Advanced practice roles have tended to emerge from local clinical drivers and/or in response to national strategies and policy. Many of the initiatives have been developed rapidly and until recently there has been little national guidance on the educational preparation required at this level. As a result, practitioners have often had very different experiences of educational preparation, clinical supervision and competence assessment.

In NHSScotland Masters level education has been agreed as the appropriate educational level for advanced practice.  Completing an academic programme is not, however, sufficient for advanced practitioner development and educational preparation to develop competence, capability and expertise in practice is equally important.

Experience of the support and development of practitioner roles for primary care out-of-hours and hospital at night services has shown that role development requires significant educational support, and that consistency is the key to creating confidence in the capability and competence of the resulting practitioners.