Different types of area-specific workforce development interventions at advanced practice level
November 2022; updated May 2023
- This document explains different types of intervention that can define and support multi-professional workforce development at advanced practice level. Its focus is on multi-professional advanced practice credentials and other interventions that develop area-specific capabilities to meet identified service, patient and population needs.
- The document recognises the value of different types of intervention to meet different types of areaspecific workforce development needs in flexible, responsive ways. It seeks to avoid any sense of ‘hierarchy’ in different types of intervention. Its emphasis is on thinking through which different types of intervention are the most appropriate solution to meet different needs. This includes in the context of the scale of need and existing education provision.
- The interventions outlined in the paper (presented in alphabetical order) are as follows:
- Area-specific pathway (through an advanced practice Master’s degree).
- Capability framework.
- Credential specification.
- Module (within an advanced practice Master’s degree).
- Standards of practice.
- The document seeks to clarify different types of intervention, highlight interventions’ distinctive and shared features (see the Table below for a summary of these) and explain how different types of intervention relate to each other. Terms used across the document are highlighted in bold.
Table: Key features of different types of intervention
Area specific capabilities
Defined target group
Unit of learning as primary focus
Standards of practice as primary focus
- The different types of intervention outlined in this paper are neither mutually exclusive nor exhaustive. They can be used in conjunction with one another. They can also be developed from one another to provide pragmatic solutions to address particular workforce development needs, including as needs change over time (e.g., as the scale of need in an area of practice increases or addressing a particular workforce development need becomes a higher priority). Suggestions are made in the paper about how this can usefully be done. As examples,
- Standards of practice can be developed to form a capability framework.
- A capability framework can be developed to form a credential specification.
- An HEI’s development of an area-specific pathway through an advanced practice Master’s degree can form a vehicle for delivering a credential specification.
Scope of the document
- The document primarily explains how the Centre for Advancing Practice defines different types of workforce development intervention, while also referring to other parties’ interventions (such as those of higher education institutions) that contribute to building area-specific advanced practice capacity. A key reference point is the Advanced Practice Framework published by Health Education England in 2017, while it is expected that HEIs will seek Centre accreditation for their advanced practice Master’s programmes (and area-specific pathways through these).
- It is recognised that other organisations will define some interventions in different ways and that other types of workforce development interventions exist.
- The following sit outside the scope of this document:
- How workforce development interventions are commissioned and/or funded (i.e. whether, how or by whom an intervention’s development, delivery and take-up is procured).
- Broader types of learning and development provision that support health and care professionals’ continuing professional development (CPD).
- An area-specific pathway is a named route through an advanced clinical practice Master’s degree. The particular workforce development need that it addresses can be recognised in the title of the qualification conferred on its successful completion (e.g. by the area being denoted in brackets in the award title). It is therefore specific to and defined by the higher education institution (HEI) offering the programme and award. This includes in terms of the admission criteria and the specific requirements attached to engaging with and successfully completing the area-specific pathway for learners to be eligible for the area-specific award. An HEI specifies the compulsory and optional modules for individuals to engage with the pathway through to successful completion.
- An HEI may offer a range of area-specific pathways through its advanced practice provision. This fits with how HEIs optimise their responsiveness to workforce development needs in ways that have economies of scale and sustainability. This includes through different area-specific pathways comprising a number of shared modules (both with other area-specific pathways and generic pathways) and the importance of each area-specific pathway addressing development needs across the four pillars of advanced practice (i.e. clinical practice, research, education, and leadership and management), with all being key to clinical roles and service delivery.
- An area-specific pathway can reflect other kinds of workforce development interventions. As examples,
- Its design can be informed by one or more capability frameworks and/or standards documents.
- It can form an HEI’s delivery of one or more Centre-endorsed credential specifications, with the institution needing also to seek Centre approval for its delivery plan for learners to be eligible for their successful completion of the credential to be recorded (e.g. in the form of a digital badge).
- While an area-specific pathway can form an HEI’s response to delivering a Centre-endorsed credential specification, they are distinct types of workforce development intervention. This is for the following reasons:
- An HEI-delivered area-specific study pathway is owned by the HEI, is bespoke to that institution and leads to that institution’s academic award.
- A credential specification is an open-source document made available by HEE; it is not owned by an HEI that delivers it.
- An HEI-delivered area-specific study pathway is not the only way in which a Centre-endorsed credential specification can be delivered.
- There are and will be many more area-specific pathways through advanced practice Master’s degrees than credential specifications, with pathways forming a crucial response to workforce development needs (including in ways that can be more responsive to highly specialised, uniprofessional or localised needs than credential specifications).
- A capability framework defines area-specific knowledge, skills and behaviours (KSBs). Its focus is on what practitioners need to be able to do to practise safely and effectively in a particular area within advanced-level practice. Depending on a framework’s area of focus, the capabilities it defines can have greater or lesser specificity. However, the defined capabilities describe more than individual competencies, tasks or interventions, or the activities required in a specific job role or of one profession. They may be expressed as entrustable professional activities.
- A capability framework is different from a credential specification in that it generally does not include the elements listed below.
- Learning outcomes.
- A curriculum framework (setting out how practitioners’ learning should be developed and assessed, indicative content or volume of learning involved).
- Pre- or co-requisites to engaging with the framework.
- The resources required to deliver the framework.
- This is because a capability framework does not define a structured, standardise unit of learning. Rather, it is intended to be used flexibly to support workforce planning, development and deployment. It may be used by employers, as well as HEIs and other education providers. It may also be used by practitioners themselves to inform and support their professional development (including to reflect on their learning progress and needs).
- A capability framework can do the following:
- Form an integral part of a credential specification.
- Support learning needs analysis.
- Support HEIs’ development and delivery of a module or modules (including ‘shell modules’ to meet individual learning and development needs).
- Support HEIs’ development and delivery of an area-specific pathway through an MSc in advanced clinical practice. Support HEIs’ recognition of prior learning.
- A credential specification defines a structured, standardised component of assessed learning. It is designed to develop and test area-specific multi-professional advanced-level capabilities in response to a defined, high-priority, high-stakes workforce development need that exists at scale and that is not currently met by existing education provision. It forms a national, open-source document for use by different education providers.
- A credential specification therefore needs to contain sufficient detail to be interpreted and delivered consistently by different education providers. In turn, key stakeholders (including employers, practitioners and patients) need to be able to have confidence that the learning experience and learning outcomes created and achieved through a credential specification’s delivery and take-up will be equivalent across education different providers. The Centre’s credential approval and assurance process is designed to deliver and enact the quality assurance mechanisms to build this trust and confidence.
- In line with meeting the Centre’s endorsement criteria for credentials, a credential specification sets out the following:
- Area-specific capabilities that the defined, standardised component of learning is designed to develop and assess.
- The intended target group, in terms of the regulated health and care professions for which the component of learning is designed to enable safe, effective and efficient workforce development (with a dual focus both on taking an inclusive approach and ensuring practitioners who undertake the component of learning all have the underpinning professional knowledge, skills and behaviours to engage with it safely, effectively and efficiently and to learn effectively together and from one another).
- How individuals’ learning and development should be developed (in terms of content, approach and volume of learning, as defined by a curriculum framework and with due explanation of the workplace-based supervision, learning and assessment requirements as an integral part of this).
- The learning outcomes that practitioners should achieve to be deemed to have completed the credential successfully. How fulfilment of the learning outcomes and capabilities should be assessed.
- Pre- or co-requisites for practitioners to engage safely, effectively and efficiently with and complete the unit of learning.
- While focused on achieving consistency of ‘output’, a credential specification enables education providers to exercise their expertise in how they deliver the credential.
- Once a credential specification is endorsed by the Centre and finalised and formatted as a Centreendorsed credential specification, it is made available as an open-source for delivery. The Centre considers education providers’ delivery plans for approval. The quality, implementation and currency of both Centre-endorsed credential specifications and their delivery will be kept under review through the Centre’s approval and assurance process.
- A credential specification can do the following:
- Integrate and build on a capability framework.
- Support HEIs’ development and delivery of an advanced practice programme and/or module(s), including through being used in combination with other credential specifications and including in the design and delivery of area-specific pathways and awards.
- Support learning needs analysis.
- Support HEIs’ recognition of prior learning.
- Credentials can be undertaken either as an integral part of a full advanced practice Master’s degree or on a freestanding basis by practitioners who have already successfully completed an advanced practice MSc (or demonstrated the educational equivalence of this through the Centre’s ePortfolio(supported) route). They can be delivered as one or more HEI-delivered modules. In turn, these modules can contribute to an HEI’s delivery of an area-specific pathway through a full advanced practice Master’s degree programme.
- A module is a unit of learning that is designed, owned and delivered by an HEI. It forms a discrete component of a fuller programme of learning that leads to that HEI’s academic award (e.g. an MSc in advanced clinical practice and including an area-specific pathway within this). Its design and delivery are underpinned by the HEI’s wider provision and resources, academic regulations and quality assurance processes.
- An HEI does following in relation to its own modules:
- Defines the admissions criteria.
- Defines the learning outcomes.
- Sets any pre- and/or co-requisites.
- Holds the intellectual property rights.
- Determines the learning content, the volume of learning and modes of learning and teaching involved (and therefore the syllabus).
- Determines and enacts the mode of assessment.
- Awards academic credit in line with the defined level and volume of learning.
- Defines how it can be used in combination with other modules towards a specific academic award.
- Assures its quality.
- Modules can link with other types of workforce development intervention. This includes through HEIs doing the following:
- Using a capability framework to inform its design and delivery of a module, or series of interlinked modules.
- Designing and delivering a module, or series of modules, to adhere to a Centre-endorsed credential specification, and seeking Centre approval for its delivery plan for the credential specification.
- Designing and implementing one or more area-specific pathways that build on specific combinations of modules that align with meeting identified workforce development needs.
- Using standards of practice to guide its design and delivery of a module, or series of interlinked modules.
- Responding to individual practitioners’ learning and development needs by providing ‘shell’ or learning contract modules.
- Modules completed by practitioners at one HEI can count as credit towards a programme offered by another. This is subject to fitting with an institution’s regulations on the recognition of prior learning and aligning with its requirements for a particular academic award.
Standards of practice
- Multi-professional standards of practice define how practitioners are expected to engage in professional practice in a particular area to deliver safe, effective person-centred care. They reflect current best, evidence-based practice, technological advances and changing models of care. They are designed to provide clarity about expectations of multi-professional practice in a particular area and to build confidence in the quality of patient care and service delivery through their adoption and application.
- By taking a multi-professional approach (rather than focusing on the activity of a particular profession), standards should support multi-disciplinary team-/agency working and collaboration. They should therefore increase responsiveness to population and patient care needs in timely, accessible and integrated ways.
- Standards of practice generally do not include the elements listed below.
- The specific knowledge, skills and behaviours (capabilities) required to meet them.
- The target group, in terms of the professions to which they are designed to apply, although they will set out the area of practice to which they apply (and reflect any restrictions on which professions or practitioners can undertake specific activities).
- Learning outcomes.
- How individuals’ learning and development should be developed, or the curriculum framework or syllabus that should be created and followed to meet the standards.
- How individuals’ learning should be assessed against them.
- Pre- or co-requisites to practitioners’ engagement with them.
- Standards can underpin and inform the development and implementation of other types of workforce development intervention. This includes the following:
- Capability frameworks.
- Credential specifications.
- HEI modules and programmes, including area-specific study pathways.
- Individual practitioner learning need analysis.
- The evidencing and recognition of prior learning.
Relationship between different types of intervention
- Decision-making on the most appropriate type of intervention to meet a workforce development need has to take account of the specific nature of the need (with this appropriately defined and scoped) and its particular context and starting points. This is to ensure that the most appropriate type of intervention is selected and progressed to respond to the particular need. All decision-making needs to be predicated on addressing the following questions:
- What will best manage patient safety and risk?
- What will form the most expedient, efficient and sustainable way of addressing the defined workforce development need?
- There is also a value of considering the interface between different intervention types to meet needs. This can include in the following ways:
- Over time; e.g. either by a particular type of intervention being built on or distilled from another to meet workforce development needs in more responsive ways.
- By one type of intervention being integrated into another to enhance responsiveness to need (e.g. to increase the pace and scale of how provision meets priority needs).
- By one type of intervention being used as the vehicle to deliver another (to optimise use of high-quality interventions and increase the pace and scale of interventions’ responsiveness to need).
- The Centre’s approach to multi-professional advanced practice credentials is informed by the considerations shared here on different types of workforce development intervention and their respective key features and value.
- The Centre will continue to work with stakeholders to explore the interface between different interventions in greater depth, with a focus on optimising solutions to meeting population health, patient care, system and service delivery needs in responsive, sustainable and transformative ways.
 It is recognised that uni-professional standards also have an important role to play in providing clarity of expectations in particular areas of practice. Uni-professional documents are usually most appropriately developed by professional bodies or sub-specialty networks (at a national or international level).