Advanced practice

• What problem is the role intended to address?
• How does it support wider service priorities and patient pathways?

• How will the role complement existing roles within the multidisciplinary team?
• How does it support safe skill mix and clinical leadership?

• A clearly defined scope of practice.
• Alignment with national frameworks and local expectations.
• Clear distinction between role purpose and job title.

NHS England introduced the multi‑professional framework for advanced practice to create greater consistency and clarity across advanced practice roles, regardless of profession or setting.

The framework supports employers by:

• providing a shared definition of advanced practice
• setting expectations for education, capability and scope of practice
• supporting consistent role design across professions
• enabling clearer career pathways into and within advanced practice,

For employers, the framework offers a common reference point to support workforce planning, role assurance and governance, while allowing flexibility to meet local service and population needs.

What the framework includes

The framework sets out:

• a national definition of advanced practice
• entry requirements and expectations for development
• principles and guidance to support safe and effective practice
• a clear career pathway across professions and settings.

Advanced practitioners are expected to demonstrate capability across four pillars of practice: clinical practice; leadership and management; education; and research, evidence and improvement.

The way these capabilities are demonstrated will vary depending on the service, setting and role. This flexibility enables employers to tailor advanced practice roles to local priorities while maintaining consistency of level of practice.

Access the maturity matrix on our role of governance in advanced practice page.

The Health and Care Professions Council (HCPC) has published a suite of resources to support practitioners working at advanced levels of practice, as well as their managers and employers. Commissioned by NHS England, the resources provide practical guidance on regulatory expectations, scope of practice, supervision and delegation, and are designed to support safe, effective and confident practice across professions and settings.

For employers and managers, the resources can help inform role design, strengthen governance and supervision arrangements, and support staff development in line with national regulatory standards. Explore the full range of resources, including downloadable guidance and recorded webinars, on the HCPC website.

Building on the framework, NHS England has developed advanced practice credentials. These define the purpose, learning outcomes and training requirements for specific, clearly described scopes of advanced practice.

Credentials are designed to:

• develop advanced capability in priority clinical and service areas
• support sustainable workforce development and deployment
• improve consistency and efficiency in education and training
• support local governance and workforce deployment and mobility.

Credentials help employers align advanced practice development with population need, service priorities and workforce strategy, rather than relying on bespoke local approaches.

Employers can access published credentials via NHS England’s Centre for Advancing Practice.

Advanced practice programmes accredited by the NHS England Centre for Advancing Practice are typically delivered in partnership with employers and support development across all four pillars of practice. 

The ePortfolio (supported) route, developed by NHS England’s Centre for Advancing Practice, enables the recognition of experienced practitioners already working at an advanced level.

This route:

• supports practitioners to evidence equivalence to current framework requirements
• recognises prior learning and experience
• avoids unnecessary duplication of education.

For employers, the ePortfolio route:

• supports workforce assurance
• helps retain experienced staff
• provides clarity where roles pre‑date current frameworks.

Information on eligibility, application processes and cohorts is available via NHS England’s ePortfolio guidance and the advanced practitioner applicants’ guide.

The advanced clinical practitioner (ACP) degree apprenticeship remains an established route for developing advanced practitioners. However, changes to level 7 apprenticeship funding from January 2026 mean that access to government apprenticeship funding is now subject to specific eligibility criteria and national funding arrangements. 

In response, NHS England has confirmed targeted mitigation funding for priority NHS roles, including advanced clinical practitioners, to support workforce development where this aligns with national and local priorities.

Apprenticeship routes can support employers to:

• grow advanced practice capability in a planned way
• support workforce development and retention
• align education investment with service and population need.

Employers are encouraged to work with their NHS England regional teams, education providers and workforce partners to understand current funding options and eligibility.

Watch how Nottingham University Hospitals NHS Trust are using the apprenticeship route to train their Advanced Clinical Practitioners in this video.

Enhanced practitioners are highly experienced, knowledgeable healthcare professionals managing increasing complexity and clinical risk within a defined scope of practice. 

• primarily work within the clinical pillar
• operate as part of multidisciplinary teams
• work across a wide range of settings, including acute, community, primary care, mental health, social care and dentistry
• come from all multi‑professional backgrounds.

At this level, practitioners typically:

• make complex decisions using specialist knowledge and skills
• manage discrete aspects of patient care, specific to the service, pathway or population
• contribute to service productivity, quality and continuity.

Enhanced practice can be a developmental stage on the pathway to advanced practice, and a career destination in its own right.

NHS England's Principles of enhanced-level practice positions enhanced practice as a critical level for building workforce capability and capacity, reducing reliance on advanced roles for routine complexity, and supporting retention. 

National AHP programme for enhanced practice 

This session explores how enhanced level practice is being used to effectively optimise the workforce across health and care. Presenters from Coventry University and the University of Salford share how enhanced level practice can help manage complexity and risk, reduce reliance on advanced practice for routine care, and create clear progression pathways that support retention.

With the appropriate experience and development, advanced practitioners may progress to consultant‑level practice.

Consultant practice focuses on:

• leadership and impact beyond individual services
• system‑level change and service transformation
• strategic influence, innovation and improvement.

The multi‑professional consultant‑level practice capability and impact framework supports practitioners and employers to plan progression from advanced to consultant level, recognising that pathways are individual, contextual and service‑led.

Advanced Critical Care Practitioners (ACCPs) are part of the multidisciplinary team within intensive care medicine. They represent a distinct, nationally recognised advanced practice role with specific training and governance arrangements. 

What are advanced critical care practitioners?

Advanced critical care practitioners (ACCPs) are clinical professionals who have developed their skills and theoretical knowledge to a very high standard.

ACCPs are highly experienced and educated members of critical care teams who are able to provide an advanced level of care, perform a number of minor procedures and educate other members of staff.

ACCPs are aligned to the Centre for Advancing Practice. 

What do advanced critical care practitioners do?

ACCPs are trained to:

• undertake an extensive assessment of the critically ill patient, including taking a history and completing a clinical examination
• perform or order diagnostic and therapeutic procedures
• prescribe medications and fluids (subject to current legislation)
• develop and manage an acute management plan and pathway for the patient
• perform invasive interventions and other practical skills under appropriate supervision
• teach and educate patients, relatives and other members of the multi-professional team.

What training and qualifications do advanced critical care practitioners have?

ACCPs must complete a programme leading to an appropriate postgraduate diploma/master's degree with a higher education institution recognised by the Faculty of Intensive Care Medicine.

To enrol on the programme, ACCP students must already hold an undergraduate degree in a health-related subject and have three years post-qualification work experience as a registered health care practitioner (for example nurses, physiotherapists or paramedics with appropriate critical care experience).

The programme aims to produce high-quality, patient-centred ACCPs with appropriate knowledge, competencies, skills and attitudes to enable them to practice in intensive care medicine.

Investment in training is extremely important for ACCPs in terms of performance outcomes. Therefore, there needs to be a clear arrangement and commitment from employer organisations towards in-house training and assessment. This requires consultant commitment within their job plans and agreement at the organisational level to provide such training.