Assessing the benefits of advanced clinical practice for key stakeholders

Advanced clinical practice roles, usually filled by nurses, have had positive effects on clinical effectiveness, including in patient satisfaction, but their benefits for other stakeholders (such as employers, health professionals, education providers and commissioners and professional/regulatory bodies) are less clear.

This study aimed to identify UK research on the potential benefits of advanced clinical practice and evaluate the evidence base for key stakeholders in this field.

A mixed-methods systematic literature review was carried out to inform a narrative interpretive synthesis.

44 articles of mixed quality were identified. Consensus was found regarding the definition of and barriers and facilitators to advanced clinical practice. This role is split into substitution (eg, of doctors) and supplementation (eg, adding value) aspects, and the clinical practice element dominates. Training for the role varies, as do scope of practice and regulation.

There are several barriers to the implementation of advanced clinical practice and therefore the realisation of its benefits for key stakeholders. Areas requiring attention include training, support from others for role expansion and organisational issues.