The advanced practitioner role is an innovative workforce solution implemented in the UK and internationally to address healthcare demand and capacity challenges, including in emergency care. In the UK, advanced clinical practitioners (ACPs) are experienced professionals—such as nurses, paramedics, and pharmacists—who complete a master’s degree and extended clinical training to independently assess, diagnose, and treat patients.
Attempting to improve emergency care (EC) advanced clinical practitioner (ACP) training, Health Education England (HEE) South West (SW) implemented a pilot, whereby emergency departments (ED) were provided with enhanced funding and support to help ED consultants deliver teaching and supervision to EC ACPs to ensure more timely completion of EC ACP training compared with previous cohorts training in the region.
ARC Yorkshire & Humber researchers from the Urgent Care theme undertook a qualitative evaluation to understand the experiences of trainee EC ACPs and consultant EC ACP leads working in EDs which had implemented the new regional pilot. Four themes were identified from the interviews:
- The master’s in advanced practice and Royal College of Emergency Medicine e-portfolio could be better aligned with each other.
- EC ACP training needs some flexibility to reflect the individual – “one size does not fit all”.
- Supervision and teaching were recognised as important but requires significant staff capacity which is impacted by external pressures.
- Unclear role expectations and responsibilities hinder role transition and impact role identity.
Overall, the findings indicated that a clear supervision structure, along with dedicated time for teaching and assessing clinical skills within the emergency department (ED), is crucial for supporting the progression of trainee EC ACPs. However, the increasing demands on EDs present significant challenges in achieving this goal. Additionally, issues related to role identity remain, despite the introduction of new guidance aimed at clarifying the ACP role.
Authors: Suzanne Ablard , Maxine Kuczawski , Colin O’Keeffe , Fiona C Sampson , Jedidah Mould, Suzanne M Mason
