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P97 Development of the advanced nurse practitioner role in hospice care: A medical model
  1. Claire Hookey and
  2. Jane Whelan
  1. Douglas Macmillan Hospice, Stoke- on-Trent, United Kingdom


Background/Context The role of the Advanced Nurse Practitioner (ANP) encompasses the provision of advanced levels of clinical practice, knowledge and skills. Whilst involving aspects of education and research, it is firmly grounded in direct clinical care. Responsibilities include assessing, diagnosing, planning and implementing programs of evidence based care and treatment. The drive to reduce junior doctors’ hours in hospitals in the last decade led to further development in the ANP role, with increasing autonomy and application of expertise ( RCN 2012). More recently, the ANP role has translated into hospice care, although generally these roles have developed within hospice nursing teams.

Aim Following the resignation of a Speciality Doctor it was decided to develop an innovative ANP role within an already established, experienced medical team.

Approach used An ANP role was defined for our local context with reference to national guidance and recommendations from the Royal College of Nursing. The role sits within the medical team, and involves the assessment and management of hospice patients, working autonomously but with support from the medical team. The ANP also participates in the medical on call rota, supported by the Consultant on call. The successful candidate had many years of nursing experience both in hospital and community, working at an advanced level within nursing.

Outcomes The ANP role challenges traditional professional boundaries. However, the ANP has integrated well into the medical team, and both medical and nursing staff have identified benefits from the skills and experience that the role has brought. The post has also provided a cost effective means of fulfilling many roles normally undertaken by a doctor.

Application to hospice practice Other hospices may wish to explore the development of Advanced Nurse Practitioner roles within their own medical teams.

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