A national network for Respiratory Advanced Clinical Practitioners

Wednesday, June 2, 2021

We spoke with Andy Lee, an Advanced Clinical Practitioner working in Respiratory at the Nottingham University Hospitals NHS Trust, about a new network for ACPs he has co-founded.

For those not yet familiar with their work, could you briefly spell what a respiratory ACP does?  

The role of a respiratory ACP varies depending on which Trust you work for and the current needs of the department or specialty. The wide variety of roles that you can undertake is what makes becoming an ACP so interesting. In Nottingham we have a team of 8 qualified and 3 trainee ACPs from varying professional backgrounds covering 2 separate inpatient areas (an admissions unit and a respiratory support unit). Recently we have started to undertake the review of routine referrals from other specialties. The referrals service has been undertaken by the ACP team due to the permanency of the workforce and enables us to deliver the expertise gained from our professional backgrounds to add value and support the medical teams.

Do you have any example of ACPs work elsewhere?

One of the ACPs in Harrogate, Kirsty Laing, has been able to set up and streamline the process of a pleural clinic for patients and she performs pleural aspirations and chest drain insertions independently. These are all roles that nurses traditionally would not have had the opportunities to undertake in the past. Advanced practice allows us to use the skills we already possess to deliver a comprehensive assessment and effective treatment plans for patients.

At Wythenshawe hospital, Rebecca Chamoto and her team have set up a Respiratory ambulatory care unit taking referrals from ED and primary care which aim to improve ED work flow and support admission avoidance. This unit enables them to support the community respiratory team with reviews on the unit or provide advice on management. Their role is quite varied and has ACPs with sub-speciality interests being supported in different aspects of respiratory disease.

In Leicester, Padma Parthasarathy and her colleagues provide cover in the same day emergency clinic.  They independently assess, diagnose, treat and discharge or refer patients. This has reduced pressure on the admission unit diverting appropriate patients once they have been triaged. During the COVID-19 pandemic the Glenfield respiratory ACP team also played a key role in the creation and staffing of an acute respiratory response team, providing care for patients needing a higher level of respiratory support.

Kathryn Thomas in Derby is actively involved with medical education, working 2 days a week in the University of Nottingham Medical School.  As well as playing an active role in the education of pre and post registration nurses.

Emma Toplis is part of a multidisciplinary quality improvement faculty within the respiratory department, whose focus is to increase knowledge and understanding of QI methodology through training and leadership. They also support and engage staff with QI projects and provide guidance on publication of this work in journals and at conferences. Emma is due to present the QI project she is involved in on improving the management of tobacco addiction at an International conference this year.

Is there a national respiratory ACP association or network?

There are many ACP associations but none are directly associated with respiratory, other than the one that we are going to create. Health Education England has recently set up the Centre for Advanced Practice to oversee the workforce transformation and education of advanced level practice.

There is also work ongoing behind the scenes currently between HEE and the RCP with relevant stakeholders from respiratory advanced practice in order to create a capability framework for specialty specific accreditation.

When did you decide that respiratory ACPs needed their own network?

We set up a regional network for the East Midlands 2 years ago as we found that there was a good number of ACPs working in respiratory medicine. This allowed us to meet up, share best practice and we held 2 study days aimed at delivering shared teaching. Unfortunately, COVID had slowed the progression down somewhat which is when we came up with the idea of creating a national network for respiratory advanced practitioners.

The work for this began around 4 months ago and we have been trying to identify as many people as possible from around the country to join and get involved. At present there are 7 of us who are pushing forward with the creation of this network with ACPs based in Nottingham, Derby, Leicester, Harrogate and Manchester.

How is your respiratory ACPs network going to benefit its members?

We are hoping that once the network is established members will be able to call upon the collective experience to share best practice, share and develop policies and procedures and help newer teams establish themselves within their respective departments. We are also aiming to become a leading voice for respiratory advanced practice by becoming involved with established national partners to help shape the future for advanced practitioners specialising in respiratory medicine. Part of this will hopefully be to ensure that parity is reached and there is a set minimum standard that you can expect, irrespective of where you work within the UK.

What have you done so far?

So far we have established the base roles for the operation of the network and have begun trying to reach as many people as possible. We are in the process of creating a website for our members and are looking at hosting our first conference in 2022. We will hopefully be able to offer our members regular education events and some other incentives.

Edit October 2021 - The ACP Network Website is now live. 

How can people get in touch with the network?

The network is open to all professions that are working at an advanced or consultant level practice within respiratory medicine. Whether you are a trainee or qualified ACP, Nurse Consultant or Advanced Specialist Nurse, Physiotherapist, Paramedic or other AHP we want to hear from you. Advanced Practice is a level of practice that is open to all Nurses and AHPs, and if you are thinking about a career in respiratory advanced practice and would like some friendly advice on how to achieve this then we are more than happy to help.

Do you see a particular role for the National respiratory ACP network in the future?

We would like to see the network grow and be shaped by its members and partners, delivering education and support to help address the shortages in the respiratory workforce. Professionals working at advanced level in respiratory medicine are uniquely placed to deliver care to patients in roles that may not previously been considered for nurses and AHPs. We believe that ACPs compliment and support the workforce adding to permanency and professional expertise to what is now seen as a blended medical workforce working alongside nurses, doctors, physiotherapists, physiologists and more to ensure that respiratory patients receive a high level of care. ACPs provide opportunities to support leadership, education and development for the existing workforce and can play in leading role in research and innovation supporting clinical academic career opportunities. By gaining as many members as possible we would then be ideally placed to shape the future for advanced practice and ensure that respiratory have a voice in the national agenda.