New principles for advanced practice to bring clarity and consistency

Subject to Council approval next Wednesday (26 March), these principles aim to bring clarity and consistency to advanced nursing and midwifery practice across the UK. They will enable the public to understand the role of an advanced practitioner, support professionals by setting clear expectations for their practice and help employers develop and sustain systems in which advanced practice can thrive.

The principles have been developed through extensive UK-wide engagement with professionals and the public. They distinguish between experienced practice and advanced practice – emphasising that advanced practice is not about the title but a level of expertise achieved through additional, often specialised, education and experience after initial registration.

The principles recognise the well-established four pillars of advanced practice (clinical practice, education, research, and leadership and management). They are relevant to all workplace settings and are aligned to the advanced practice frameworks of each of the four nations of the UK.

What the principles include

According to recent research, there is a lack of clarity around advanced practice and what it means. That’s why the principles include a regulatory definition, which seeks to achieve consistency in professional and public understanding of the role. To ensure there is clarity and accessibility for these audiences, the principles include two versions of the definition – one for the public and one for professionals.

The principles also set key expectations for advanced practitioners, including autonomous decision-making, managing risk and uncertainty, and working within inter-professional teams. They highlight the importance of embedding equity, equality, diversity, and inclusion in practice to ensure that care meets the needs of people from diverse communities.

Supporting employers and the public

The principles support employers in recognising and developing advanced level practice, ensuring advanced practitioners are working within safe, well supported and governed structures. They also explain what the public can expect from advanced practitioners and the benefits they bring to health and social care services.

While these principles are advisory, we strongly encourage professionals and employers to use them to ensure people receive the best possible care.

Next steps

If approved by Council, we’ll publish the principles in English and Welsh during May. We’ll also build on the principles to help develop our new advanced practice education programme standards and standards of proficiency in 2027.

In the meantime, we will consider requirements for advanced practitioners as part of the Code and revalidation reviews for 2025-26. We will also continue to explore the transitional arrangements for existing advanced practitioners.

We will work closely with professionals, employers, educators and other regulators to support the implementation of these principles.

Sam Donohue, Acting Executive Director of Professional Practice at the NMC, said:

"These principles mark a major milestone in the history of nursing and midwifery. By clearly defining advanced practice, they will support the public to understand the role and expertise of advanced practitioners. At the same time, they provide professionals and employers across the UK with clear principles to achieve safe, consistent, and high-quality care.

"Developed in partnership with professionals, employers, our stakeholders and the public, the principles reflect an evolving health and social care landscape. They highlight the importance of education, leadership, research, collaboration and innovation in driving excellence.

“We look forward to further engagement with our stakeholders and ensuring these principles are embedded effectively across the sector.”

You can read the principles and more information in our Council papers (page 107)

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