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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 NUH's Consultant ACP Lead

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.