International Practice Development Journal


Title of ArticleAdvanced practitioner roles: relevance and sustainability in a ‘liberated’ NHS
Type of ArticleCritical review of literature
Author/sElaine Pierce and Ruth Belling
ReferenceVolume 1, Issue 2, Article 6
Date of PublicationNovember 2011
KeywordsAdvanced practitioner, allied health professionals, doctors, National Health Service, nursing, role


Background: The advanced practitioner or extended scope of practice role has been introduced into many countries worldwide. However, reviews of the advanced practitioner role within nursing and the professions allied to health (physiotherapy, radiotherapy, occupational therapy) are usually confined to a single specific discipline, and have not been explored to include nursing and those allied health professions who have adopted this role.

Aim: The purpose of this article is to discuss and explore the development of the advanced practitioner role within nursing and the allied health professions from a United Kingdom and a global perspective. This follows from the United Kingdom government’s vision for the National Health Service (NHS) in England, as set out in ‘Equity and excellence: Liberating the NHS’ (Department of Health., 2010a).

Approach: In light of regulations and guidance on, for example, shorter working hours for doctors, workforce shortages, retention and recruitment problems and the current financial crisis affecting European countries and the USA, far more severe than first anticipated, we explore the development of advanced practitioner roles in nursing and allied health. We raise critical questions to determine whether such roles remain relevant, beneficial and sustainable within the NHS system of healthcare management and the government’s vision for healthcare reform and service delivery.

Implications for practice:

  • The trend for new roles and extended scope of practice amongst non-medical professions is increasing
  • Nursing particularly provides some evidence that advanced practitioners remain relevant and beneficial
  • Advanced practitioners have the potential to enhance the workforce, while maximising patient choice and care management tailored to individual needs, which are central elements within the vision of most healthcare providers
  • Longer-term sustainability, however, may depend on addressing issues of education, training and professional regulation

This article by Elaine Pierce and Ruth Belling is licensed under a Creative Commons Attribution Non-Commercial 3.0 License.

In this section