Advanced Nurse Practitioners are central to the delivery of safe, timely, and effective care across the UK, yet recent commentary has sought to question their role and contribution in ways that risk division rather than progress.

As Chairs of the RCN Professional Nursing Committee and Trade Union Committees, representing nursing staff across the UK and Crown Dependencies, we want to make it absolutely clear that the RCN stands unequivocally in support of Advanced Nurse Practitioners (ANPs).

For decades, these professionals have been fundamental to the delivery of safe and effective care. They are highly educated nurses who assess, diagnose, prescribe, and lead services in their fields. They aren’t an optional addition to care - they are essential to it, delivering complex, evidence-based practice solely and as part of multidisciplinary teams every single day.

What is now deeply concerning is not only the tone, but the trajectory of commentary that has recently been emerging from the British Medical Association (BMA); questioning the safety of advanced nursing practice and misrepresenting the ANP role. It risks creating division at precisely the moment when our health system needs cohesion.

We want to be clear: ANPs are not a substitute for doctors. They are highly experienced and autonomous nurse professionals who make a distinct and vital contribution. Framing their role otherwise misrepresents their expertise and distracts from the shared goal we all hold - delivering safe, high-quality, person-centred care.

Advanced nursing practice represents a distinct level of practice across clinical and non-clinical roles including leadership, management, education and research. It is not one single job title. ANPs assess, diagnose and manage complex conditions, often working in unpredictable environments that demand high levels of clinical judgement and critical thinking.

ANP-led care improves safety and outcomes through a combination of holistic assessment, often longer and more continuous patient contact, strong adherence to evidence-based protocols, collaborative team working, and improved access to timely care.

This expertise is not just theoretical; it is evidenced in outcomes. For example, a Cochrane review of 82 randomised trials across 20 countries found improvements in health outcomes in nurse-led care compared with physician-led care, in areas such as diabetes control, cancer follow-up, and dermatology (Butler et al 2026). And in neo-natal care, a positive impact of advanced nurse led care is evident across various outcomes - including length of stay, readmission, return and referral rates (Hyde 2020).

Recently at the RCN’s annual Congress, members made their position clear. Delegates backed action to challenge narratives, policies and practices that risk diluting or mispresenting advanced level nursing. The debate reflected a growing concern that misunderstanding these roles carries implications for patient safety and service delivery. As one speaker in the debate put it, advanced practice is not about replacing other professionals; it is about strengthening the whole team.

Delegates also emphasised the importance of ensuring that any regulatory developments reinforce the standards associated with advanced nursing practice. The RCN supports moves to introduce additional regulation of advanced level nurses.

We appreciate and support the BMA’s view that the medical profession requires investment, therefore this recent action is also highly concerning from a trade union perspective. Trade unionism is grounded in solidarity, mutual respect, and collective strength - not in hierarchy, exclusion, or the systematic undermining of another profession.

We must challenge narratives that risk undermining the contribution of and public confidence in nursing staff. Suggesting that one profession’s development comes at the expense of another creates unnecessary tension and does nothing to address the real challenges facing our workforce – widespread staff shortages, increasing demand, financial constraints and the need for sustainable workforce planning.

If patient safety is the priority, then the answer is not division - it is collaboration. Safety is strengthened when professions work together, and when professional competencies are respected.  

And we must ask ourselves: what is the alternative? Limiting the scope of highly trained ANPs does not enhance safety - it reduces capacity, increases pressure on other parts of the system, and risks delays in care. Patients benefit when they are seen by the right professional, at the right time, with the right skills. ANPs are a critical part of making that happen.

As Chairs of the RCN’s Professional Nursing Committee and Trade Union Committee, we stand united in our support for ANPs and for the nursing profession as a whole. ANPs are central to modern health care delivery across a wide range of settings. We will not accept their misrepresentation, and we will not tolerate the erosion of our profession.

We will always work constructively with colleagues across the health care system. But we will stand firm against division - because unity is what protects patients, strengthens our workforce, and safeguards the future of our health services.