Updates on Advanced Practice
Advanced practice is an increasing feature of multi-professional healthcare practice across the UK.
HCPC registered Advanced Practitioners work in a diverse range of settings alongside other regulated and unregulated professionals. Within this context, regulators have been exploring how advanced practice fits within their regulatory framework.
We began our work on advanced practice in 2020, with a review aimed at understanding any risks associated with advanced practice and any implications for the regulation of HCPC professions. The review involved engagement with around 4,000 stakeholders and included research conducted by the University of Bradford and Community Research. This work did not identify any hard evidence of risks to service users. While some stakeholders considered there were inherent risks relating to advanced practice, these risks were not shown to be unique to advanced practice and there was no evidence that these risks could be addressed by additional regulation.
We believe that any decision around additional regulation should be proportionate to the risk to public and to service user safety. In the case of HCPC profession advanced practitioners, these professionals are already our registrants. Therefore, they are required to meet our standards, and our requirements for continuing professional development (CPD), which registrants should link to their scope of practice which includes advanced practice for those in advanced roles. In situations when someone is not able to practise safely or within their scope of practice, we can take action to protect the public via our fitness to practise processes.
We believe further work is needed to create a common understanding of advanced practice. This is because what ‘advanced’ means can vary across different professions, the health system they are operating in and the needs of the population.
On this basis, our Council agreed in July 2021 that the case for additional regulation of advanced practice had not been made and that remains our position. We are working with our stakeholders to develop that common understanding of what advanced practice is while ensuring we do not stifle innovation and the development of advanced practice roles.
Our position
We understand that advanced practice is a nuanced and complex area. The HCPC makes independent regulatory decisions based on data and evidence to ensure we use our regulatory powers to protect the public.
In 2020-2021 we commissioned an independent review of advanced practice. A key finding from the review was that there was no evidence that advanced practice within HCPC regulated professions present a risk to the public.
All HCPC registrants working at an advanced level are already fully regulated and must meet all HCPC standards which are relevant to their scope of practice. All our registrants must undertake continuing professional development that reflects their scope of practice, which can be as an advanced practitioner.
Our Council agreed in July 2021 that the case for additional regulation of advanced practice for HCPC regulated professions had not been made, and that remains our position.
In other professions and for one other health regulator, the position is different. Recently, the Nursing and Midwifery Council (NMC) announced that it is exploring a combination of approaches to the regulation of advanced practice. We have been providing input into this work as it has developed and have welcomed the opportunity to collaborate with the NMC and other regulators by sharing our own research and conclusions. Different professions and settings will always have their own requirements, and it is right that each regulator take decisions based on their own assessment.
We remain confident that our position in relation to the regulation of HCPC advanced practitioners is the right one for the professions we regulate.
However, that doesn’t mean that our work stops. We are scoping the development of a common understanding and guiding principles for advanced practice and are leading in partnership with Chief Allied Health Professions Officers across the UK to offer clarity about the interactions between advanced practice and prescribing.
This year we will also explore how we can emphasise the importance of continuing professional development (CPD) reflecting the scope of practice in order to support those working in advanced practice roles.
As always, we recognise that the situation relating to regulation may change as advanced practice evolves. We monitor all aspects of our role in protecting the public and will continue to work proactively with registrants and policy makers to optimise advanced practice and public protection.
Rachael Gledhill, Head of Policy & Standards
Statement on Advanced Practice from the Chief Allied Health Professions Officers in each of the four UK countries:
Whatever the specific profession, role and context, all advanced practice AHPs will have the necessary advanced-level capabilities across all four pillars of practice needed to provide safe, high quality, holistic care with people, their families and carers.
All AHPs, including those working in advanced practice roles, are statutorily regulated by the Health and Care Professions Council (HCPC) or General Osteopathic Council (GOsC).[1]
Robust employer governance is central to the safe and effective employment, utilisation and deployment of advanced practice AHPs.
[1] Osteopaths are considered AHPs in England only