Nursing and Midwifery Council (NMC) Principles for Advanced Practice
Embed fundamental principles to enable consistent, high-quality, safe and effective care
Align yourself and your organisation with advanced level practice expectations
A Registered Nurse or Midwife working at an advanced level is an expert professional with additional post-graduate education and experience. They use their evidence-informed knowledge, skills and capability to influence, shape, deliver and lead safe and effective care, while managing risk, uncertainty and complexity.
The NMC has produced best practice guidance for the principles of advanced practice for Nurses and Midwives. It is split into two sections, with 12 principles each for:
This guidance outlines the conditions and working practices which should in place to ensure that organisations and clinicians are 'regulation ready' and to ensure any clinician working at an advanced level has the appropriate governance behind them at an organisational level.
In addition to the guidance, a checklist is being created to help people track their progress against the principles. This is soon to be released. Join our waiting list to be the first to receive it when it is published.
Benefits to patients of working at an advanced level
Advanced Practitioners add value and impact to both individuals and environments, and this impact will vary according to their scope of practice and the setting in which they work.
Public assurance
Right person, right time
Continuity of care
Consistency and quality
Effectiveness of person-centred care
Enhancing trust and confidence
Making contacts count
Improve health outcomes
Forward thinking practitioners
12 principles for individual professionals
These principles provide clear expectations for advanced level practice across a range of roles and settings.
Advanced Practitioners should:
1
Practise within their individual scope of practice and in line with their level of knowledge, experience, qualifications, training and employment role.
2
Demonstrate expertise, confidence, critical thinking, and evidence appraisal and synthesis within their individual scope of practice to lead and influence education, research and practice.
3
Demonstrate professional accountability and capability in making complex evidence-informed decisions, managing varying degrees of risk, unpredictability and uncertainty while exercising professional judgement. This includes using initiative, demonstrating significant autonomy and being accountable for their actions.
4
Demonstrate self-awareness with compassionate and inspirational leadership within inter-professional teams to influence practice for effective, holistic, person-centred care.
5
Demonstrate use of evidence-informed expert knowledge to practise reflectively, identifying areas for self-improvement and improved outcomes for a diverse range of individuals, teams and people.
6
Role model reflective and reflexive practice and advocate for access to individualised support and clinical supervision to ensure continuous learning, improvement and professional development across the four pillars.
7
Role model professional practice, advocating for and contributing to inter-professional learning and working to provide leadership and effective support and supervision to a broad range of colleagues and learners.
8
Use their expert, advanced level knowledge and experience to challenge themselves and others to promote and embed professional curiosity and the principles of equality, equity, diversity and inclusion in their area of practice, seeking and acting upon feedback received from peers, colleagues and the public.
9
Support, influence and lead projects in the environments they work in to shape a reflective learning culture
where safety, quality, continuous improvement and sustainability are prioritised, including promoting allyship and advocacy for all, speaking up and raising concerns where required.
10
Evidence continued capability, reflective and reflexive practice, ongoing learning and professional development at an advanced level, relevant to their scope of practice through local appraisal processes and through professional revalidation requirements.
11
Utilise their expertise and experience to minimise environmental impacts, enhance economic growth and embed sustainable approaches to service planning, delivery and implementation.
12
Lead and contribute to the proactive identification and resolution of challenges to health, safety and wellbeing for individuals and population groups, shaping the design and delivery of effective services and policies that
promote holistic health and wellbeing.
12 principles for employing organisations
These apply to organisations that employ individual practitioners working at advanced level, including educational organisations and those that manage the learning and working environments of individual Advanced Practitioners.
To provide an environment where advanced practice can flourish there should be:
1
Robust governance processes for advanced level practice in line with local and national legal, regulatory, professional and educational requirements, with clear lines of accountability and communication, appropriate resources and processes that facilitate and encourage high performance and optimise autonomy, leading to consistently improved outcomes.
2
A culture that supports shared learning and a high standard of working for advanced practitioners within and across inter-professional teams that is safe and effective for all.
3
Opportunities for individual practitioners to learn and work at an advanced level within their scope of practice, job role and setting, practising with increased autonomy across the four pillars of advanced practice with support from appropriately qualified, proficient and skilled individuals.
4
Development of new and existing advanced practitioners to provide effective leadership and management that ensures co-ordinated care across professions and teams to a high standard of professional practice.
5
An open and honest culture for advanced practitioners with opportunities for feedback from other professionals at all levels and members of the public which then encourages reflective and reflexive evidence-informed practice and supports professional development across the four pillars.
6
A reflective environment that facilitates access to individualised support and/or clinical supervision for advanced practitioners across the four pillars throughout their career.
7
An environment that enables and sustains shared learning for advanced practitioners along with other professionals, to optimise effective teamwork, use of resources and improved outcomes, demonstrating impact and value.
8
Equity of opportunity for individual practitioners to access advanced practice education, qualifications, ongoing professional learning and opportunities to practise at an advanced level to maintain capability. Professional curiosity should be encouraged and the principles of equality, equity, diversity and inclusion embedded at all levels.
9
An open culture where individuals are encouraged to actively seek and receive feedback, reflecting on their experiences, actions and decisions; where safety, quality and continuous improvement are valued and prioritised; and where advanced practitioners feel safe to act as advocates, speak up and raise concerns.
10
An environment where interprofessional learning is prioritised and valued and with robust local governance processes to support, attain and maintain competence, capability and professional development, in line with revalidation requirements.
11
Systems, processes and resources for advanced level nurses and midwives to lead and support the delivery of sustainable practices and minimise environmental impacts in health and social care in collaboration with others.
12
Opportunities and support for nurses and midwives working at an advanced level to lead effective change where health and social care challenges have been identified, transforming services today and in the future.