Advanced Practice Toolkit 

2. Designing an Advanced Practitioner role 

2.4 Pay and conditions 

TIP: Have a clear vision and justification for pay, and consider what the employer can provide in terms of maternity leave, parental leave, sick leave and study leave. 
TIP: Be aware of national guidance for pay progression in advanced practice and consider collaborating in a standardised approach wherever possible. 
TIP: Consider pay progression connected to opportunities across the 4 pillars of advanced practice e.g. band increase as an Advanced Practitioner takes on Primary Care Network advanced practice leadership role. 
Although there is a considerable body of research about intrinsic motivation factors like interesting roles and acknowledgments, pay and conditions will be an important factor in recruitment and retention. Bird [3] found that for nurses in Nottinghamshire, there was a relationship between parity with agenda for change sick and maternity pay, and willingness to stay in their current role. This association was stronger for younger nurses, and there is no reason to believe that Advanced Practitioners are less concerned about the financial impact of ill health or parenthood than nurses are. Whilst acknowledging that primary care economic conditions are different from hospitals, it is important to acknowledge this finding. It is supported by evidence from other studies that the AP role comes with additional responsibilities and “practical acknowledgement” from colleagues (e.g. being looked to for advice and guidance, being thanked in meetings) but not necessarily higher pay [29]. Studies showed that people were increasingly and openly willing to change their employer if pay was felt to be unfair [43]. Studies also were concerned about the wide range of pay bands, which could range from the equivalent of Agenda for Change 6 to Agenda for Change band 8c without clear justification in terms of responsibilities or additional duties [42; 47]. 
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