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Three nurses walking down corridor

The levels of nursing

Setting definitions and standards for nursing practice beyond registration

Here at the RCN, we are developing a professional framework for nursing which will encompass the whole nursing workforce, from the nursing support worker through to the consultant nurse. We issued the revised definition and principles of nursing which underpin the Framework. We have now defined the levels of nursing practice beyond the point of registration as a nurse.


Standards of proficiency

The Nursing and Midwifery Council (NMC) sets the standards of proficiency for the registered nurse. These standards represent the knowledge, skills, and behaviours that all nurses must have. The NMC has also developed a framework for nursing and midwifery education to ensure that the standards of proficiency are met in practice.

Beyond the point of registration, the work of the registered nurse increases in its complexity. Across the following pages you will find definitions and standards for enhanced, advanced and consultant levels of nursing. These definitions will help those who aspire to practice at these levels, as well as giving greater clarity to employers and higher education institutions. They can be applied across all fields of nursing and in all settings.

Why we need definitions of the levels of nursing practice beyond registration

Our new and updated definitions and standards clarify and bring consistency to the levels of nursing beyond a registered nurse. Through these definitions, along with a shared language and consistent approach, the levels of complexity involved in nursing practice can be recognised by practitioners, employers, service users and other professionals within health and care teams.

While advanced level nursing is widely recognised, it lacks consistent definition, is currently unregulated and covers a wide range of roles and titles. We have updated our own definition and added a new definition of consultant level nursing. Enhanced level nursing is a newer concept, which we have also defined.

We are now working on bringing the same consistency of approach to defining other roles within the nursing workforce. This will include assistant practitioners and registered nursing associates.

Levels of practice of the registered nurse 

Explore the definitions and standards which apply to all fields of nursing, and all settings in which registered nurses practice.

The standards that have been developed alongside each definition are aligned to the four pillars of nursing. These will serve to underpin continuing professional development and education.