‘My two-year nightmare of trying to prove I am an ANP’

Exclusive A community advanced nurse practitioner (ANP) is on sick leave and considering their future in the health service after having their work rejected by an NHS advanced practice accreditation scheme – despite more than 30 years’ nursing experience.

The ANP, who works in the North West and wanted their identity to be kept anonymous, has spoken about their ‘two-year nightmare’ in trying to secure an NHS England (NHSE) advanced practice ‘digital badge’.

They said that despite being an ANP for over seven years and prior to that many years as a clinical nurse specialist; completing a master’s degree and having taught advanced practice as a senior lecturer; they were denied a badge.

They were told this was because their ePortfolio – required for obtaining the badge through the ePortfolio supported route – was too descriptive in places, despite being approved by an initial supervisor.

This ANP, who is not alone in their struggles to access the badge, has told Nursing in Practice how they are ‘broken’ by the situation and feel ‘completely worthless’.

The digital badge scheme was launched by NHSE in 2022 as a way of evidencing the ‘accredited education and training’ of ANPs. It is currently voluntary for all ANPs, apart from those seeking employment under the additional roles reimbursement scheme (ARRS) in general practice.

It can be obtained via two routes: from doing an accredited master’s programme or via an ePortfolio which requires significant academic work including  a  5,000-word essay.

Concerns have been raised that it is largely courses post-2017 that are accredited, meaning more experienced ANPs have to undergo the extensive ePortfolio option to (see below).

Nursing in Practice understands there have been ‘huge delays’ and several barriers in ANPs and advanced clinical practitioners (ACPs) in accessing the digital badge, especially via the ePortfolio route.

‘It’s like my past experience doesn’t count’

While working in the community – where the digital badge is meant to be voluntary – the ANP explained they wanted to obtain the accreditation ‘just in case’ around two years ago.

However, in the months and now years that followed, this ANP has been made to feel as if their prior and current experience and qualifications ‘doesn’t count’.

‘My big thing for me is that I feel that the ones that were the pioneers and innovators and the most experienced advanced practitioners are the ones that have been penalised the heaviest and I feel that it is discriminatory in its approach,’ they said.

‘I do not understand why when we’ve already been awarded the academic merit, we have to then repeat this with a huge volume of work.’

This ANP has previously worked as a senior lecturer, teaching other future ANPs. They also have a master’s degree incorporating clinical examination and diagnostics, research, leadership and education, an independent prescribing qualification and are even doing a PhD alongside years of clinical practice at advanced level.

They were therefore left ‘broken’ when their digital badge was ‘rejected’ because their writing for the ePortfolio assessment was seen as ‘too descriptive’.

They said the feedback they received was ‘completely damning’ and that they were made to feel like ‘a huge failure’.

‘I’m off sick from the NHS because of the ludicrousness of this whole process, because it’s made me feel completely worthless,’ they said, adding that the ‘goal posts have been ever changing alongside the assessment brief’.

‘Even though I used to be a senior lecturer teaching advanced practice, have years of  clinical experience, have mentored numerous trainee advanced nurse practitioners and AHPs advanced practitioners in both clinical and academic settings – it still doesn’t appear to be enough”.’

‘There does not appear to be standardisation across. Surely the goal is to ensure we have safe and competent advanced clinical practitioners and that the public can be assured that we all meet that same level,’ they added.

They felt those behind the process were not interested in the ANPs decades’ worth of experience and that they were made to ‘prove that we’re capable of doing the job that we’ve been doing and teaching others to do for years’.

But because they did their qualifications before 2017 and before the new advanced practice framework, ‘we’ve got to prove our worth all over again’, they added.

‘Standardisation is needed’

While the ANP agreed standardisation and regulation of advanced practice was needed, they said it ‘should not be at the detriment of all the people that have been doing it for years that can prove they’ve already been awarded the academic qualifications, are doing the role, and have the evidence and experience’.

‘The ePortfolio is a huge piece of work and nearly all the work has been undertaken in my own time between my NHS job and PhD studies,’ they said.

‘There is surely a fairer way to provide assurance, perhaps something along the lines of revalidation with specific focus to advanced practice, especially if the university do not require any additional academic modules.’

Amid a nursing workforce shortage, the ANP questioned how ‘is this valuing and retaining your most experienced staff’.

‘We know in community services and general practice our rates of staffing are just falling through the floor, and this to me rather than encouraging any of us to stay, all it is doing is getting us thinking about retiring earlier or leaving, because we’re not feeling valued in any shape or form,’ they said.