Introducing the role of the advanced clinical practitioner in haematology and oncology

Abstract

Background: In 2015 the haematology and oncology directorate introduced the role of the Advanced Clinical Practitioner (ACP). A nurse practitioner with an extensive background within the speciality was tasked with setting up the service. A further trainee ACP post was created; both posts were fixed term posts for 2 years. Methods: 1) Gain the necessary academic qualifications to undertake the role 2) Gain competence in clinical procedures; some of which previously undertaken by SpRs 3) Support off shore haematology clinic in the Channel Islands as well as set up telephone clinics in Birmingham 4) Ensure protocols in place to adhere to clinical governance framework 5) Audit practice and prove 'worth of role' to secure substantive funding Both ACPs completed the PG Cert in Advanced clinical practice at Warwick medical school and as they had both already obtained MSc programmes and were qualified non-medical prescribers this was the only academic work required. Procedure competency was required in order to undertake: Lumbar punctures Bone Marrow Biopsies PICC line insertions and Hickman line removals. Competency in prescribing chemotherapy and blood products Both ACPs were required to maintain chemotherapy administration and apheresis competencies. The trainee ACP focussed primarily on setting up haematology clinics whilst the senior ACP set up clinics in oncology in Birmingham and haematology in the Channel Islands. Results: Within 12 months of setting up the service the trainee ACP achieved all of her competencies and both posts have been made substantive. Both ACPs are undertaking procedures autonomously, running clinics, prescribing chemotherapy, reviewing patients presenting unwell and function at an advanced level within the MDT. Conclusions: Not without its challenges, yet hugely rewarding; plans are already afoot to learn further procedures including the insertion of arm portacaths, perform skin biopsies and paracentesis. Advancing the role of the ANP in cancer nursing has proven to be fundamental in supporting patients throughout the illness trajectory and well received by both clinicians and patients alike.