Advanced Practice Standards

To be able to work at an advanced level of nursing practice, nurses need to meet a number of standards. Use our resources to find out more about working at an advanced level of practice. 

Advanced practice is defined as: 

Advanced practice is a level of practice, rather than a type of practice. Advanced Nurse Practitioners are educated at Masters Level in clinical practice and have been assessed as competent in practice using their expert clinical knowledge and skills. They have the freedom and authority to act, making autonomous decisions in the assessment, diagnosis and treatment of patients.

Registered nurses working at this advanced level must meet the following standards. They must:

• have an active registration with the NMC
• practice within the four pillars
• have a Job Plan that demonstrates advanced nursing practice and has equity with peers working at this level
• be educated to Masters level
• be an independent prescriber
• meet NMC revalidation requirements
• demonstrate autonomous evidence

See: Royal College of Nursing Standards for Advanced Level Nursing Practice

The Advanced Nursing Practice/Practitioner (ANP) and the care of pregnant women

Maternity care is the one domain where legislation stipulates that only a registered medical practitioner or a practicing midwife can provide care for a pregnant woman. A team approach needs to be in place so that when an assessment of the pregnancy is necessary a GP/doctor or midwife can see the woman. Where there is no midwife attached to the practice area, good links and communication systems need to be in place for easy referral. Having a good working relationship with the local head of midwifery services will enhance overall care.

Should the ANP also be a registered practicing midwife, they will be able to care for pregnant women so long as they continue to meet the NMC requirements. These include notifying their intention to practice and maintaining the NMC revalidation requirements for midwifery.

Local protocols and polices need to be in place to clarify the nurse’s role in relation to pregnant women. For example, it is likely that where there is no doctor/GP present, women may attend the practice for confirmation of pregnancy, or as part of a health assessment. The ANP may diagnose pregnancy. Local guidelines, therefore, should be in place so that the ANP can make an initial referral to the local maternity services.

ANPs may also find themselves being asked to provide care for non pregnancy-related conditions that may have an impact on the pregnancy or be called on to provide care in an emergency, and clear referral pathways must be in place for such scenarios.