.
There is a misapprehension that ANPs only work in A&E or general practice, but the role is being utilised throughout hospitals, from the cardiac ward to ENT and neurology. As well as being valued by the healthcare team, the role has been shown to be popular with patients. A UK study into ANPs’ effectiveness in general practice found that 65% of patients preferred to use a nurse-led clinic, with very few needing referral back to a GP.
Why did the role arise?
The ANP role was partly introduced to help fill the gap created by legal restrictions on junior doctors’ working hours – creating a new, highly skilled resource to deal with certain procedures and conditions. The Francis Report of 2013, which placed greater emphasis on patient care as opposed to targets, and on staffing levels in particular, has also led to a drive for more ANPs.
Outside of the hospital setting, the role has been seen as a route to improved efficiency in general practice. ANPs are able to carry out certain procedures that would previously have been conducted by a GP. It has also been argued that the ANP role will give experienced and ambitious nurses a range of career development opportunities, allowing them to take on more responsibility.
Sounds good, how do I take the first steps?
The Royal College of Nursing advises members interested in the role to start putting in the groundwork as soon as possible.
Gill Coverdale, Professional Lead for Education (Standards and Professional Development), said: ‘Staff nurses looking to progress on this route should talk to and spend time with an advanced nursing practitioner. That way, they can see the kind of work they do and discuss the journey to that role.
‘A nurse needs to have been registered for three years before completing their Independent Prescribing qualification – a key element of the ANP programme. However, until this point they can work in environments with ANPs and build up their skills, knowledge and expertise.
‘Once they have completed three years’ practice, nurses can apply to a university programme and then negotiate a clinical placement.’
So I need a masters degree?
Yes. Numerous universities offer MSc courses in advanced nursing practice, and these will usually be delivered on a part-time basis over two to five years. This is a financial necessity for many nurses who need to keep earning a living, but also has the benefit of maintaining continuous nursing practice.
You won’t necessarily have to undertake the training independently however, because NHS trusts have recognised the value of the ANP and are offering traineeships which combine work and study – usually with pay escalating as you get closer to completion of the course.
How much could I earn?
The role can sit at Band 6 or Band 7 on the NHS pay scales. This means nursing salaries for ANPs could range from £26,302 to £41,373 per annum. One salary aggregation website suggests median pay for the role is £36,659.
Will the role be better defined in future?
The lack of clarity and the low profile of the role has been recognised as an issue by the RCN, which is now trialling a credentialing process so that ANPs can register their credentials with the organisation. The scheme will be opened to all from spring 2017.
Credentials will be based on experience, qualifications and competence – and ANPs will join a register of Credentialed Advanced Practitioners with the RCN. They will then be reviewed every three years as part of the revalidation process.
Gill Coverdale said at its launch: ‘This will be the only register of ANPs in the UK. ANPs will be part of a collegiate faculty of advanced practice and will then be offered tailored support for revalidation and will be working within nationally defined criteria to inform scope of practice.’
Janet Davies, the RCN’s chief executive and general secretary, added: ‘This programme will use the RCN’s expertise and unparalleled knowledge of the profession to help nurses develop their careers and give patients and employers confidence in the continuing development of their nursing staff.’
Staffnurse.com currently boast over 700 roles to fill for Advanced Nursing Practitioners, and the demand keeps increasing over years