Enhanced practice

Enhanced practice is a level of practice within the healthcare workforce. It covers the graduate professional workforce delivering the majority of clinical activity, those who have moved beyond novice/competent and who are not working at the level of advanced practice. This is a highly valued, broad and essential level of practice within the workforce for whom training and development to maximise their professional skills and capability is a vital aspect of building safe and effective services, workforce productivity and retaining our staff.

People working at enhanced level practice will use a wide variety of job titles and are experienced registered professionals (first level statutory registration or a managed voluntary registration) who undertake complex work and manage day to day risk, including risks on behalf of, or with people. Enhanced practice occurs in multiple settings including secondary, community, primary and social care.

The enhanced practice workforce have many job titles and roles across many different professions. They tend to have undertaken post registration education relevant to their profession, area of practice and role. They usually work in their professional role as part of a multidisciplinary team and apply their skills, knowledge, and experience to substantially contribute to patient care. Although they work across different settings, they will often have a skillset and depth of knowledge related to their professional background.

Those working at enhanced practice level, occupy a space before advanced practice in terms of the management of complexity and uncertainty with enhanced practice can be a precursor to advanced practice, or it can be a valued workplace destination in itself, offering services and patients a consistent level of expertise.

To support our work and growth in this area, we have developed two documents which are available to view. 

• A workforce modelling project 
• The Principles of Enhanced Level Practice

Speaking on this work, Alison Leary for the Enhanced Practice Steering Group said:

‘Sustainable health and care requires a confident, capable, registered workforce able to fully realise their scope of practice at each level of practice from novice to expert. Developing as professionals means that clinical staff can effectively work with increasing levels of complexity and unpredictability.’

And Beverley Harden, National AHP Lead, Deputy Chief AHP(England), Multi-professional Advanced & Consultant Practice Lead, NHS England, noted:

‘Each profession develops approaches and expertise to meet the needs of patients and populations and to develop a body of knowledge that they hold and apply. Enhanced level practice is very much rooted in that development of knowledge and expertise, therefore different professional different groups express what it looks like to work at this level of practice. This means there is no generic “enhanced clinical practitioner” role or training.’