The following is copied from the Nursing and Midwifery Council Website, and helps us to understand why we still have confusion on the place, status and titles of those nurses who are working at a level above that achieved at registration:

“Advanced Nursing Practice – update 19 June 2007

Previous Work:

For a considerable amount of time, a major concern of the NMC, the public and many NMC registrants is the existence of the plethora of job titles that do not help the public to understand the level of care that they can expect. There are nurses who hold job titles that imply an advanced level of knowledge and competence, but who do not possess such knowledge and competence. In addition, their practice may not be subject to the scrutiny of another professional as they often act as independent practitioners.

The NMC also recognises that there are now significant changes in the way that services are delivered to patients, particularly following the General Medical Services (GMS) contract and European Working Time Directive (EWTD). Nurses, midwives and specialist community public health nurses are undertaking treatment and care that was once the domain of other health care professionals, notably doctors.

Therefore, a national consultation was undertaken during the months of December 2004 – February 2005 following which external analysis was undertaken and reported to June Council 2005. Council agreed that ‘advanced nurse practitioner’ should be a registrable qualification and that the NMC should seek approval from the Privy Council for opening a further sub-part to the nurses’ part of the register.

To implement the Council’s decisions of 9 June 2005 regarding the outcome of the consultation for the framework for the standard for post-registration nursing, a letter was sent to the Privy Council in December, with additional information being sent in January 2006.

The NMC’s mandate is set out within the legislation of the Nursing and Midwifery Order (2001); therefore the Privy Council has been seeking the views of the Department of Health (England), which takes the lead on regulatory matters relating to healthcare professions across the UK. The NMC has been awaiting the response from the Privy Council.

Current Position:

Following an interval of very little movement, the NMC has now been very encouraged to read within the recent White Paper Trust, Assurance and Safety – the Regulation of Health Professionals in the 21st Century (2007), that;

‘The Government agrees that the regulatory body for each non-medical profession should be in charge of approving the standards which registrants will need to meet to maintain their registration on a regular basis. Where appropriate, common standards and systems should be developed across professional groups where this would benefit patient safety. The Department will ask the Council for Healthcare Regulatory Excellence (CHRE) to work with regulators, the professions and those working on European and international standards to support this work. This will encompass the development of standards for higher levels of practice, particularly for advanced practice in nursing, AHPs and healthcare scientists. The Department will discuss with the Nursing and Midwifery Council the outcome of their consultation on advanced nursing practice to agree next steps (2.30)’.

Council has interpreted this very positively and looks forward to working in partnership with all the relevant stakeholders to progress this and we are currently awaiting further detail from the White Paper Implementation Plan (WPIP). Please note that it is impossible to pre-empt any debate on the progression of this work until we have looked at the WPIP in totality, as the work from many aspects of the White Paper will cross over to the work on advanced nursing practice such as revalidation.”

I guess this suggests that this is a bigger issues than just nurses, after all we have physios and other practitioners delivering advanced practice as well. But I think this issue is continuing to fuel the whole ‘quacktitioner’ debate. If we as nurses don’t know what qualifications you should have to be allowed to called yourself advanced, specialist etc. then what hope do the rest of the world have? If I attend a GP practice and see a nurse how will I know, based on what he or she calls themselves what qualifications they have to see me and provide me with the treatment I need. I ask these questions and I am a nurse. Not all patients have the knowledge I have. No wonder our poor doctors are in a state of utter confusion. Come on Department of Health and NMC get on with the work you have been doing for 3 years!