Advanced Nurse Practitioners (ANPs) are experienced and highly educated Registered Nurses who manage the complete clinical care of their patients, not focusing on any sole condition (Chief Nursing Officer Directorate, Transforming Nursing Roles Paper 2, 2017). ANPs are generalists and are trained to work within one of five broad areas (Chief Nursing Officer Directorate, Transforming Nursing Roles Paper 7, 2021)
· Neonatal acute care
· Paediatric acute care
· Adult acute care
· Primary/community care
· Mental Health
Some ANPs have undertaken additional specialist training to work in specific specialist areas e.g. Intensive Care, Emergency Care etc. Within NHSGGC there are over 100 ANPs working across a wide variety of areas from primary care through to intensive care.
NHSGGC has been training and employing ANPs for many years and works closely with Glasgow Caledonian University, University of the West of Scotland, University of Stirling and Napier & Queen Margaret Universities in Edinburgh to prepare ANPs.
Training
Advanced Practice is a level of practice, rather than a specific role or title (Transforming Nursing Roles Paper 2 CNOD 2017)and has four pillars of practice, which the ANP must have as part of their core role and function. These are:-
• Clinical practice
• Leadership
• Facilitation of learning
• Evidence research and development
Definition
” An Advanced Nurse Practitioner (ANP) is an experienced and highly educated Registered Nurse who manages the complete clinical care for their patient, not solely any specific condition. Advanced practice is a level of practice, rather than a type of speciality of practice.
ANPs are educated at Masters Level in advanced practice and are assessed as competent in this level of practice. As a clinical leader they have the freedom and authority to act and accept the responsibility and accountability for those actions. This level of practice is characterised by high level autonomous decision-making, including assessment, diagnosis, treatment including prescribing, of patients with complex multi-dimensional problems. Decisions are made using high level expert, knowledge and skills. This includes the authority to refer, admit and discharge within appropriate clinical areas.
Working as part of the multidisciplinary team ANPs can work in or across all clinical settings, dependent on their area of expertise.”
(Scottish Government 2017)
Competency Framework
“The Advanced Nurse Practitioner role has a specific focus on the clinical pillar, but must demonstrate competence within all four pillars of advanced practice. With regard to the clinical pillar all ANPs must be able to demonstrate competence in:
a) Comprehensive history-taking b) Clinical assessment c) Differential diagnosis d) Investigations e) Treatment f) Admission, discharge and referral.” (Chief Nursing Officer Directorate, Transforming Nursing Roles Paper 2, 2017)
ANPs are paid at a minimum of Band 7, and within NHSGGC the generic ANP Job Description should be used for any new Band 7 ANP roles.
Advanced Nurse Practitioners in General Practice
Advanced Nurse Practitioners who work within General Practice and are not directly employed by NHSGGC but work within the Board area, are encouraged to join the Board held list of ANPs in General Practice. The benefits of joining this list are:
On-going access to specific ANP education and information
The process to join is exactly the same as for those who are Board employed, but with the following grandfathering arrangements for those employed before 2010 or between 2011 and 2017.
meet all the appropriate competencies for their area of practice,
can evidence the formal learning undertaken relevant to the role which may have been below master’s level (commonly degree level modules)
provide evidence of recent workplace based assessments (within last 5 years)
provide satisfactory feedback from others (minimum of 4 within the last year)
provide a satisfactory supervision report
provide evidence of reflection and a broad range of patients seen
evidence continuing professional development
Employed as an ANP between 2011 and 2017
In addition to the above, ANPs employed between these years should demonstrate master’s level learning. This could be done, for example, through having completed a module at master’s level.
Employed as an ANP after 2018
Expected to demonstrate that they meet all the appropriate competencies for their area of practice, a master’s level qualification in advanced practice, workplace based assessments, reflection, feedback from others, and a satisfactory final supervisors report (see Final Sign-off).
Recording General Practice ANPs
There are two stages to the process.
Stage 1: Involves the Post being recognised as an ANP post (please note that posts which utilise the Board’s generic ANP job description automatically meet this requirement)
A completed ‘Final Sign-off’ form and the poster-holder’s Job description should be submitted to the Consultant Nurse for Advanced Practice (AdvancedPractice@ggc.scot.nhs.uk) . Following the moderation process the following will occur.
The individuals name, NMC number, NHS email address and place of work will be recorded on the Board held list of GP ANPs
The individual will receive written confirmation that their name has been recorded (a copy will be sent to their line manager and practice supervisor)
Access will be given to the NHSGGC ANP Continuing Professional Development Moodle site so that ANPs can be kept up-to-date with news and resources relevant to ANPs including West of Scotland Advanced Practice Academy CPD days
Annually the ANP will receive an email asking them for confirmation that they remain in their ANP post (a nil response will be taken to mean that the individual has left the post and their name will be removed from the list).
Annually, ANPs will be requested to submit an updated ‘share pack’ from their ePortfolio evidencing continuing professional development and reflection on practice to their line manager.
[1] Set out in Chief Nursing Officer’s Directorate (2017) Transforming Nursing, Midwifery and Health Professions’ (NMaHP) Roles: Paper 2 Advanced nursing practice. Edinburgh: Scottish Government
Transitioning ANPs
An ANP who moves from one broad area to another, for example from acute care to primary care, is still regarded as an ANP while they transition. In this example, the ANP can be viewed as an Acute Care ANP practising within Primary/Community Care until they have met all the Primary/Community Care competencies.
Transitioning ANPs will need a Practice Supervisor and Practice Assessor to help them meet any learning needs and assess that they’ve met all appropriate competencies for their new role.
Transitioning ANPs may choose to undertake additional courses to help with transition.
Evidence of meeting additional competencies will need to be uploaded into the ANP’s Professional portfolio, a transitioning ANP sign-off form, should be completed by the Practice Assessor and line manager and emailed to advancedpractice@ggc.scot.nhs.uk along with the portfolio sharepack link. A sample of transitioning portfolios will be moderated
The ANP will then be recorded on the Board’s Advanced Practice database under the new broad area as well as their previous area.
Clinical Nurse Specialists (CNSs) and Nurse Practitioners (NPs) are registered nurses with relevant experience and post-registration education for working within a specific area of practice. They assess, manage, deliver care, advise on, and support the care for people within a specialist area (Chief Nursing Officer Directorate, Transforming Roles Paper 8, 2021)
Across NHSGGC there are over 200 Clinical Nurse Specialists and Nurse Practitioners practising in a wide variety of different areas including:
Oncology, Cardiology, Dermatology, Diabetes, Minor Injuries, Gastroenterology, Nutrition, Gerontology, Orthopaedics, General Surgery, Pain, Palliative Care, Respiratory, Rheumatology, Sexual Health, Vascular, Urology, HIV, Diabetes, Osteoporosis, Parkinson’s disease, and Stoma Care The recently published CNO’s Transforming Roles Paper 8 provides an updated definition.
Definition
“A registered nurse with relevant experience and post-registration education for working within a specific area of practice. Educated in an appropriate subject to the level of graduate certificate (honours degree) at a minimum, although a postgraduate certificate is recommended, they are assessed as clinically competent in their defined area of practice. They assess, manage, deliver care, advise on, and support the care for people within a specialist area.
As a Level 6 Senior Practitioner they work under guidance in a peer relationship with other members of the multidisciplinary team. They have the autonomy to act and accept responsibility and accountability for their actions, acting as a skilled advisor or resource for others. This includes specialist assessment, informed decision making, and treatment using a personalised approach to care for patients’ multidimensional presentations. This may require supporting specialist care over a prolonged period of time. They have the authority to refer patients, and may admit or discharge within appropriate clinical areas of practice. This is characterised by a level of decision making based on detailed knowledge and understanding of their area of practice.
As part of the multidisciplinary team they can work in or across many settings, including non-clinical, depending on their area of expertise and scope of practice.” (CNOD 2021)
Training
CNSs and NPs train in post for the role. Increasingly, CNSs and NPs are being formally employed in training posts (using Annex 21 from Agenda for Change) while they learn. Trainee CNSs and NPs are supervised whilst they learn and will also undertake appropriate post-registration education at university to support their learning. Trainees will build a portfolio of evidence to demonstrate they are competent to practice which is formally assessed at the end of their training.
Competency Framework
Transforming Roles Paper 8 sets out the core competencies for any CNS or NP. To these additional specialist competencies are added. The competency framework needs to be completed before a new CNS or NP can be regarded as appropriately prepared.
Agenda for Change
CNSs/NPs are paid at a minimum of Band 6
These pages are for for the Nurse Practitioners, Advanced Nurse Practitioners, Clinical Nurse Specialists & Advanced Clinical Nurse Specialists of NHSGGC. Here you will find important information about these roles with links to key documents, information on education and CPD, and support with the ANP / ACNS sign off procedure.
Contact details
The key Advanced Practice contacts for NHSGGC are:
Dr Mark Cooper – Consultant Nurse, Advanced Practice
Victoria Campbell – Lecturer Practitioner, Advanced Practice
Edward Pool – Lecturer Practitioner, Specialist Practice
Newly Qualified Practitioners (NQPs) should attend a Day 1 and a Day 2 study day in their first year of practice, these contribute to your 24 hours protected study time. NQPs may book on to a session at any of the sites, please ensure you discuss booking with SCN/SCM/Line Manager to ensure date is suitable for you to attend. Information will be sent in advance of the session to print and bring with you. Please click the relevant box for available dates.
DAY 1: Please click on preferred date to book Flying Start Day 1 (choose only one date to attend Day 1)
Throughout your first year and your career, as a healthcare professional, you are likely to experience a range of emotions, which could affect your health and wellbeing. The link below will take you to the NHSGGC organisational page for health and wellbeing, where you can explore these emotions and become aware of the supports available to you, to ensure you can address your emotions in a positive way.
NHSGGC has also produced a brief booklet with a number of resources which can support staff to take care of their own mental health and support colleagues to do so too. Click here to access this booklet.
As NQPs, commencing your career in healthcare, it is imperative that you are aware of, and look after your own wellbeing. Access this link Newly Qualified Staff – Looking after your wellbeing for guidance which could support you to do this.
It is recognised that exceptional demands are currently being placed on people working in health and social care. The National Wellbeing Hub contains information, resources and supports which you may find helpful at work and at home.
(Please note: the Hub is not specifically for NQPs, but you may find the contents are beneficial to you).
Within this section you will find Flying Start portfolio examples, which have been kindly submitted by NQPs who have completed the programme. This is to allow publication of examples for your information.
Please note: The portfolios have been published in the formats provided by the NQPs and are intended to be published in full. For anonymity reasons there may be portfolios where a piece of evidence has been replaced with a blank template. Furthermore, these portfolios may not reflect discussions which have taken place between NQP and Facilitator to meet learning outcomes.
Below you will find the Flying Start Facilitators Information Guide, which provides information on the programme, protected study time and the role of the Facilitator, as well as guidance around the resources that NQPs can use to evidence their learning. Information regarding the LearnPro module: GGC Flying Start Facilitator Guide can also be found below. (Please note: For nurses and midwives, it is likely that your preceptor and facilitator will be the same person).
There is also a LearnPro module GGC: Flying Start Facilitator Guide that your facilitator can complete to refresh their knowledge or to familiarise themselves with the role of facilitator. Please find this information thin LearnPro, under CPD.
Facilitators Information Sessions
The NHSGGC Practice Education Team host Flying Start Facilitator information sessions on MS Teams for nurses, midwives and allied health professionals who are currently supporting, or will support, newly qualified practitioners (NQPs) in their first year of practice. These 90-minute group sessions (dates and times below), will offer guidance on supporting NQPs with the requirements of the Flying Start NHS programme, the NHSGGC Flying Start Portal and address any related questions or queries. Please click links below to book.
Forthcoming session dates to be confirmed.
Read and view some of the experiences of registered professionals who have completed the Flying Start programme. For newly qualified practitioners these highlight what they feel have been the benefits of the programme and some of their experiences throughout their first year in practice. This is further reflected in the video messages from NQPs, which you will find helpful.
Facilitator testimonials are also included below and highlight the benefits of this role for both the NQP and the facilitator themselves.
“Flying Start resources have given me the opportunity to become more self-aware by way of the reflective accounts I have to do. It enables me to see what point I ‘m at as a Newly Qualified Practitioner and how far I need to go to become a better practitioner.”
“Flying Start modules should also give me a headstart when revalidating as a nurse and will populate my portfolio ready for that.”
AHPs
“I still use the 4 pillars structure to help me navigate my way around my learning.”
“Being able to manage yourself, as well as leading your patients is important, this has made me more confident in my role.”
“Through Flying Start Leadership pillar, I took most learning in self leadership and strategies to help manage myself and the impact I have on other people.”
“Through Flying Start Evidence, Research and Development pillar, I became involved in developing a formal pathway for patient feedback, making feedback accessible for all, patients felt listened to.”
“By working through Flying Start, my portfolio evidence has helped me with my TURAS Appraisal and has enough in it to get me through the HCPC process.”
Midwives
“Flying Start has helped me bridge the gap from student to newly qualified midwife, and has allowed me to become more independent.”
“Meeting learning outcomes for Flying Start has supported my transition to being a capable confident midwife.”
Mental Health Nurse
“I realised the importance of the programme early on and this was reinforced by my colleagues supporting me.”
These Flying Start resources should be used to support NQPs working through the Flying Start programme.
Booklet 1: Getting Started
Booklet 1 has been designed to support you when working through the Flying Start programme. Please utilise this booklet for getting started and registering for the programme.
Booklet 2: Resources
Booklet 2 has been designed to support you when working through the Flying Start programme. Please utilise this booklet and the resources, aligned with the presentations and videos, to ensure you are thinking about evidencing your learning and development when working towards meeting the learning outcomes of the programme.
Booklet 3: Sign off for completion
Booklet 3 below has been designed to support you when working through the Flying Start programme. Please utilise this booklet for sign off for completion and downloading your completion certificate.
Booklet 4: TURAS
Booklet 4 below has been designed to support you to create and build your TURAS portfolio. This can be used to document your learning throughout your career.
Presentations and videos
The presentations and videos below have been designed to support you when working through the Flying Start programme. They should be utilised along with the guidance booklets, to ensure you are thinking about evidencing your learning and working towards meeting the learning outcomes of the programme.
Further resource videos from the NHSGGC Nurse Director and the NMC have also been included, as these will be helpful to you.
As part of NHSGGC Let’s Talk Practice Education – Learn your way series of podcasts, the Practice Education Team have developed podcasts to add to the learning resources available within the NHSGGC Flying Start Portal. The addition of podcasts to our learning resources offers staff more flexibility with their learning.
The resources within the Flying Start Portal aim to support nurses, midwives and allied health professionals, in the first year of practice as newly qualified practitioners (NQPs), whilst undertaking the Flying Start programme. Facilitators may also find these resources helpful when supporting the NQPs through the programme.
Please note: The use of the resources contributes towards NHSGGC Protected Study time and CPD for NMC Revalidation and HCPC Standards
Pillars of Practice
The four Pillars of Practice and related learning outcomes must be achieved to complete the Flying Start NHS programme. Please familiarise yourself with these and think about which learning outcomes you may be achieving, or can work towards achieving, dependent on your learning at that time. How you meet these outcomes, will be specific to you, your role, and your practice setting. See also Pillars of Practice presentation.
Clinical Practice
Critically reflect on your contribution to the delivery of safe care.
Examine your practice in relation to enhancing person-centred care.
Leadership
Examine your practice in relation to how you demonstrate self-leadership.
Critically reflect on your behaviours and actions that impact on working collaboratively with colleagues.
Facilitating Learning
Engage in professional development that demonstrates your commitment to career-long learning and excellence in practice.
Demonstrate ability and confidence in developing and supporting others to learn.
Evidence, Research and Development
Source evidence relevant to an aspect of your practice.
Review service user participation in your workplace.
Responsibilities
It is your responsibility as a registered professional to ensure you are aware of the requirements of the programme. The following information is a list from The Definitive Guide, which highlights who is involved in the process to support you, and the responsibilities of each individual.
