Advanced Clinical Practice

Advanced Clinical Practice is viewed as a growing and significant part of the healthcare workforce transformation globally to address increasing socio-health-economic costs, and drivers in the public and political arena. We present this special collection on advanced clinical practice with a primary and community care focus that aims to provoke critical thinking, discussion, and share best practice. The International Council for Advanced Nurses defines Advanced Practice Nurse as a “registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice.” ¹ This definition has now been expanded by NHS England ² to include multi-healthcare professionals who practice at advanced level across 4 domains or pillars of practice (clinical practice; leadership and management; education; and research). Despite attempts to define advanced practice, variations on how this role is applied persist, and professional statutory regulation varies between countries. The important contributions that advanced practice makes are recognized and include increased access to healthcare services, high levels of patient satisfaction, opportunities for career progression, and reduction in hospital admissions. ³ Nevertheless, there has been controversy about advancing roles, with some concerns raised about blurring of professional boundaries and the need to standardize care and ensure robust governance. ⁴ A collaborative and regulatory approach could bring consistency and optimization to this significant workforce. In particular, Primary and Community services require the talent, skill-mix, and practice-based experience that Advanced Clinical Practitioners can add to service provision.