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Advancing practice: a legacy of innovation

Volume 1 · Issue 0

Health Education England Centre for Advancing Practice

Welcome to the inaugural issue of the International Journal for Advancing Practice. We are so pleased to have this journal in place to enable the advanced practice community to share and celebrate achievements and developments across the continuum of enhanced, advanced and consultant level practice, research of advancing practice, education innovations, best practice guidance, and analysis, observations and opinions on advancing practice. This launch issue of the journal is a special edition and will establish the purview and scope of this quarterly publication, as included in this issue are the abstracts of articles that are planned for future issues. To help the launch, this new journal has been supported by Health Education England's (HEE) Centre for Advancing Practice; we will work together with the editorial and publishing team to develop a journal that reflects the needs of the four nations of the UK, and internationally, and captures the full and varied range of exciting advancing practice developments that are now happening globally to improve health care, build population health and reduce health inequalities.

In England, 2017 was a landmark moment for advanced practice following the publication of HEE's (2017) Multi-Professional Framework for Advanced Clinical Practice, which recognised the intrinsic multi-professional opportunity of advanced level practice. The phrase ‘multi-professional’ does not refer to the development of a homogenous worker. Instead, it emphasises the inclusivity of the framework to all professions' abilities to work at advanced level practice. The framework recognises that every profession is different and it does not expect all professions to follow the same clinical content within the advanced educational programme; capability 1.11 of the clinical practice pillar of the multi-professional framework offers specificity to the clinical nature of the work needing to be done, which enables both areas of shared and unique skills to be simultaneously prized. The level of practice of the Multi-Professional Framework illustrates the advanced level within the journey of registered practitioners from novice to expert in their ability to build the knowledge, skills and behaviours to undertake increasingly complex clinical decision making, manage high complexity, risk and uncertainty through interwoven learning and application across the clinical practice, leadership and management, education and research pillars. The development of HEE's (2017) Multi-Professional Framework ensued after the preceding advanced practice guidance developed within NHS regions (HEE East Midlands 2014; HEE, 2015), and across the four nations of the UK, such as The Advanced Practice Toolkit (NHS Education for Scotland, 2012), the Framework for Advanced Nursing, Midwifery and Allied Health Professional Practice in Wales (CIG Cymru and NHS Wales, 2012) and the Advanced Nursing Practice Framework (Northern Ireland Practice and Education Council for Nursing and Midwifery, 2014).

In 2020, HEE subsequently published the Multi-Professional Consultant-level Practice Capability and Impact Framework (HEE, 2020) for those working beyond advanced practice in consultant-level practice roles. These individuals demonstrate expert practice, enable leadership, improve practices, foster research and innovation, embed learning and take part in strategic development while integrating these domains within their consultancy across systems. Consultant training pathways are currently being developed by the Centre for Advancing Practice in collaboration with experts in consultant-level practice capability and impact. Furthermore, since 2017, there has been significant work to establish the enhanced level of practice (preceding the advanced level of practice), including the launch of the associated apprenticeship standard (HEE, 2022; Institute for Apprenticeships and Technical Education, 2022). There is still ongoing work to further establish the enhanced level of practice (NHS Employers, 2022).

We envision this journal working as a partnership between colleagues in the advanced practice community, with individuals from the different professional groups and with different perspectives contributing papers to allow the sharing of innovations in advanced practice. Articles of all types are welcomed, including clinical reviews, research papers, service improvement evaluations, commentaries, evidence reviews, literature reviews and editorials. Please consider contributing to the journal; members of the journal's Editorial Board can provide advice and guidance on developing papers for submission. The journal will also need peer reviewers, so please do think about getting involved. Even if you have not been a peer reviewer before, the journal aims to develop all aspects of our advancing skills – the crucial feature needed is your experience and expertise as an advanced or consultant level practitioner.

The success of advanced practice is that it is not a flash in the pan initiative imposed top-down by government policy. Instead, it is a practitioner-led movement emerging from the ground upwards, which has grown over six decades of global development through healthcare professionals innovating in practice to improve care outcomes for the people they interact with on a daily basis. We hope this journal will act as a key conduit for promoting and sharing those advanced practice innovations across all areas of health and care provision, leadership, education delivery and research progression for optimising population health and reducing health inequalities.