NHS Education for Scotland

Specialist and Advanced Practice

Specialist and Advanced Practice

Nurses working with a 'Specialist' title continue to contribute in important ways to health care provision in Scotland. As roles have evolved there has been significant debate over how to differentiate these two important roles as shared features can be identified.

In essence, the differentiation centres on the focus of the role. Advanced Nurse Practitioners focus on managing whole episodes of complete clinical care in contrast to a Specialist Practitioners focus on discrete aspects of a patient’s care.

It can be seen that that 'specialist' can be considered as one pole of the 'specialist-generalist' continuum, rather than on the developmental continuum from 'novice' to 'expert'. This approach defines 'specialist' practice as that which is particular to a specific context, be it a client group, a skill set or an organisational context. (Fig. 2.1).

The developmental pathway towards advanced level practice in nursing may be different for individual practitioners, with some following a 'specialist nursing' route through focus on high-level skills and decision-making within a particular client group or clinical context, while others will develop a portfolio that reflects high-level assessment, decision making and autonomous practice across a greater breadth of practice.

Figure 2.1 Definitions