Results of the ANP Forum survey 2012
Published: 21 September 2012
The recent survey by the ANP Forum sought to capture a snapshot of advanced practice in the United Kingdom. It posed questions about the basic demographic profile of the advanced nursing community, about their place of work, their academic qualifications, remuneration, obstacles to practice and priorities for the future.
The survey ran from 27 April to 18 May, with 689 responses. It revealed a mature workforce, embedded in primary and secondary care, the independent sector, in education and management; predominantly a female workforce populated by older, more experienced nurses, many undertaking additional training, including prescribing, to support their advanced roles.
More than 70 per cent of respondents hold a first degree and 40 per cent have progressed to a master’s level qualification. When compared to the 2006 nurse practitioner survey conducted on behalf of the RCN there has been a doubling in the number of nurses continuing to study to master’s level (RCN 2006). Prescribing qualificationshave increased too. In the 2006 survey, prescribing was not considered to be a core function of the advanced role. In 2012, most nurses recognise its importance in delivering frontline care. Unsurprisingly therefore, 76 per cent of respondents have a non-medical prescribing qualification, the vast majority as independent or supplementary prescribers, with a further seven per cent in training.
The ability to refer appropriately to colleagues in other clinical specialities is an essential part of the advanced role. An overwhelming 93 per cent of respondents confirmed that they can and do refer. However barriers still persist. Individual responses evidence problems within local services; the most commonly identified were from advanced nurse practitioners in general practice to clinical specialities within secondary care.
One respondent remarked that a “traditional medical approach” predominates, in which “nurses need to pass everything by a doctor first regardless of experience or qualifications”.
An area the ANP Forum was anxious to explore was that of equality of pay across the discipline. When asked about pay scales, fewer than two thirds of respondents confirmed that they were paid according to Agenda for Change. The fact that so many, more than one third, are on locally identified pay scales derides the premise of national pay and conditions.
It demonstrates that regional pay is not just on the agenda, it is already here. It is service-specific; those nurses providing care without proper remuneration for their skills are more likely to be found in general practice. Currently the RCN is leading the fight against regional pay. We must also raise the profile of this issue.
Responses were unequivocal. There should be no disparity between nurses working in an advanced role across sectors, primary care nurses demanding "recognition of the same pay and conditions as ANP in the acute setting", or on the national stage, the necessity of "being paid and graded nationally and banded appropriately".
The survey asked advanced nurse practitioners what they considered to be priorities for the ANP forum for the next 12 months.
Respondents identified four priority areas:
- regulation, to include a commitment to rationalisation of multiple titles under one umbrella term with defined core competencies
- remuneration, national pay and appropriate banding for nurses willing to undertake the extra training and responsibilities demanded by advanced practice
- recognition, by their peers and the public and education, structured unified educational pathways
- access to funded continuing professional development.
Looking back at the survey of 2006, there seems much similarity, suggesting that little progress has been made in key areas. A continually changing political climate with its inevitable short-term focus makes professional progress difficult. The respondents of 2006 were concerned about their job security in a changing health arena, as are the respondents of 2012. But as individuals they continue to progress, with higher educational attainment, new skills adapted and accrued to match the advanced role, lobbying for professional recognition and regulation.
The forum committee will continue to work on behalf of all nurses in advanced roles, using your responses to guide our activities over the next 12 months. If you have any further comments you wish to add please use the contact details on the website and give us your opinions.
Download the RCN 2006 survey: Nurse Practitioners 2006 (PDF 138KB) [see how to access PDF files].
Julie Hall, Advanced Nurse Practitioner Forum steering committee member