Advanced practice as a ‘level’ of practice
Until recently, 'advanced practitioner' posts have tended to be characterised principally by high-level clinical and technical competence. Central to the toolkit's 'benchmarking' approach is the idea that advanced practice is a 'level' of practice rather than a particular role.
We believe that separating these ideas allows the contribution of 'advanced practice' to be better articulated across different contexts. NHS Education for Scotland (NES) has built upon the international literature to identify four overarching themes that articulate 'advanced' practice and reflect the different spheres of advanced practice (NES, 2007).
Underpinning principles
These themes are further supported in the NES model (NES 2007) by 'underpinning principles' such as:
- autonomous practice
- critical thinking
- high levels of decision-making and problem-solving
- values-based care
- improving practice (NES 2007)
The NES advanced practice themes and the underpinning principles are clearly depicted in the NHS Wales Advanced Practice Framework (2010) and Department of Health Advanced Level Practice: A Position Statement (2010) strengthening the case for benchmarking of this level of practice.
