Advanced Practice Toolkit 

8. Career Progression 

TIP: Consider issues of turnover, retention and continued CPD and personal development when designing Advanced Practice roles. 
TIP: Ensure appropriate governance/ assurance is in place for an advanced practice workforce (e.g. job descriptions/ person specifications, job plans, appraisal criteria that map directly to national advanced practice guidance). 
Advanced Practice is a means of career progression for people who do not want to move completely out of clinical practice into academia, research or management (e.g. [43; 11]). As such, the role needs to be an interesting, engaging role, and not a mere attempt to “fill gaps” caused by shortages of doctors 44; 45]. Some studies also found Advanced Practitioners who had been working in secondary care and “fell into” primary care as part of the process of reducing shift work or physically demanding work as they approached retirement age (e.g. [28; 46]). 
Taylor [43] found that Advanced Practitioners valued a job role and title that gave them acknowledgement for their existing expertise and recognition that they were experts in a specialised clinical area. They were interested in the opportunity to teach and some were interested in having a greater impact on patients, potentially at a system and pathway redesign level. Roles that offer these opportunities offer intrinsic reward for career progression. 
However, career progression will not necessarily translate into organisational loyalty, especially where people have had to self-fund training or study in their own time [3; 43]. Loyalty to an organisation will be more likely to arise where people’s wellbeing is considered, where their job plans match the reality of the role and where they have regular supervision and annual appraisals which result in a mutually agreed personal development plan. 
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