Advanced practice roles will not function in isolation. Their nature and number will be influenced by the availability of support roles and senior and junior professional staff. The development of advanced nursing practice roles should, however, always be based in service need.

How and where advanced practice roles are developed will also depend on the pattern of staffing required. Larger teams will allow for more differentiation of roles by clustering activities in terms of level and type of skill required. The relationship between 'specialist skills' (context-specific but across levels) and 'advanced practice' (autonomy, decision-making, dealing with complexity) is again important in determining the type of role required.

In identifying the types of advanced practice roles that we need to develop, it will be important to consider those that:

• fully match the skills profile of an existing role or professional category
• are enhancements/expansions of existing roles drawn from a specific professional group, with additional skills training required to support the new role
• could be filled from more than one professional group, but which require additional skills training or development.

NES have developed a Service Needs Analysis Tool to support a systematic needs based approach to establishing advanced practitioner posts.  The Service Needs Analysis Tool has drawn on, and collated information from a variety of existing sources.  It can be used by Health Boards to strategically plan future workforce solutions or, at a more local level, to plan staffing for a single unit or specific field of clinical practice.  The service needs analysis tool is complementary to existing workforce planning tools and can be used alone or in conjunction with there tools.