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Not invisible, just overlooked

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ANPs are overlooked not invisible

Ghislaine Young's comment in Independent Nurse described advanced nurse practitioners (ANPs) as an invisible workforce. I can understand why. In a recent statement Jeremy Hunt talked about 'growing the workforce with a new class of medic so that busy doctors have more time to care for patients'. His medic of choice is not the healthcare clinician already in post, not the clinician already in training but a new dependent clinician – the physician associate.

ANPs are not invisible in practice, nor are we invisible to patients accustomed to interacting and consulting with nurses – patients who trust and have developed longitudinal therapeutic relationships with us. We embody a silent revolution across many areas of healthcare, driven by the commitment and courage of nurses.

Initial work, including a national consultation by the NMC, gave us real hope that regulation and indeed recognition would come in 2005/6. Any possibility of regulation was abandoned when the Council for Healthcare Regulatory Excellence published their report Advanced Practice: Report to the four UK Health Departments in 2009, which concluded that:'What is often called "advanced practice" across many of the health professions does not make additional statutory regulation necessary.'

The NMC refocused on Fitness to Practice and caused the desire of ANPs for regulation and registration to falter. We understand and share Ghislaine Young's disappointment. She was part of the RCN ANP steering committee during that devastating period. But as a profession we need to focus on new possibilities and consider what might be achieved through a voluntary registration framework or employer-led models of regulation/governance rather than statutory regulation.

A major concern and one highlighted by the testimony of Ghislaine Young and Kirsty Armstrong is the very definition of an advanced nurse practitioner.

Many of the ANPs in general practice would challenge whether or not compression bandaging and childhood immunisations are actually within the scope of advanced practice. This issue must be addressed. The public and our professional colleagues need to know who we are, what we do and what the advanced nursing role can offer. Physician associates will have no such problem with role clarity, as they will have a unified national qualification and voluntary registration. If we do not do the same, we will be overlooked.

The debate must move forward and we urge the RCN to support us, to explore innovative ways of recognising, owning and accrediting the standards of advanced nursing practice. We need to clarify and inform to demonstrate why ANPs are best placed to add value to health services across the NHS.

What do you think? Leave a comment below or tweet your views to @IndyNurseMag

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This response to previous letters doesnt answer the question of why we are being ignored by the poiticians. We have shouted long and hard for the NMC to recognise advanced practice to no avail. I agree with making sure we know what advanced practice is but why hasnt it been done yet?
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I work in the field on mental health as an advanced practitioner. there are very few of us within the Trust and we have striven to be recognised for the skills we have including the abilitily to assess, diagnose and treat not only mental health problems but also physical health problems. In this day and age when the focus is on both the mental and physical health of patients ANPs are the ideal practitioners to fulfill this role with autonomy and authority. Many GP surgeries would benefit from having ANPs in their practice and patients would benefit from the holistic approach. The Northwest Advanced practitione forum has recently approached the NMC regarding regulation to be told once again it is not even on the agenda. Until we have a registered qualification it will be difficult to regulate.
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