A definition of advanced practice nursing and midwifery has been set out by the Nursing and Midwifery Council (NMC) as part of its ongoing work to regulate this level of practice.
The NMC has this week unveiled its ‘principles’ for advanced practice, which includes its ‘expectations’ for supporting those working at an advanced level and a definition for the profession and public around what advanced practice is.
The move comes as part of its wider work around regulating advanced practice, which has faced several delays in recent months.
It said its new principles for advanced practice – which are subject to approval by its governing Council next week – seek to bring ‘clarity and consistency’ to advanced practice nursing across the UK.
While they are advisory, the NMC said it would ‘strongly encourage professionals and employers to use them to ensure people receive the best possible care’.
Developed via UK-wide engagement with professionals and the public, they emphasise that advanced practice is based on a level of expertise gained through additional, usually specialised, education and experience after initial registration, rather than a title, role or specialism.
The principles recognise the four established pillars of advanced practice that are aligned to the advanced practice frameworks of all four nations:
- Clinical practice
- Education
- Research
- Leadership
- Management
And they include a professional and public definition of what advanced practice is:
- The professional version: 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 public version: A registered nurse or midwife working at an advanced level of practice is a professional who has completed extra post-qualification education to increase their knowledge and skills, allowing them to give expert, higher-level care.
In March 2024, the NMC’s governing Council agreed to develop a combination of approaches to the regulation of advanced practice including:
- Principles: The principles outline the regulator’s expectations to support nurses and midwives working at an advanced level. They aim to help the public understand the role of an advanced practitioner and to help employers develop and sustain systems where APs can work safely and thrive.
- Setting standards: The NMC will establish standards of proficiency for advanced practice programmes to establish consistency in what APs should know and be able to do. It will regulate AP standards of proficiency and associated programme standards and monitor AP education programmes, in line with existing education and training standards.
- Enhancing The Code and revalidation: The NMC will consider requirements for advanced practitioners as part of the Code and revalidation reviews scheduled for 2025/26. This could include additional requirements in the Code for nurses working at an advanced level and in providing additional assurance of their ‘continued capability’.
Council approval
The principles are subject to approval at the next Council meeting on Wednesday 26 March.
If approved by Council next week, the principles will be published in English and Welsh during May.
As part of its regulatory work for advanced practice, the NMC had originally intended to put its principles before its governing Council in November 2024 and consult on a draft set of standards in January 2025.
This was pushed back last year, when the NMC then said it looked to bring the principles to council in March 2025 and launch its consultation in November 2025.
In February, the regulator confirmed that while it will still bring its principles to its council meeting in March, it will not develop standards for consultation until the 2027-28 financial year.
‘A major milestone’
Sam Donohue, acting executive director of professional practice at the NMC, said the principles ‘mark a major milestone’ and will help provide clarity on the role of advanced practitioners and on the principles of advanced practice.
‘By clearly defining advanced practice, they will support the public to understand the role and expertise of advanced practitioners,’ she said.
‘At the same time, they provide professionals and employers across the UK with clear principles to achieve safe, consistent, and high-quality care.’
Earlier this week, the NMC revealed its three-year Culture Transformation Plan to build a ‘positive, empowering and inclusive culture’ for its staff and registrants.
