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What is Advanced Practice?


The Advanced Clinical Practitioner (ACP) role at Nottingham University Hospitals NHS Trust (NUH) is mapped to the Health Education England (HEE) 2017 Multi-professional Advanced Clinical Practice Framework. The level of advanced clinical practice is defined in the framework as:


Advanced clinical practice is delivered by experienced, registered health and care practitioners. It is a level of practice characterised by a high degree of autonomy and complex decision making. This is underpinned by a master's level award or equivalent that encompasses the four pillars of clinical practice, leadership and management, education and research, with demonstration of core capabilities and area specific clinical competence.

Advanced clinical practice embodies the ability to manage clinical care in partnership with individuals, families and carers. It includes the analysis and synthesis of complex problems across a range of settings, enabling innovative solutions to enhance people's experience and improve outcomes.

Hee 2017


The qualified ACP at NUH can carry out activities historically only undertaken by medical staff including physical examination, ordering and interpreting diagnostic tests, advanced health needs assessments, differential diagnosis, prescribing medication and discharging patients.  They are a source of expert knowledge for both nurses, AHPs, and doctors, they provide leadership by role modelling excellent practice and identifying, researching and developing innovative ways of working. 

The domains of ACP:


A graphic showing the domains of ACP


The NHS Long-Term Plan (2019) and the NHS People Plan (2020) highlights how advanced clinical practice is central to helping transform service delivery and better meet local health needs by providing enhanced capacity, capability, productivity and efficiency within multi-professional teams

NUH is already recognised nationally as a leading employer of ACPs and an innovator of ACP services. With over 180 trainee and qualified ACPs across 17 specialties to date NUH has shown a clear intention in the investment of the ACP role and the surrounding governances and assurances, the road map to continue developing this role is detailed in the NUH ACP strategic plan 2020-2025.

Meet the ACP team

James Pratt

James Pratt

James Pratt - Consultant Advanced Clinical Practitioner Lead

James is the Consultant Advanced Clinical Practitioner (ACP) Lead at Nottingham University Hospitals NHS Trust (NUH), a large acute care NHS organisation. James is responsible for the development and leadership of ACPs across NUH. James has led on the development of implementing a multi-professional, organisational ACP strategy and associated pieces of work. James has led on the Nottinghamshire Integrated Care System ACP agenda and supported multiple national pieces of work related to advanced practice. James is currently supporting the HEE ACP governance and assurance agenda. James continues to work in emergency medicine as a senior clinician.

Chris White

Chris White

Chris White - ACP Supervision and Assessment Project Lead

Chris is a Registered Paediatric Nurse who qualified from the University of Southampton in early 2010. After spending some time working clinically on the children’s surgical ward and paediatric intensive care he moved to NUH in 2014 to work in Children’s ED. He has subsequently gone on to train as a Children’s Advanced Clinical Practitioner (ACP), and sits on the trusts ACP Research and Innovation steering group.

Chris’ role is looking at how trainee ACP’s are supervised across NUH and how we can improve it. He is using this work to shape a new document of guidance on supporting trainee ACP’s

Jennifer Parrish

Jennifer Parrish

Jennifer Parrish - Senior Leadership Fellow CNS Project Lead

Jennifer Parrish is a Haematology Outreach Clinical Nurse Specialist (CNS) at the Centre of Clinical Haematology, Nottingham University Hospitals NHS Trust (NUH). She completed her training at Keele University and after working on a Haematology Ward at University Hospital of North Staffordshire for a few months she moved to Nottingham in 2006.

Jenny has continued to work in Haematology since, initially as a staff nurse on a busy ward then as a Myeloma Clinical Nurse Specialist, initially as a part-time Band 6 trainee, working her way up to a full-time Band 7 CNS after developing experience in the field and completing her non-medical prescriber training.

In 2016, Jenny left the Myeloma team and with her colleague set up the Haematology Outreach Service, delivering specialist haematology treatments to patients in their own homes. This Service has been an overwhelming success, completing over 4600 home visits in the last year alone, and increasing its workforce from the initial 2 nurses to 6 nurses and 2 CSW’s. As a result Jenny has enjoyed sharing her experiences with other centres nationally and supported them in developing their own bespoke services using a similar model.

In September 2022, Jenny came into post as CNS Project Lead for NUH. She sees this as an exciting opportunity to scope current practices across the Trust and celebrate successes of CNS teams, ensuring that their perspective is heard by members of the senior nursing team.