Evidence map›Paper›PMID 34353799›Full record

ArticleBMJ open2021

Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review.

Catrin Evans, Brenda Poku, Ruth Pearce, Jeanette Eldridge, Paul Hendrick, Roger Knaggs, Holly Blake, Gowsika Yogeswaran, John McLuskey, Philippa Tomczak and 4 more

Abstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. What Advanced Practice Roles Are Dietitians Undertaking? A Mixed Methods Systematic Review.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
    Pooled it
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  4. Outcomes of a novel multidisciplinary approach to delivering sacral neuromodulation services away from the operating theatre.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Catrin EvansSchool of Health Sciences, University of Nottingham, Nottingham, UK catrin.evans@nottingham.ac.uk.ORCID 0000-0002-5338-2191
Brenda PokuSchool of Sociology and Social Policy, University of Nottingham, Nottingham, UK.
Ruth PearceSchool of Education, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Jeanette EldridgeFaculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
Paul HendrickSchool of Health Sciences, University of Nottingham, Nottingham, UK.
Roger KnaggsSchool of Pharmacy, University of Nottingham, Nottingham, UK.
Holly BlakeSchool of Health Sciences, University of Nottingham, Nottingham, UK.
Gowsika YogeswaranFaculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
John McLuskeySchool of Health Sciences, University of Nottingham, Nottingham, UK.
Philippa TomczakSchool of Sociology and Social Policy, University of Nottingham, Nottingham, UK.
Ruaridh ThowEmergency Department, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Peter HarrisHealth Education England East Midlands, Leicester, UK.
Joy ConwayCollege of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.ORCID 0000-0001-6464-1526
Richard CollierCentre for Advancing Practice, Health Education England, Leeds, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIn response to demographic and health system pressures, the development of non-medical advanced clinical practice (ACP) roles is a key component of National Health Service workforce transformation policy in the UK. This review was undertaken to establish a baseline of evidence on ACP roles and their outcomes, impacts and implementation challenges across the UK.

designA scoping review was undertaken following JBI methodological guidance.

methods13 online databases (Medline, CINAHL, ASSIA, Embase, HMIC, AMED, Amber, OT seeker, PsycINFO, PEDro, SportDiscus, Osteopathic Research and PenNutrition) and grey literature sources were searched from 2005 to 2020. Data extraction, charting and summary was guided by the PEPPA-Plus framework. The review was undertaken by a multi-professional team that included an expert lay representative.

results191 papers met the inclusion criteria (any type of UK evidence, any sector/setting and any profession meeting the Health Education England definition of ACP). Most papers were small-scale descriptive studies, service evaluations or audits. The papers reported mainly on clinical aspects of the ACP role. Most papers related to nursing, pharmacy, physiotherapy and radiography roles and these were referred to by a plethora of different titles. ACP roles were reported to be achieving beneficial impacts across a range of clinical and health system outcomes. They were highly acceptable to patients and staff. No significant adverse events were reported. There was a lack of cost-effectiveness evidence. Implementation challenges included a lack of role clarity and an ambivalent role identity, lack of mentorship, lack of continuing professional development and an unclear career pathway.

conclusionThis review suggests a need for educational and role standardisation and a supported career pathway for advanced clinical practitioners (ACPs) in the UK. Future research should: (i) adopt more robust study designs, (ii) investigate the full scope of the ACP role and (iii) include a wider range of professions and sectors.

Indexed as

MedicineState MedicineEnglandHealth EducationHumansUnited Kingdomhealth policyhuman resource managementorganisation of health services

Identifiers

PMID34353799
PMCPMC8344309

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.