Widespread confusion regarding the role expectations, preparation and capability of those operating as specialist nurses, specialist practitioners, nurse practitioners, advanced practitioners and the many other titles that exist has supported a move to rationalise titles and benchmark advance practice roles. There is also a degree of perceived 'risk' associated with the high levels of autonomy, role complexity and decision-making involved in these roles.  Changes to the statutory regulatory framework has previously been viewed as a solution to these issues. 

Different thinking is, however, required to address the contemporary focus on risk, proportionality' and employer led models of regulation/ governance rather than statutory regulation.  A recognised and agreed set of national standards will be required to ensure public protection. Consistent, benchmarked role definitions, job profiles, competency/capability outlines and robust education processes will provide the basis for such standards.

This approach would allow central guidance to be issued around the use of the title 'advanced practitioner' and how it can be governed within NHS organisations without recourse to an external regulatory body. The move from government to governance is a sign of a modern approach to regulation that acknowledges professionalism in its purest form.

The Scottish Government have already issued guidance for NHS Boards on governance of Advanced Nursing Practice roles and Consultant Nurses, Midwives and Allied Health Professionals (SGHD 2010) and work is ongoing to implement this guidance.

Advanced Nursing Practice Roles Guidance (SG 2010)

Consultant Nurse, Midwife and Allied Health Professionals Guidance (SGHD 2010)