Regulation of advanced practice in nursing

Did you know that advanced nursing practice is not regulated? I was very surprised by my own ignorance, recently, to discover this fact. However, there is a move by the Nursing and Midwifery Council (NMC) to consider this over the next year. It is not without complication. A recent report by the Nuffield Trust will feed its findings into the regulatory process – it makes for interesting consideration. The impact of the report is to consider advanced practice roles for a range of different healthcare professionals, although nursing and midwifery are the main protagonists. 

The concept of what is advanced practice is not only dynamic but also based on the ‘normal’ scope of practice of a nurse or midwife. The scope of practice is essentially a definition of all the activities carried out within a role and provides expectations of behaviours, responsibilities and duties. An advanced role is expected to practise the scope but still within acceptable boundaries. The interesting element here is that the responsibility for maintaining expertise in practice within the boundaries is largely down to the individual, their role and oversight by their employer. Governance is self-determined and very specific to the role the individual plays in the team and according to their job description.

The report cites international comparisons that the UK is behind the curve in terms of regulation with only Finland sharing the position of self-regulation. Countries such as Australia, New Zealand, US, Canada and Ireland all have regulatory systems set up for advanced practice roles.