Welcome to the new Centre Lead for Programme Accreditation, Natalie Ruscoe

Natalie has spent the last fifteen years working in advanced practice in clinical and academic roles, she recently joined us to lead the Centre for Advancing Practice work around programme accreditation.

I am a nurse by background, qualified for over 20 years. Before joining the Centre team, I worked clinically as an advanced practitioner in an Emergency Department. Remaining in practice part time, in 2016 I moved into an academic role as a lecturer, and covered roles that included the interim director of postgraduate programmes and the award lead for ACP Masters programmes.

Looking back, I didn’t think I’d become an advanced practitioner, I initially thought I’d follow the traditional route and become head of nursing or something similar, that seemed to be the normal pathway at the time. This changed when I witnessed an advanced practitioner at work, I saw the care they gave to a patient; I saw how they were able to complete a full episode of care from admission to discharge, and I wanted to know ‘how do I do that?’

There have been significant changes in my advanced practice over the years, my earlier role, as a night nurse practitioner is poles apart from what I’ve practiced more recently. Advanced practice is much more recognised now, it has gained a lot of momentum in the last decade, responding to service demand, multi-professional team working, and an appreciation that people are able to work safely beyond traditional role boundaries.

As autonomous practitioners, we’re able to see, assess, examine, order investigations, treat the patients and refer appropriately. The impact on the patient is amazing, it can positively impact on patient experience and the patient journey, which may be shorter and less convoluted.

The number of practitioners has also grown too, which has helped. Advanced practice is a great option for practitioners to progress their career enabling experienced professionals to stay in clinical roles and opening opportunities for people to develop without leaving front line care.

Role of the Centre

The Centre has several core functions, programme accreditation is one of them. My role is to support and develop a high-quality programme accreditation process and oversee the accreditation of programmes in England. I work with reviewers, regions, stakeholders, and education providers. Ultimately, to make the accreditation process as good as it can be.  

The Centre is quite new, so are the systems and processes, and for me, this is what is exciting (and scary) about this role, building something from the ground up, be part of the bigger picture and influence and develop advanced practice.

For years, we’ve been talking about advanced practice, there have been local frameworks out there for a while before the Multi-professional Framework for Advancing Practice was launched in 2017. I was involved in contributing some case studies to the Midlands Region framework and I became interested in how it all worked at a strategic level and how the decisions we make need to be standardised across all regions to offer consistency. Many of the changes we have been talking about for a long time are now being realised through the work of the Centre.

Programme accreditation is about consistent quality assurance across all education providers. The Centre works with independent reviewers to ensure programmes meet the standards set in the Multi-professional Framework for Advanced Practice and the Standards for Education and Training.

Although there is variation in what advanced practice looks like, we want to be assured that the delivery of that education is to a certain standard and consistent across all providers. Not every programme has to be identical, but is it safe and effective, does it put the patient at the heart of what we do, and does it deliver a high quality academic and clinical programme?

This is the first step to develop a national directory that is inclusive of practitioners that have undertaken advanced level programmes within England. We’re looking for consistency across advanced practice, what is an advanced practitioner, what are the requirements? We’re only just getting started but it is a good starting point.

How to explain advanced practice to people who don’t know about them?

In my words, advanced practitioners are:

“Non-medical workforce who are working at the top end of their license, pushing the boundaries of their scope of practice. They are experienced practitioners, trained to be able to undertake additional responsibilities safely, such as assessment, examination, diagnosis, treatment, and referrals. These extend beyond the traditional boundaries of their role.”

As an advanced practitioner, we contribute to more than just patient care. Yes, there is the clinical aspect, which is essential, but advanced practice works across four pillars, leadership and management, education, research and clinical. We’re senior practitioners who contribute to service delivery and leadership, you’re making genuine differences to how services are delivered, to patient targets, waiting lists, quality of life. The work I’ve seen advanced practitioners do as part of their master’s dissertation makes a huge difference to workforce transformation. It isn’t just about the clinical component.

Next ten years?

Advanced practice is a brilliant career option, but we should think long-term about how we keep clinicians in practice. How we develop people past initial development and training, into consultant posts and how we engage practitioners into things like research and grow the priority beyond the clinical pillar.

I’d like to see more advanced practice representation at senior level, so our voice is part of strategic decision making and service redesign.

I don’t envisage a day where I don’t work in advanced practice anymore, I’ve lived and breathed it for well over a decade and it’s what gets me up in the morning. Doing a job that I love, in an area that I love.