NSP-12: The impact of an advanced clinical practitioner role in myeloma on service at a tertiary haematology centre: an exploratory case study analysis

Introduction: Although well established in other countries, the advanced clinical practitioner (ACP) role remains a relatively new role in the UK (Mann et al 2023). The variation in role was further explored in a recent national review, recommending it become a regulated level of practice within the UK (The Nursing and Midwifery Council 2024).

A key benefit of the role is that of enhancing capacity and capability within multiprofessional teams (Evans et al 2020). A high level of critical thinking and the ability to make complex, safe, autonomous decisions is essential (Woodman 2022). In order to do this it is important that the ACP is working to their full potential within their scope of practice (Hook and Walker 2020).

In 2019, the first trainee ACP post was implemented locally in one of the largest haematological centres in the UK. This study aimed to review the impact of the role on patient flow and capacity whilst understanding the perceptions of clinical and non-clinical roles within the myeloma specialism around the role of the ACP.

Methods: A single centre study collected data over a period of 12 months quantifying outpatient appointments conducted by the ACP. In addition an electronic questionnaire was developed. Questions were aimed at identifying frequency of contact with the ACP, understanding of the role and perceptions of the impact of the role on service delivery. Target participant groups included Consultants, Registrars, Physician Associates, Clinical Nurse Specialists, ward nurses and administrative staff. Data was analysed using thematic analysis.

Results: The ACP reviewed a total of 615 patients in the outpatient setting over a 12 month period, 100 of which were new referrals with suspected myeloma or MGUS.

16 survey responses were received (40% completion rate). Responses were categorised via thematic analysis in to 7 identified themes – support, continuity, safety, enhanced capacity, clinical skills, service development and knowledge.

93.75% of respondents worked directly or indirectly with the advanced clinical practitioner. 93.75% of respondents felt they understood the advanced clinical practitioner role, however responses largely focussed on clinical skills with only 3 respondents exploring non clinical aspects of the role (research, education and leadership).

Conclusions: The role of the advanced clinical practitioner has proven to be of significant value in supporting patient care (Fowler 2018). This study suggests that locally the role has had a significant impact on capacity and patient flow, providing support to the wider multidisciplinary team. The work highlights the benefit of the advanced clinical practitioner role in myeloma, however it is proposed that further education is needed amongst the multidisciplinary team to ensure full understanding of the role.