Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review
Objectives In response to demographic and health system pressures, the development of non-medical advanced clinical practice (ACP) roles is a key component of National Health Service workforce transformation policy in the UK. This review was undertaken to establish a baseline of evidence on ACP role...
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BMJ Publishing Group
2021-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/8/e048171.full |
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| author | Catrin Evans Jeanette Eldridge Roger Knaggs Paul Hendrick Peter Harris Brenda Poku Ruth Pearce John McLuskey Philippa Tomczak Ruaridh Thow Joy Conway Richard Collier Gowsika Yogeswaran |
| author_facet | Catrin Evans Jeanette Eldridge Roger Knaggs Paul Hendrick Peter Harris Brenda Poku Ruth Pearce John McLuskey Philippa Tomczak Ruaridh Thow Joy Conway Richard Collier Gowsika Yogeswaran |
| author_sort | Catrin Evans |
| collection | DOAJ |
| description | Objectives In response to demographic and health system pressures, the development of non-medical advanced clinical practice (ACP) roles is a key component of National Health Service workforce transformation policy in the UK. This review was undertaken to establish a baseline of evidence on ACP roles and their outcomes, impacts and implementation challenges across the UK.Design A scoping review was undertaken following JBI methodological guidance.Methods 13 online databases (Medline, CINAHL, ASSIA, Embase, HMIC, AMED, Amber, OT seeker, PsycINFO, PEDro, SportDiscus, Osteopathic Research and PenNutrition) and grey literature sources were searched from 2005 to 2020. Data extraction, charting and summary was guided by the PEPPA-Plus framework. The review was undertaken by a multi-professional team that included an expert lay representative.Results 191 papers met the inclusion criteria (any type of UK evidence, any sector/setting and any profession meeting the Health Education England definition of ACP). Most papers were small-scale descriptive studies, service evaluations or audits. The papers reported mainly on clinical aspects of the ACP role. Most papers related to nursing, pharmacy, physiotherapy and radiography roles and these were referred to by a plethora of different titles. ACP roles were reported to be achieving beneficial impacts across a range of clinical and health system outcomes. They were highly acceptable to patients and staff. No significant adverse events were reported. There was a lack of cost-effectiveness evidence. Implementation challenges included a lack of role clarity and an ambivalent role identity, lack of mentorship, lack of continuing professional development and an unclear career pathway.Conclusion This review suggests a need for educational and role standardisation and a supported career pathway for advanced clinical practitioners (ACPs) in the UK. Future research should: (i) adopt more robust study designs, (ii) investigate the full scope of the ACP role and (iii) include a wider range of professions and sectors. |
| format | Article |
| id | doaj-art-7c0153ecf8a141d08b9982c4bedcb64f |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-7c0153ecf8a141d08b9982c4bedcb64f2025-08-20T02:20:44ZengBMJ Publishing GroupBMJ Open2044-60552021-08-0111810.1136/bmjopen-2020-048171Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping reviewCatrin Evans0Jeanette Eldridge1Roger Knaggs2Paul Hendrick3Peter Harris4Brenda Poku5Ruth Pearce6John McLuskey7Philippa Tomczak8Ruaridh Thow9Joy Conway10Richard Collier11Gowsika Yogeswaran121 School of Health Sciences, University of Nottingham, Nottingham, UK4 Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UKPain Centre Versus Arthritis and NIHR Nottingham Biomedical Research Centre, School of Pharmacy, University of Nottingham, Nottingham, UK1 School of Health Sciences, University of Nottingham, Nottingham, UK7 Health Education England East Midlands, Leicester, UK2 School of Sociology and Social Policy, University of Nottingham, Nottingham, UKSchool of Nursing, AHPs and Midwifery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, UK1 School of Health Sciences, University of Nottingham, Nottingham, UK2 School of Sociology and Social Policy, University of Nottingham, Nottingham, UK6 Emergency Department, Nottingham University Hospitals NHS Trust, Nottingham, UKDepartment of Health Sciences, Brunel University London, College of Health Medicine and Life Sciences, Uxbridge, UK9 Centre for Advancing Practice, Health Education England, Leeds, UK4 Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UKObjectives In response to demographic and health system pressures, the development of non-medical advanced clinical practice (ACP) roles is a key component of National Health Service workforce transformation policy in the UK. This review was undertaken to establish a baseline of evidence on ACP roles and their outcomes, impacts and implementation challenges across the UK.Design A scoping review was undertaken following JBI methodological guidance.Methods 13 online databases (Medline, CINAHL, ASSIA, Embase, HMIC, AMED, Amber, OT seeker, PsycINFO, PEDro, SportDiscus, Osteopathic Research and PenNutrition) and grey literature sources were searched from 2005 to 2020. Data extraction, charting and summary was guided by the PEPPA-Plus framework. The review was undertaken by a multi-professional team that included an expert lay representative.Results 191 papers met the inclusion criteria (any type of UK evidence, any sector/setting and any profession meeting the Health Education England definition of ACP). Most papers were small-scale descriptive studies, service evaluations or audits. The papers reported mainly on clinical aspects of the ACP role. Most papers related to nursing, pharmacy, physiotherapy and radiography roles and these were referred to by a plethora of different titles. ACP roles were reported to be achieving beneficial impacts across a range of clinical and health system outcomes. They were highly acceptable to patients and staff. No significant adverse events were reported. There was a lack of cost-effectiveness evidence. Implementation challenges included a lack of role clarity and an ambivalent role identity, lack of mentorship, lack of continuing professional development and an unclear career pathway.Conclusion This review suggests a need for educational and role standardisation and a supported career pathway for advanced clinical practitioners (ACPs) in the UK. Future research should: (i) adopt more robust study designs, (ii) investigate the full scope of the ACP role and (iii) include a wider range of professions and sectors.https://bmjopen.bmj.com/content/11/8/e048171.full |
| spellingShingle | Catrin Evans Jeanette Eldridge Roger Knaggs Paul Hendrick Peter Harris Brenda Poku Ruth Pearce John McLuskey Philippa Tomczak Ruaridh Thow Joy Conway Richard Collier Gowsika Yogeswaran Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review BMJ Open |
| title | Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review |
| title_full | Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review |
| title_fullStr | Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review |
| title_full_unstemmed | Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review |
| title_short | Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review |
| title_sort | characterising the outcomes impacts and implementation challenges of advanced clinical practice roles in the uk a scoping review |
| url | https://bmjopen.bmj.com/content/11/8/e048171.full |
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