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Journal cover: Clinical Governance: An International Journal

Clinical Governance: An International Journal

ISSN: 1477-7274
Previously published as: British Journal of Clinical Governance

Online from: 2003

Subject Area: Health Care Management/Healthcare

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Addressing workforce capacity and safety issues for new nurse-led services through competency modelling

Document Information:
Title:Addressing workforce capacity and safety issues for new nurse-led services through competency modelling
Author(s):John Howard, (School of Health, University of Central Lancashire, Preston, UK), Katie Barnes, (Kids Health Matters, Salford, UK)
Citation:John Howard, Katie Barnes, (2012) "Addressing workforce capacity and safety issues for new nurse-led services through competency modelling", Clinical Governance: An International Journal, Vol. 17 Iss: 4, pp.317 - 331
Keywords:Health services, Nursing, Organization, Training, United Kingdom
Article type:Conceptual paper
DOI:10.1108/14777271211273206 (Permanent URL)
Publisher:Emerald Group Publishing Limited

Purpose – The purpose of this paper is to show how competency models can be used to govern the increased autonomy of advanced practitioners in nursing, and to assist in workforce development.

Design/methodology/approach – The study shows how competency frameworks for advanced nurse practitioners (ANPs) have evolved in the UK. It compares the current thinking in the UK to the latest competency models from the USA. The article uses the authors' own adaptation of Benner's novice-to-expert framework to derive a framework from the current approaches. The authors then demonstrate how the resulting framework can be deployed to target development of new ANPs to address workforce development and governance issues over ensuring the right skill mix for safe autonomous practice. Finally, they argue for registration of advanced practitioners as a distinct professional group to address medico-legal concerns over increased autonomy.

Findings – The study shows that there are currently limited numbers of ANPs constraining the development of new nurse-led services, for example paediatrics. The study argues that current developments in the UK are unhelpful to the development of new nurse-led initiatives that could flourish under the new commissioning arrangements. The study demonstrates how an enhanced framework can be used to target potential new ANPs for bespoke training, to assure that existing role holders have the correct level of competency for safe autonomous practice, and could form the basis of professional registration of advanced practitioners.

Research limitations/implications – The small numbers of existing ANPs and the early stage of development of nurse-led services limit the opportunities for evaluation.

Practical implications – This study suggests that competency modelling can contribute to the effectiveness of ANP education, help to address workforce planning issues and provide re-assurance for commissioners in terms of governance and safety.

Originality/value – Competency modelling for ANPs in the UK is in its infancy, but the lack of a safe and competent workforce is a barrier to innovation for commissioners of services.

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