Transforming Nursing, Midwifery And Health Profession (NMaHP) roles: review of Clinical Nurse Specialist and Nurse Practitioner roles within Scotland

Annex C Outcomes from Review - Role Definitions

1.1 Role Definitions

Clinical Nurse Specialist/Nurse Practitioner (Level 6)

A registered nurse with relevant experience and post-registration education for working within a specific area of practice. Educated in an appropriate subject to the level of graduate certificate (honours degree) at a minimum, although a postgraduate certificate is recommended, they are assessed as clinically competent in their defined area of practice. They assess, manage, deliver care, advise on, and support the care for people within a specialist area.

As a Level 6 Senior Practitioner they work under guidance in a peer relationship with other members of the multidisciplinary team. They have the autonomy to act and accept responsibility and accountability for their actions, acting as a skilled advisor or resource for others. This includes specialist assessment, informed decision making, and treatment using a personalised approach to care for patients' multidimensional presentations. This may require supporting specialist care over a prolonged period of time. They have the authority to refer patients, and may admit or discharge within appropriate clinical areas of practice. This is characterised by a level of decision making based on detailed knowledge and understanding of their area of practice.

As part of the multidisciplinary team they can work in or across many settings, including non-clinical, depending on their area of expertise and scope of practice.

Clinical Nurse Specialist - Advanced Practice (Level 7)

The Advanced Clinical Nurse Specialist (ACNS) is an experienced and highly educated registered nurse working within a specific field of practice. They manage, deliver, advise on and support the care for people within a specialist area. Educated to at least Postgraduate Diploma level in an appropriate subject, they are assessed as clinically competent in their defined specialty. They have a wider scope of practice than the clinical nurse specialist at Level 6 and will manage greater complexity.

As a clinical leader they have the autonomy to act and accept responsibility and accountability for their actions, acting as an expert advisor or resource for others. This includes specialist assessment and treatment using a holistic approach to managing complex, multidimensional situations. This may require management of care over a prolonged period of time. They have the authority to refer, admit and discharge within appropriate clinical areas. Their practice is characterised by a high level of clinical decision making based on in-depth, expert knowledge in their specialism of care delivery.

Working as part of the multidisciplinary team, they can work in or across all settings, including non-clinical areas, dependent on their area of expertise.