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Most Clinical Nurse Specialists (CNSs) work at an Advanced Practitioner level of practice (Level 7). Advanced Clinical Nurse Specialists have a wider scope of practice than CNSs at level 6 and will manage greater complexity (CNOD 2021).
Across NHSGGC there are over 300 nurses working at this level of practice in ACNS roles. They work in a wide variety of areas including:
Breast Care Nursing, Burns, Oncology, Cardiology, Mental health, Urology, Dermatology, Diabetes, ENT, Emergency Medicine, Epilepsy, Gastroenterology, Haematology, Multiple Sclerosis, Neurology, Nutrition, Gerontology, Ophthalmology, Orthopaedics, Pain, Palliative Care, Parkinson’s Disease, Plastic Surgery, Renal, Respiratory, Rheumatology, Sexual Health, Tissue Viability, and Vascular. The recently published CNO’s Transforming Roles Paper 8 provides an updated definition. Transforming Nursing, Midwifery And Health Profession (NMaHP) roles: review of Clinical Nurse Specialist and Nurse Practitioner roles within Scotland - gov.scot (www.gov.scot)
“The Advanced Clinical Nurse Specialist (ACNS) is an experienced and highly educated registered nurse working within a specific field of practice. They manage, deliver, advise on and support the care for people within a specialist area. Educated to at least Postgraduate Diploma level in an appropriate subject, they are assessed as clinically competent in their defined specialty. They have a wider scope of practice than the clinical nurse specialist at Level 6 and will manage greater complexity.
As a clinical leader they have the autonomy to act and accept responsibility and accountability for their actions, acting as an expert advisor or resource for others. This includes specialist assessment and treatment using a holistic approach to managing complex, multidimensional situations. This may require management of care over a prolonged period of time. They have the authority to refer, admit and discharge within appropriate clinical areas. Their practice is characterised by a high level of clinical decision making based on in-depth, expert knowledge in their specialism of care delivery.
Working as part of the multidisciplinary team, they can work in or across all settings, including non-clinical areas, dependent on their area of expertise.” (CNOD 2021).
ACNSs train in post for the role. Trainee ACNSs are usually CNSs before they embark on deepening and broadening their knowledge for an ACNS role. Trainee ACNSs are increasingly being formally employed in training posts (using Annex 21 from Agenda for Change) while they learn. Trainee ACNSs are supervised whilst they learn additional skills and will also undertake appropriate post-registration education at postgraduate level at university to support their learning. Trainee ACNSs will build a portfolio of evidence to demonstrate they are competent to practice which is formally assessed at the end of their training.
Transforming Roles Paper 8 sets out the core competencies for any ACNS. To these additional specialist competencies are added. The competency framework needs to be completed before a new ACNS can be regarded as appropriately prepared.
CNSs/NPs are paid at a minimum of Band 7
Not all Band 7 CNS posts will be Advanced CNS posts. Some are lead CNS posts where the Band 7 is for additional managerial and leadership responsibility.
Where the Job Description meets the criteria for an ACNS (as set out in Transforming Roles Paper 8), the post can be recognised as an ACNS post. The process and application form can be downloaded here (add). Nurses who are already in these posts will have already met the Knowledge, Training and Experience required for the role and will be annotated as ACNSs.
ACNSs who don’t already hold a masters level qualification can apply for funding to undertake a Work Based Learning contract to build their portfolio and evidence the learning they have undertaken for the role. An application form can be downloaded here https://forms.office.com/r/dHwMkUiBZq. Closing date 1st December 2021