The regulation of health and social care professions is intended to protect the public from the risk of harm, and to maintain public confidence. Nurses and midwives as a whole are regulated by the Nursing & Midwifery Council (NMC). However, with nurses and midwives increasingly taking on more complex, autonomous and expert roles – commonly referred to as ‘advanced practice’ – this advanced area of care has no specific additional regulation associated with it, so nurses and midwives working in advanced practice are themselves responsible for ensuring that they work within existing frameworks. Meanwhile, employers are responsible for assuring individual qualifications, along with previous experience of undertaking advanced practice roles.
With the expectations, understanding and scale of use of the role of advanced practice in nursing and midwifery in the UK evolving at pace, the Nursing & Midwifery Council committed to undertake ‘a comprehensive review of advanced nurse practice including consideration of whether regulation is needed’ and commissioned Nuffield Trust's work to feed into the review.
The intention of this report is to highlight the range of regulatory approaches and the key risks and benefits of these. It provides a review of the key regulatory implications of advanced practice in nursing and midwifery in the UK by taking stock of the existing policy and published international literature on these roles; reviewing job adverts for advanced practice roles; analysing available administrative data; and reporting the views and analysis of a range of stakeholders. We explored the issues across the UK, and this report presents our findings relating to all four UK countries.