North East and Yorkshire Faculty for Advancing Practice Handbook

Answer: Advanced level practice isn’t a specific role; it includes all practitioners who have progressed to an advanced level through further education and training.

Advanced Practice is delivered by experienced, registered health 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 area specific clinical competence. Advanced Practitioners come from a range of registered professional backgrounds. The Advancing Practice Multi-Professional Framework provides a clear and consistent approach to the development of advanced practice across England.

Four pillars of Advanced Practice

Answer: Advanced practice can be undertaken by statutory regulated health professions. This list is not exhaustive and is likely to grow as Advanced Practice roles, frameworks and credentials progress.
These are the professional groups that are eligible for NHSE Advanced Practice funding example:

• Biomedical/Clinical Scientists (HCPC Registered)
• Chiropodists/Podiatrists
• Dieticians
• Midwives
• Nurses
• Occupational Therapists
• Operating Department Practitioners
• Optometrists
• Orthoptists
• Osteopaths
• Paramedics
• Pharmacists
• Physiotherapists
• Practitioner Psychologists
• Prosthetists/Orthotists
• Radiographers – Diagnostic & Therapeutic
• Speech and Language Therapists

Answer: An Advanced Practitioner is a registered health care practitioner whose role is characterised by a high degree of autonomy, complex decision making, analysis and synthesis of complex problems, and the ability to complete whole episodes of care. They work at level 7 across all 4 pillars of Advanced Practice and have completed a NHSE recognised MSc Advanced Practice programme or achieved educational equivalence via the ePortfolio (supported) route which encompasses the four pillars of advanced practice. Advanced Practitioners come from a range of registered professional backgrounds.

The Advancing Practice Multi-Professional Framework provides a clear definition of advanced practice across England.

Answer: A trainee Advanced Practitioner should be employed in a supported training post designed specifically to undertake the required training to work at the level of Advanced Practice on completion. This includes formal study at master’s level (level 7) and work-based learning to develop competence across all four pillars of the Advancing Practice Multi-Professional Framework. 

Entry criteria for MSc Advanced Practice programmes is defined by the Higher Educational Institution where study is undertaken. A NHSE Supported Trainee Advanced Practitioner is in a training post where their employer has met all eligibility criteria and successfully applied to NEY Advanced Practice Faculty for Clinical Salary Support in regard their training post.

Answer: No, Advanced Practice is different from specialist practice. Specialist practitioners are experts in their chosen clinical area and work predominantly within the clinical pillar. 

For example, asthma care clinicians have a depth of knowledge in that specific area. Advanced practitioners have a breadth of knowledge and work across the four pillars of clinical, research, education and leadership, crossing traditional professional boundaries. Continuing the previous example, a respiratory Advanced Practitioner would work across the respiratory scope of practice, which can include the depth of knowledge in asthma care. Services may need both specialist clinicians and Advanced Practitioners to provide comprehensive care to all patients.

Answer: Patients often feedback that they want a quicker, more responsive service that treats them as an individual, not as a combination of different health conditions. They also want different parts of the health service to work better together.

Advanced practitioners have broad roles within their scope of practice, enabling them to lead and manage a whole episode of patient care, providing assessment, diagnosis, and treatment of patients. Advanced practitioners are highly skilled in their chosen scope of practice and are trained to think about a person’s holistic health needs. They can manage clinical care in partnership with patients, families and carers within the multi-disciplinary team and work across patient pathways in a range of areas and services.

Advanced Practitioners provide enhanced capacity, capability, productivity and efficiency within multi-professional teams, helping provide safe, accessible and high-quality patient care.

Answer: Capabilities in practice are professional activities within the scope of Advanced Practice.
In 2017, Health Education England and NHS England and NHS Improvement worked in partnership to develop the Multi-professional framework for advanced clinical practice in England, which ensures that there is national consistency and understanding about practicing at an advanced level . All health and care professionals working at the level of advanced practice should have developed their skills and knowledge to the standard outlined in this framework; the capabilities are common across this level of practice enabling standardisation.

Capabilities are mapped to level 7 as people working at this level are required to operate at master’s level i.e. to have the ability to make sound judgements in the absence of full information and to manage varying levels of risk when there is complex, competingor ambiguous information or uncertainty.

The pathway towards advanced clinical practice may be different for individual practitioners. Health and care practitioners will demonstrate the capabilities in different ways, depending upon the nature of their scope and context of their practice, role, and profession.

Capabilities are grouped in three categories:

Core: The universal requirements of all Advanced Practice specialties across all four pillars, largely focuses on wider professional skills, knowledge and behaviours required to deliver advanced practice.

Generic clinical: The universal requirements of all Advance Practice specialties, largely focuses on the clinical aspects of advanced practice that are common across all specialties.

Specialty clinical: The specialty specific requirements for advanced practice within a particular specialty.

Answer: In the North East & Yorkshire NHSE advanced practice funding is based on an agreement between trainee, employer,
ICB Faculty and education provider, all of whom have responsibilities to be met.

Trainee: The trainee will work in partnership with their employer, education provider and the Faculty for Advancing Practice to gain their Advanced Practice qualification. The readiness to become an advanced practitioner checklist further details the expectations and commitment needed to train for this role and enables aspiring and trainee advanced practitioners to self-assess their readiness for advanced practice training.

They agree to proactively identify any supervision issues, learning environment needs or difficulties in achieving learning objectives that may affect their progression and ensure these are raised at the earliest opportunity to try to find a resolution. The trainee will inform their Educational Supervisor, Employer and the NEY Faculty of Advancing Practice by completing the change of circumstances form at the earliest opportunity if personal circumstances change that affect completion of their training or changes to the planned end date.

Employer: The employer will work in partnership with the trainee, education provider and the Faculty for Advancing Practice to support the trainee to achieve their Advanced Practice qualification. The employer must be committed to supporting the Advanced Practice trainee whilst providing significant supervision and support to develop a sound approach to work-based learning. 

They must provide a positive learning environment with named appropriate educational supervisors and an agreed supervision plan for each trainee. An induction must be provided at the start of the programme. A Coordinating Education Supervisor and Associate Work-based Supervisors should be allocated to provide the best chance for the trainee to successfully complete the Advanced Practice MSc.

The employer must proactively identify any supervision issues, learning environment needs or difficulties in achieving learning objectives that may affect the trainee’s progression and ensure these are raised at the earliest opportunity to try to find a resolution. The employer commits that the trainee Advanced Practitioner has an appropriately banded post available to progress into at the end of the training, and that the post is in line with organisational and population health requirements, as identified by the organisational workforce plan.

We also advocate each organisation allocating an Advanced Practice Lead to enable ‘cross fertilisation’ of learning opportunities, to ensure organisational clinical governance, policy development and development of a larger network of support. The Employer is responsible for appropriate use of funding. The Governance Maturity Matrix provides 8 domains which support robust organisation governance and assurance to mitigate risks to patient safety.

Education Provider: The education provider will work in partnership with the trainee, employer, and the Faculty for Advancing Practice (Regionally or ICB) to educate the trainee to achieve their Advanced Practice qualification. 

Education providers must provide a high quality academic and clinical Advanced Practice programme that meets standards set out in the Multi-professional framework for advanced clinical practice in England and be engaged in seeking NHSE accreditation for their Advanced Practice MSc if accreditation not already attained.

NHSE: The NHSE North East & Yorkshire Faculty will provide funding and support for trainees and their co-ordinating education supervisors who receive confirmation they have been successful in the yearly advanced practice application round. For funding options please see Section 3 – NHSE Funding and Support. 

The NHSE North East & Yorkshire Faculty provide access to support for trainees and organisations with relevant knowledge and experience to assist and support the training process whilst ensuring regional consistency in training provision and standards in accordance with national standards.

NHSE North East & Yorkshire Faculty will support trainee progression, as required alongside the Coordinating Education Supervisor and organisational Advanced Practice Lead to identify any issues or barriers that may affect successful completion of the programme. NHSE will also support any issues with supervision and learning environment quality and escalate for further investigation if appropriate

Answer: It is recommended that at the start of their training journey the employing organisation should provide the trainee with an induction. This should be done with existing employees beginning their advanced practice programme as well as new starters. Induction programs help trainees to adjust to their new role, it is a chance to give them the information they will need to succeed, remove their anxieties and eliminate confusion.

In their induction trainees can expect to cover: 

• Role specific information and expectations
• Terms and conditions of the employment contract
• Meeting other key employees (supervisor/manager/HR team/other trainees)
• Learning and development plan
• Physical orientation of working environment
• Organisational policies and benefits
• Health and Safety / Mandatory training
• Facilities and IT
• Incident reporting
• Wellbeing and Freedom to Speak Up

Answer: An experienced clinician, who has often obtained additional skills in leadership or teaching and wishes to further pursue their career further through academic and work-based development, with the completion of a NHSE accredited MSc Advanced Practice programme. The requirement for a supportive employer and surrounding clinical team is a pre-requisite for success. Different employment often requires utilisation of different elements of the Advanced Practice pillars.

A strong sense of self-motivation and a commitment to continuing professional development is required to complete Advanced Practice training.

Answer: The timetables and study time required will vary according to the Advanced Practice programme, but all trainees will need periods of study leave to complete the programme and will be required to produce course work, undertake work-based assessments and produce a portfolio of evidence. Trainees may also benefit from rotations or placements in other areas within the organisation to gain the required breadth of experience.

Answer: Trainees are required to attend programme teaching;days, practise clinical skills in their workplace and complete work-place based assessments. They will also need time to meet their supervisor regularly to plan their individual educational needs and monitor their progress. The requirements of supervisors are explained in more detail in the Minimum standards for supervision. It is expected that each trainee will dedicate many hours to independent study to achieve their qualification. The notional number of hours of study and teaching expected is approximately 100 hours per 10 academic credits (which includes both contact hours and independent study hours) however, the actual time spent may be more, or less, dependent on individual learners. It is therefore important for Advanced Practice trainees to have sufficient work-based learning time to develop their advanced skills.

Answer: For trainees on the apprenticeship programme 80% of an apprentice’s time will be in the workplace, with 20% off the job training. For trainees on the Advanced Practice Programme, employers are expected to provide the trainee with sufficient study leave and protected time for work-based learning each week, for non-apprenticeship routes NHSE recommends this remains as 20% off the-job training. Off the job training can include study days, placements with other clinical areas to expand breadth of knowledge or other activities which allow the trainee to meet their learning needs. The education provider programme lead will provide information on the total amount of study days required.

Answer:For the apprenticeship programme it is a minimum of 30 hours per week. For the MSc Advanced Practice and other;Programmes, this will differ at each University but again, this is generally a minimum of 30 hours. If the employer is recruiting a new person as a trainee Advanced Practitioner, then it is suggested they are recruited on a minimum contract of 30 hours.

For existing employees, if they work less than 30 hours per week, please contact the relevant programme lead at the education provider to discuss their suitability for the programme.

Answer: An ACP Apprenticeship Pathway is the preferred route to be supported by NHSE. NHSE will support ACPs through this route, with access to a training grant at the same overall value as the Fees Funded Route. An ACP Fees Funded Pathway will only be available in exceptional circumstances for applicants who do not meet the requirements of the apprenticeship route. NHSE funding for Advanced Practice programmes is limited and therefore levy paying employers are encouraged to adopt the apprenticeship programme and consider apprenticeships as their primary option as this will enable the full training grant available to be utilised to support the wider learning needs and protected educational time for their trainees. 

For non-levy paying employers, there is an option for either a levy transfer from a larger organisation or by government coinvestment. If you have any questions, please contact your Integrated Care Board apprenticeship lead in the first instance. To view the Apprenticeship Standard for an Advanced Practitioner, click here. Employers should ensure that individuals put on to an apprenticeship route are committed to completing the full programme. 

For trainees who undertake the apprenticeship programme entry onto each of the modules in the programme is guaranteed. However, for trainees who undertake a non-apprenticeship programme there is a risk of over subscription to individual modules which could cause a delay to completion of the programme. NHSE needs to be informed if there is any change to the end date of the programme as this may affect funding. 

If you are unsure of who your ICB Apprenticeship Lead is email NHSE on england.neyadvancedpractice@nhs.net

Answer:It is possible for an Advanced Practitioner to alter their field of study, but they would need to undertake training in the new scope of practice. NHS England are planning to offer a series of Credentials in various scopes of practice in order to verify skills in specific areas (such as Acute or Emergency Medicine). There are also specific Royal College curricula applicable to certain areas. However, Advanced Practice trainees from different settings can undertake generic Advanced Practice MSc or Level 7 Apprenticeship courses and develop their own portfolio of evidence in their clinical training environment / employment, making cohorts truly multi-professional and clinically varied.

Whilst all Advanced Practitioners will develop their own specific set of expertise there are many transferable skills. However, Advanced Practice training is a combination of work-based and academic experience so once training commences it would be difficult to move between specific scopes of practice. Upon completion it may be possible to transfer skills to other clinical areas although this would likely require a further period of training, portfolio building, supervised practice and verification within the new scope of practice.

To provide some guidance on timeline on the annual cycle –please see below. Please note this is only a guide to support and only includes key parts of the process – additional internal / recruitment processes are not included within the timeline.

Answer: A list of education providers that provide programmes that are either NHSE accredited, undergoing accreditation or have confirmed intention to accredit in the region is shown on the next page. Please note it is not a list of recommended education providers or module codes. This is not an exhaustive list of education providers offering Advanced Practice programmes.

If an individual wishes to study at an education provider not included in the list, then please discuss with your organisations Advanced Practice Lead and contact the Faculty for Advancing Practice on england.neyadvancedpractice@nhs.net to discuss. 

Answer: We would recommend checking with the education provider directly on their specific entry requirements, which can often be found on their website. A list of courses in the North East & Yorkshire with the corresponding weblink can be found below.

Entry requirements will likely consider current professional registration, significant post-registration experience of professional practice, evidence the employee is / will be operating in a role that will offer the opportunity to practice at an advanced level within their profession and evidence of professional and academic development, including any international qualifications and levels of English and Maths proficiency. See Appendix 1 for further information on apprenticeship application and enrolment requirements.

Answer: If a trainee already has the NMP qualification the training provider can sometimes APEL (Accreditation of Prior Experiential Learning) this aspect of the course. As this is at the discretion of the education provider the Trainee would need to discuss this and get agreement from their chosen education provider prior to starting the course. For those who don’t need it the training provider may provide a choice of module(s) that the student can undertake instead and agree this with their employer.

Answer: Some education providers will allow trainees to APEL (Accreditation of Prior Experiential Learning) in credits for course modules they have already undertaken. As this is at the discretion of the education provider the trainee would need to discuss this and get agreement from their chosen education provider prior to starting the course. 

Answer: NHSE is aiming to support the development of Advanced Practice roles as inclusively as is possible and we are offering a number of funding and support options for Advanced Practice trainees to ensure this inclusivity whilst quality assuring standards. The Clinical Salary Support for 2024/25 is based on £10,200 Per Annum (TBC), for those undertaking a full MSc.

For 2024/25 there are four possible funding options, with the apprenticeship route being the preferred route by NHSE.

• Advanced Practice Apprenticeship MSc (3 years)
• Non-Apprenticeship Advanced Practice MSc (3 years) * only in exceptional circumstances
• Advanced Practice MSc top-up (for staff already holding 60-120 credits towards MSc Advanced Practice – either apprenticeship or non-apprenticeship programmes)

Answer: NHS organisations such as Trusts, GP Practices (via their Training Hub or PCN) in the NHSE NEY region are invited to submit their applications for AP training for new learners. Funding is also available, on a proportionate basis to not-forprofit organisations providing NHS services such as Community Interest Companies & Hospices/Private Voluntary Independent Organisations. 

Answer: Once you have been identified by your organisation as appropriate for Advanced Practice training, the Advanced Practice Lead within your organisation/ Primary Care Training Hub will need to complete the NHSE NEY Annual Application form on your behalf. This form goes out yearly in December to seek expressions of interest for funding support for the next academic year.  

Answer: NHSE requires a single Advanced Practice Lead (or an individual responsible for Advanced Practice within an organisation or training hub) contact for each employer/organisation/training hub to submit applications. This person will act as the key liaison for all enquiries relating to the applications. This is to ensure there has been appropriate scrutiny applied to the application, that appropriate support will be provided by the employer and that the development of Advanced Practice in this area is part of the organisations workforce planning. Direct applications from individuals seeking funding will not be accepted. Only applications submitted through the organisations Advanced Practice lead or named contact will be considered. 

Answer: The Advanced Practice Lead is an individual who is responsible for developing and co-ordinating the advanced practice workforce within your employing organisation or Primary Care Training Hub. This person acts as the key liaison for all enquiries relating to advanced practice training and is the key point of contact for all NHSE advanced practice funding. 

If you are unsure of who the Advanced Practice Lead is within your organisation email NHSE on england.neyadvancedpractice@nhs.net   

Answer: NHSE will review all applications forms and the indicative demand. Funding will be confirmed where possible, depending on the allocated budget. It may not be possible to provide funding for all applications received. Applications must include as much detail as possible including preferred University and course.

In some instances, it may be necessary to contact the nominated supervisors directly where there may be ambiguity as to their exact scope of practice and to ensure optimal training requirements are met by all. It is important to note completion of an NHSE Application does not automatically confirm funding has been approved nor does it confirm a university place. 

Answer: For most trainees, self-funding a Masters level advanced practice programme is not recommended. Advanced practice roles can only make the desired impact on patient care when integrated and fully supported by organisations as a strategic workforce plan, rather than individuals self-funding their own development. In addition, the availability of places on advanced practice programmes is co-ordinated by universities in conjunction with NHSE and it cannot be guaranteed that places will be available for applicants who are self-funding. Some Advanced Practice courses have employment as a trainee in a specified scope of practice as a requirement for a place on the course.

Answer: The funding is offered on a named basis only for either: existing employees or those who have been appointed and will be commencing in post prior to the commencement of the course of study so can be clearly identified. 

The employer should provide assurance that there will be an Advanced Practice post on completion of training, demonstrated in the service/division establishment by way of a job description or job plan, to avoid investing in the upskilling of staff who cannot then put their advanced skills into practice. Organisations are asked to confirm if a job description or job plan is in place when submitting their expressions of interest.

Answer: A supervision fee of £2,600 (this is within the funding offer of the Clinical Salary Support of £10,200) is available to support trainees on an Advanced Practice pathway, to contribute to organisational costs of supporting a trainee Advanced Practitioner. Examples of how this funding can be used to support the trainee can be found in our Clinical Salary Support Guidance Document.  

A lack of support often results either in individuals withdrawing from the programme or seeking alternative employment; employers should consider whether they can fully support individuals before seeking funding for training. 

The supervision fee should be used to support the employer in relation to the associated costs in helping the employee achieve their qualification. A data validation exercise will take place between education providers and NHSE to confirm enrolled students.   

The expectations of employers in return for the supervision fee are:

• Principles of the NHSE Quality Framework should be in place for all learners.
• Sufficient study leave for university training. It is not acceptable for AP trainees to be taking unpaid or annual leave for dedicated training days.
• Supervision provided by an appropriately trained supervisor. The expectation is that Advanced Practice trainees will have 1 hour of supervision per week over the course of their training.
• Inclusion of postgraduate medical education department in discussion of supervision where appropriate to enable suitable job-planning.
• Sufficient work-based learning opportunities to gain clinical competence at an advanced level.
• Appropriate governance in place in line with the MultiProfessional Advanced Practice Framework.
• Learners should be encouraged to complete NETS survey.
• Educational Supervisors engage with the Faculty Supervision and Assessment Leads in undertaking quality assurance reviews of workplace supervision and training.
• The supervision fee must not be used for equipment or capital costs.

NHSE have developed a Minimum Standards for Workplace Supervision document which can be accessed on our website.

Answer: The National Education and Training Survey (NETS) is open to all health and care trainees and students across all clinical learning environments. The survey will offer Advanced Practice trainees the opportunity to provide feedback on their clinical placements, supervision, induction, support and training. 

It is managed by NHSE and is conducted once a year (November). The survey is anonymous, and the results are analysed by NHSE Quality teams to ensure all concerns are identified, reviewed and where appropriate, acted upon. The information forms part of NHSE’s approach to the monitoring of clinical placements and will be used to develop remedial action plans in partnership with education and placement providers. All trainees who receive NHSE funding are expected to complete the NETS survey.

Answer: The North East & Yorkshire Faculty of Advancing Practice is required to keep up to date records of current NHSE supported Advancing Practice Trainees to enable it to better support and keep track of who is currently on the programme and requires continuation of funding. It is therefore important that trainees inform us as soon as possible about any changes to their personal and / or training situation by filling in and submitting change of circumstances form. 

Changes of circumstances refers to changes such as:

Answer: The Centre for Advancing Practice is offering a Programme Accreditation process for Education Providers providing existing level 7 advanced practice MSc and apprenticeship programmes. Programmes must demonstrate they meet the capabilities across the 4-pillars, fully map ping to the Multi-professional framework for advanced clinical practice in England and the Standards for Education and Training set by NHSE. Each advanced practice programme is accredited separately rather than an institution being accredited as a whole. Programmes successfully accredited are listed on the Centre’s webpage for accredited programmes.

Further details of the accreditation process can be found at: https://advanced-practice.hee.nhs.uk/programme-accreditation/  

Answer: NHSE are only funding trainees enrolled on courses providing Advanced Practice MSc programmes that are either NHSE Centre accredited, undergoing the NHSE accreditation process or have confirmed their intention to undergo the NHSE accreditation process and are highly likely to be successful in achieving accreditation.

Answer: For programmes undergoing NHSE accreditation or have confirmed their intention to go through this process, the Faculty will fund these courses in good faith that the course will receive a good outcome. However, trainees must be aware that there is a risk that the course they are enrolled on may not achieve accreditation. Should the course not be accredited, the trainee will not automatically be eligible for NHSE recognition with a digital badge. In this event, NHSE will work with the trainee, employer and education provider to identify next steps and support.

The trainee advanced practitioner will be supported by a number of different supervisors over the course of their training. This is due to the breadth of development necessary across all four pillars of advanced practice. For this reason, an integrated approach to workplace supervision is necessary, and the trainee will be supported by a number of different supervisors, for example but not exclusive:

Education Provider Course Supervisor/Personal Tutor is provided by the Education Provider/HEI. They provide individual support to trainees to progress and complete all the requirements of the AP Level 7 apprenticeship/MSc programme the trainee has enrolled in. It is best practice that the Education Provider Course Supervisor/Personal tutor will have regular engagement with each trainee’s work-based supervisors through Tripartite reviews. 

Line Managers/AP Leads have responsibility for directly managing individual employees. It provides the opportunity for performance review, setting priorities/objectives in line with the organisation’s objectives and service needs and identifying training and continuing development needs.

Associate Workplace Supervisors Associate Workplace Supervisors are supervisors who work collaboratively with the co-ordinating education supervisor to guide trainee development. Associate workplace supervisor has expert knowledge and capability within the area of practice they are supervising. The trainee advanced practitioner can expect to work with a variety of associate workplace supervisors, each matched to support the development of area-specific knowledge, skills and expertise of an advanced practice capability and/or competence.

NHSE have also developed the Advanced Practice Supervisor Capabilities. This guidance sets out learning and development principles for practitioners who are supervising colleagues as they progress to advanced level practice. It should be considered in conjunction with Centre for Advancing Practice supervision guidance and minimum standards.

Answer: From time to time, some trainees may have to pause their study for unavoidable events such as long-term sickness or significant personal reasons. Higher Education Institutes (HEI) can support with this process and will have their own policy and support structures. Where a student pauses their studies but will return to complete and have indicated the proposed timescales to the education provider, this is called ‘stepping off’.

On returning to study, NHSE will review funding on a case-bycase basis and is dependent on whether the student can complete the course within the timescales available on their return. 

Where a student is not returning to study, NHSE will discontinue the funding at the point they leave the programme. 

Coordinating educational supervisor/line manager: To work with the trainee and HEI to evaluate and to determine the most appropriate solution.

Trainee: To inform and work with the employer and HEI to look for an appropriate solution. 

HEI: To guide trainee and employer on options available and help to source the most appropriate solution. 

If a pause to studies is agreed then the employer, NHSE and HEI need to be informed.

To inform NHSE of a pause in study please contact the faculty via email: england.neyadvancedpractice@nhs.net

Answer: Training for a master’s level qualification alongside workplace demands can be challenging. It will bring both positive and negative experiences and it is not uncommon for trainees to feel overwhelmed by exams, coursework, or deadlines whilst juggling clinical placements and personal life, as they transition into the role and a new level of practice.

However, for some, they may decide the programme of academic study and work placed training is not for them and consider leaving the role.  

Initially the trainee would be expected to discuss any concerns with their coordinating educational supervisor and line manager as a solution may be possible. The supervisor, line manager and trainee should discuss options available and if possible, agree an action plan to manage challenges enabling the trainee to continue the programme. 

If they feel unable to raise the issue with their coordinating educational supervisor, associate supervisor, or line manager they should contact their organisations Advanced Practice Lead for support and advice. In addition to this, support and advice is available from the personal tutors at the HEI and speciality advisors within NHSE.

Coordinating educational supervisor/line manager: Work with trainee to listen to their challenges and develop an agreed individualised action plan to support development. This will require regular review. 

HEI: To work with trainee and employer to consider options and develop an action plan. 

Following discussions if the trainee still feels they want to leave the course they will need to inform their employer and education provider of their decision.

To inform NHSE of the decision please contact via email at:  england.neyadvancedpractice@nhs.net.                 Funding will be discontinued at the point they leave the  programme. 

Answer: For short periods of sickness (under 4 weeks) the trainee should be directed to follow their employer’s sickness and absence policy. They will need to inform their Coordinating Educational Supervisor, Associate Supervisor, and education provider so a plan can be made to ensure any missed learning is completed. 

For long term sickness (over 4 weeks). The trainee may need to pause their academic studies. It is important that the employer, trainee, and HEI remain in contact to determine an appropriate time to re-commence.

Coordinating educational supervisor/line manager: If less than 4 weeks sickness: support trainee to follow their local sickness and absence policy. If greater than 4 weeks: follow local policy and work with HEI to develop plan for continuing academic studies as appropriate and in line with the HEI policies. 

If trainee does need to pause their academic studies, NHSE needs to be informed via email at: england.neyadvancedpractice@nhs.net

Answer: The training period is usually based on a full-time contract of employment (37.5 hours). Each organisation will have its own requirements on minimum hours required to work to meet the training outcomes and objectives. The apprenticeship route guidelines suggest at least 30 hours per week and if hours are reduced the programme may need to be extended. Trainees will need to negotiate hours with their employer.

Decisions regarding part time funding from NHSE is made on a case-by-case basis.

Coordinating educational supervisor/line manager: Explore and provide options for reduced hours. Consider liaising with HEI if any change required to academic timetabling.

Trainee: Discuss with coordinating educational supervisor, line manager and HEI available options in line with your academic pathway.

HEI: Work with trainee and employer to determine most appropriate solution and inform of options. 

The Employer, HEI and NHSE need to be informed of any changes to hours or academic studies. NHSE can be contacted via email at:  england.neyadvancedpractice@nhs.net

Answer: Funding is not solely trainee based and is not transferrable between employers. Funding is allocated to employer on provision of a training advanced practitioner post. If the trainee is moving to a similar post in another organisation during an academic year, the trainee will be required to inform the NE&Y Faculty Team as soon as possible by contacting england.neyadvancedpractice@nhs.net

New Employer: New Employer must complete NEY Application form to demonstrate their commitment to the trainee role and to ensure transfer of the clinical salary support.

Coordinating educational supervisor/line manager: Inform HEI and NHSE that trainee has changed employers and left the organisation.

Trainee: if moving to another trainee advanced practitioner post in another organisation, inform HEI and NHSE of change of employer. Please be aware, funding is only available for trainee posts. If the new role is not a trainee post, ongoing academic studies will need to be self-funded or supported by the new organisation.

HEI: Explore with trainee and new employer the options available. If leaving the course, inform NHSE.

NHSE will discontinue the funding at the point they leave their previous employer.

If a trainee discontinues academic studies, NHSE needs to be informed via email at: england.neyadvancedpractice@nhs.net

Answer: Where there are concerns around performance and competence, the educational supervisor should be alerted to these and instigate actions to support, and address identified development areas whilst maintaining patient safety.

There may be occasions where the conduct or performance of a trainee is not achieving at expected level despite intervention and therefore these concerns should be escalated as per local capability policy. The employer must ensure that mechanisms are in place to support the training of trainees, and to manage employment-related issues in an open and supportive way.

Coordinating educational supervisor/line manager: Work with trainee to establish a learning plan to support the gaps identified within achievable time frames and review regularly.

Trainee: Work with educational supervisor to identify gaps and concerns and develop a learning plan to support your development.

HEI: Work with trainee and employer to support with learning plan and identify any additional assistance that could be provided.

Answer: All employees should be treated with dignity and respect at work. Bullying and harassment is behaviour that makes someone feel intimidated or offended. Harassment is unlawful under the Equality Act (2010).  Employers have a duty of care to provide a safe working environment for all their employees. Bullying and harassment in the workplace can involve arguments and rudeness, but it can also be more subtle.

Examples of bullying and harassment include:

• excluding and ignoring people and their contribution
• overloading people with work
• spreading malicious rumours
• unfair treatment
• picking on or regularly undermining someone
• denying someone’s training or promotion opportunities.

Coordinating educational supervisor/line manager: Support the trainee to follow the local policy and guidance on bullying and harassment. Inform of freedom to speak up guardians, HR and advanced practice leads as other resources to talk to.

Trainee: If you are experiencing bully, harassment or feeling psychologically unsafe this is serious. Reach out to support networks to raise your experience and to get help. There will be a local guidance to support you. Talk to your coordinating educational supervisor or line manager. If unable to go to them, consider your advanced practice lead, HR, or freedom to speak up guardian. Many organisations also provide mental health first aiders or health and wellbeing representatives. Your workplace may have an employee assistance programme (EAP) you can access.

HEI: Support and guide trainee to employer resources to help them seek help. 

If after following the bullying and harassment policy within your organisation the issue is not resolved, trainees can contact NHSE through the following email address: england.neyadvancedpractice@nhs.net

Answer: During training the trainee is expected to work under the direct and more latterly indirect supervision of their supervisors and medical team. The clinical environment is diverse and can be high pressured, with many unique personalities. This means that miscommunications and disputes may occur. Most of the time these can be resolved informally with honest and respectful communication.

Coordinating educational supervisor/line manager: If the difficulty is with an associate supervisor, then the coordinating education supervisor is best placed to support and resolve any conflicts, this may include finding alternative associate supervision. If the difficulty is the educational supervisor, then the line manager will need to be involved and potentially source an alternative educational supervisor.

Trainee: The trainee should discuss challenges with their supervisor or line manager for support, guidance, and to escalate where needed. If the trainee does not feel comfortable raising this with the supervisor or line manager, they should speak to someone else such as an advanced practice lead, HR advisor or freedom to speak up guardian.

HEI: Offer support and guidance and encourage the trainee to speak up. If appropriate contact the line manager to highlight any concerns.

The NHSE Advancing Practice Faculty can also provide support and guidance.

In the event of a change in coordinating educational supervisor, please inform NHSE via england.neyadvancedpractice@nhs.net

Answer: Yes. There may be instances where a change of is required, for example, resignation of a supervisor. Please email us at england.neyadvancedpractice@nhs.net to inform us of any change in supervisors. 

Coordinating educational supervisor/line manager: Coordinating educational supervisor should inform the line manager so alternative supervisor can be appointed as soon as possible. 

Trainee: Liaise with line manager to ensure the new supervisor is suitable and able to meet the trainees needs.

HEI: Ensure trainee has made their line manager aware of possible risk to supervision. ensure new supervisor is aware of their role in relation to the trainee’s academic pathway.

Answer: Don’t panic – this can feel overwhelming, but it is not uncommon and there will be options available to move forwards based on individual circumstances. A second attempt is usually granted in the case of failing first time. If there was illness or unexpected event at the time of assessment then exceptional circumstances can be applied for.  

Coordinating educational supervisor/line manager: Work with the trainee to review the need for additional assistance to meet the requirements of the academic module. Devise a coordinated action plan with the HEI to support the trainee.  Trainee: The HEI will have guidance and support mechanisms available which trainees are strongly advised to access and utilise. It is very important to keep in contact with the employer and HEI.

HEI: Guide the trainee through the HEI process for failing an academic module. Consider meeting with the trainee, coordinating supervisor, and line manager to develop an action plan that enables successful completion of the module.  

If the trainee is unsuccessful in completing a module then it may have implications for funding and employment contracts. However, each situation is assessed on a case-by-case basis. We would encourage you contact your ICB ACP Lead (where they exist) or the regional team as your first point of contact for any queries/issues, via the following email: england.neyadvancedpractice@nhs.net

Answer: High quality, evidence-based training and leaning is essential to the development of skilled and competent practitioners. Concerns should be raised as soon as possible with the employer, HEI and, if appropriate, NHSE.  

Coordinating Educational Supervisor/line manager: If the trainee raises concerns regarding the HEI programme then this should be discussed with the HEI programme lead.

Trainee: If there is a concern with regards to the HEI programme, the trainee should raise the issue with their coordinating educational supervisor. If there are concerns around the education and support from their coordinating educational supervisor, the trainee should approach their advance practice lead, clinical lead, or line manager.

Trainees are encouraged to fill in the NHSE National Education and Training Survey (NETS) which is open to health and care trainees and students across clinical learning environments. The survey offers Advanced Practice trainees the opportunity to provide anonymous feedback about their clinical placements, supervision, induction, support, and training.  

HEI: Review and consider any concerns raised by employer and trainee and investigate and action appropriately through the HEI policy and guidance.

If on-going concerns with quality of education the coordinating educational supervisor or advanced practice lead can contact your ICB ACP Lead or the regional team following email address: england.neyadvancedpractice@nhs.net

Answer: All universities have formal complaints and disciplinary procedures for reporting cases of harassment and bullying and students are strongly encouraged to report any incidents.

Coordinating Educational Supervisor/line manager: Support the trainee with managing the situation. Offer support, guidance and advice and escalate to the advanced practice lead. where needed. 

Trainee: Discuss with your coordinating educational supervisor and line manager about your experiences. The HEI will have a policy regarding bullying and harassment including how to make complaints and who to go to for help. You may want to speak to someone at the education provider informally first, this could be your Education Provider Course Supervisor, a campus counsellor or student union representative. They will be able to follow the HEI policy and offer advice and guidance on the informal and formal actions that can be taken to resolve the issue.  HEI: Speak with the trainee to establish the concerns and consider if they can be addressed and resolved informally. If unable to resolve informally, support the trainee to access and follow the bully and harassment policy. Direct to campus counsellor or student union representative if appropriate.

If after following the HEI bullying and harassment policy the issue is not resolved, trainees can contact their local ICB ACP lead or the regional team through the following email address: england.neyadvancedpractice@nhs.net

Answer: You can raise any concern about risk, malpractice, or wrongdoing you think is harming the service. Just a few examples of this might include (but are by no means restricted to):

• unsafe patient care
• unsafe working conditions
• inadequate induction or training for staff
• lack of, or poor, response to a reported patient safety incident
• suspicions of fraud (which can also be reported to your local counter fraud team)
• bullying and harassment (across a team or organisation rather than individual instances of bullying)

For further examples, please see the Health Education England video. Remember that if you are a healthcare professional you may have a professional duty to report a concern. If in doubt, please raise it. Don’t wait for proof, we would like you to raise the matter while it is still a concern. It doesn’t matter if you turn out to be mistaken as long as you are genuinely troubled.

Answer: Anyone who works (or has worked) in the NHS, or for an independent organisation that provides NHS services can raise concerns. This includes agency workers, temporary workers, students, volunteers, and governors.

Answer: In many circumstances the easiest way to get your concern resolved will be to raise it formally or informally with your line manager, lead clinician or tutor.  If raising it with your line manager lead clinician or tutor does not resolve matters, or you do not feel able to raise it with them, you can contact one of the following people

• Your organisations Freedom to Speak Up Guardian
• Your organisations HR team Your organisations risk management team
• Your organisations counter fraud team.
• Your Trade union representative.

All these people have been trained in receiving concerns and will give you information about where you can go for more support.

Answer: Freedom to Speak Up Guardians support workers to speak up when they feel that they are unable to do so by other routes. They ensure that people who speak up are thanked, that the issues they raise are responded to, and make sure that the person speaking up receives feedback on the actions taken.

• Watch a Health Education England video about the role of Freedom to Speak Up Guardian
• Find out more from the National Freedom to Speak Up Guardian’s Office

Answer: Your organisations Freedom to Speak Up guardian should be listed on your organisation’s intranet. Alternatively you can use this map to search for your Freedom to Speak Up Guardian