Advanced Practice Nursing in the United Kingdom

Snapshot

APN Role Exists in Country Today:
Yes

Title:
Advanced Nurse Practitioner

Nationally Certified:
Yes

Recognize Foreign Licensure:
Yes

Treatment Authority:
Yes

Prescribing Authority:
Yes

Practice Autonomously:
Yes

Contact:
Nursing & Midwifery Council
Royal College of Nursing – offers immigration consultation services

Country Specific Resource Links:
Advanced Practice Toolkit – repository for UK specific resources for practice
Nurse Practitioner UK – description of the Nurse Practitioner role in UK

Role

The role of Advanced Practice Nurses in the United Kingdom (UK) is primarily represented as Advanced Nurse Practitioners (ANPs; RCN, 2012).  While the title of ANP is used by the Royal College of Nursing (RCN), there has been inconsistencies among the general public as to the term to call ANPs in the country, and various are used as: nurse practitioner, registered nurse practitioner, clinical nurse practitioner, senior nurse practitioner, advanced nurse practitioner, and association nurse practitioner (Morgan, 2010).

The ANP role was first introduced in the UK with the initiation of a Nurse Practitioner program focusing on primary health care at the Royal College of Nursing (RCN) in 1991 (Sheer & Wong, 2008).  Much of the push for development of this role was to ease the overbearing workload of the general practitioners (primary care physicians) in the country (Pulcini, Jelic, Gul, & Loke, 2009).  Delamaire and Lafortune (2010), further identified that improving the quality of care additionally drives role development in the UK.

Since that time, the role has significantly developed over the last two decades with other specializations, protection of the title “Registered APN,” prescribing, and autonomy (Sheer, 2007; Sheer & Wong, 2008).  Currently ANPs in the UK have both prescriptive authority and work autonomously, two role qualities that have demonstrate significant advancement of the advanced practice nurse role (RCN, 2012).  Because of the origination in primary care, the ANP role in the UK is to perform the same care as a general practitioner (Morgan, 2010).

Outside of the ANP role in the UK, there are various specializations offered for general nurses allowing them to become a level 2 nurse, which is a role that is registered by the Nursing and Midwifery Council in the UK (NMC, 2013).  While these roles do require additional education, they are not the same as the ANP role described above.

There is a role of the midwife in the UK regulated by the Nursing and Midwifery Board.  This role is unique in that all midwives have a supervisor midwife to provide a check in quality of care, reflecting a role and regulatory structure existing since 1902 (NMC, 2010).

Education and Certification

Education for the Advanced Nurse Practitioner in the UK has been occurring at the masters level for more than 20 years and the majority of ANPs in the UK possess a graduate degree (Delamaire & Lafortune, 2010; Savrin, 2009).   While the recommended standard for advanced nurse practitioners in the UK is set by the recommendations by the Royal College of Nursing, it is not required that all educational programs in the country follow these recommendations (Morgan, 2010).  Within the UK however, advancement of the standardization of nursing practice will soon require that all programs educating level 1 nurses (general registered nurses) end in a terminal degree (bachelor level) by 2013, eliminating the diploma programs which lend toward greater inconsistency in education (Morgan, 2010).  While this legislation was implemented recently for level 1 nurses, there is yet to be legislation requiring the position of ANPs in the UK to have a required terminal degree (Morgan, 2010).

The majority of experts in the UK concede that education at the graduate level is the standard minimum education as an ANP in the UK, and programs can seek to have accreditation according to the RCN educational standards (RCN, 2012).  As a part of a accredited ANP program, students are required to undergo a minimum of 500 supervised clinical hours and possess a level 1 license in the UK (RCN, 2012).

An additional place of development in the UK is the development of a registry for the ANP.  Currently there is a registry for midwives and level 1 and 2 nurses, which may also show specific additional registered skills for nurses (i.e. prescribing authority), but there is yet to be a ANP registry established (Morgan, 2010).

Registration is required to practice as a midwife in the UK (NMC, n.d.).  It is required that an individual attend a level 1 program to become registered as a midwife (NMC, n.d.).

Specialties

The role of the ANP in the UK was greatly focused on primary health care (Pulcini et al., 2009).

For registered nurse specialists, there are currently various specialties that level 1 nurses can specialize in (RCN, 2013):

  • Registered specialist community public health nurse (SCPHN) qualification in
    • Family
    • Health visitor
    • Occupational health
    • Non-specific
    • School nurse
  • Specialist Practice Qualification
    • Adult nursing
    • Children’s nursing
    • Community children’s nursing
    • Mental health nursing
    • District nursing
    • General practice nursing
    • Learning disability nurse
    • Mental health

While these are the registration qualifications recognized by the NMC in the UK, nurses can have a specialization in a specific subject of nursing (i.e. epilepsy, Parkinson’s, cancer).

Have information to add to this page?

References:
Delamaire, M. & Lafortune, G. (2010). Nurses in advanced roles: A description and evaluation of experiences in 12 developed countries.  OECD Health Working Papers, 54, OECD Publishing.http://dx.doi.org/10.1787/5kmbrcfms5g7-en

Morgan, S. (2010, July 9).  What are the differences in nurse practitioner training and scope of practice in the US and UK?  NursingTimes.net.  Retrieved from: http://www.nursingtimes.net/nursing-practice/clinical-zones/district-and-community-nursing/what-are-the-differences-in-nurse-practitioner-training-and-scope-of-practice-in-the-us-and-uk/5017012.article

Nursing and Midwifery Council [NMC] (n.d.).  Registering as a nurse or midwife in the United Kingdom: For applicants outside the European Economic Area [online document].  Retrieved from: http://www.nmc-uk.org/Documents/Registration/Registering%20as%20a%20nurse%20or%20midwife%20from%20outside%20EU%20or%20EEA.pdf

Pulcini, J., Jelic, M., Gul, R, Loke, A.Y. (2009).  An international survey on advanced practice nursing, education, practice, and regulation.  Journal of Nursing Scholarship, 42(1),31-39.  doi: 10.1111/j.1547-5069.2009.01322.x

Robinson, S. & Griffiths, P. (2007).  Nursing education and regulation: International profiles and perspectives [online publication].  Retrieved from:http://eprints.soton.ac.uk/348772/1/NurseEduProfiles.pdf

Royal College of Nursing [RCN] (2012).  Advanced nurse practitioners: An RCN guide to advanced nursing practice, advanced nurse practitioners and programme accreditation [electronic document].  Retrieved from: http://www.rcn.org.uk/__data/assets/pdf_file/0003/146478/003207.pdf

Royal College of Nursing [RCN] (2013).  RCN Factsheet: Specialist nursing in the UK.  Retrieved from: http://www.rcn.org.uk/__data/assets/pdf_file/0018/501921/4.13_RCN_Factsheet_on_Specialist_nursing_in_UK_-_2013.pdf

Savrin, C. (2009). Growth and development of the nurse practitioner role around the globe.  Journal of Pediatric Health Care 23, (5),310-314.

Sheer, B. (2007).  Nurse practitioners on the move: The journey to the United States.  Topics In Advanced Nursing eJournal. 7(2).  Retrieved from: http://www.medscape.com/viewarticle/560673

Sheer, B. & Wong, F.K. (2008).  The development of advanced nursing practice globally.  Journal of Nursing Scholarship, 40(3),204-211.

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