Higher level practice: degree of specialist practice?

Higher level practice (HLP) is the determinant characteristic of any maturing profession. Nursing should make a quantum leap with the development of HLP if the patient, the nurse, the context of caring and the acquisition of expertise are at the forefront of such growth. This study shows the matching of nursing concepts with nursing context is at the heart of HLP. It also shows that nurses are developing their own understanding of HLP which is different from the UKCC functional criteria. The intention here is to contribute to the development and understanding of HLP. Seven key concepts emerge in the definition of HLP. These concepts are unpacked to reflect the possible criteria, which could be used in the practice, teaching, assessment, and further refinement of HLP. A series of thought provoking recommendations are made for the Nursing and Midwifery Council to consider.A learning module entitled "Higher Level Practice" anchored in the epistemology of practice has been developed and successfully implemented by the author within the MSc Nursing Practice course attended by senior and consultant nurses.