Nurses are increasingly extending and expanding their scope of practice beyond initial registration with the Nursing and Midwifery Council (NMC).
Advanced Level Nurses in General Practice
Advanced Nurse Practitioner means a nurse with Level 7 MSc qualifications in clinical assessment. This includes:
- History taking
- Physical examination and
- Independent prescribing,
so they can safely work in a first contact role to manage patients who present with a range of symptoms not previously assessed by another appropriate Health Care Professional.
Nurses working at an advanced level can be employed in roles such as the ANP. They must show capability against the Core Capabilities Framework for Advanced Clinical Practice (Nurses) Working in General Practice / Primary Care in England
In Primary Care Networks (PCNs) and integrated care systems, advanced level nurses may work in a variety of roles. The NMC standards state that registered nurses working at this advanced level must:
- Have an active registration with the NMC
- Practice within the four pillars
- Have a Job Plan that shows advanced nursing practice and equity with peers working at this level
- Be educated to Masters level
- Be an independent prescriber
- Meet NMC revalidation requirements
- Demonstrate autonomous evidence
For further information, please refer to the Royal College of Nursing Standards for Advanced Level Nursing Practice and Nursing and Midwifery Council [NMC] Principles for Advanced Practice.
The ANP Role
The role has developed partly to address demand and workforce issues. In general practice it is generally understood to mean a nurse who has undertaken extra training in clinical assessment, including history-taking and physical examination, so they can safely manage patients presenting with undifferentiated and undiagnosed conditions.
ANPs can:
- prescribe any medicine for any condition within their competence (including some controlled medicines) provided they have completed an Independent Prescribing qualification
- see patients with undiagnosed, undifferentiated medical conditions and make treatment decisions, including ordering necessary investigations
- refer patients to secondary care, although this can vary depending on local arrangements and protocols
- undertake appropriate home visits
- sign fit notes.
Advanced Practice (AP) is a defined level of practice within clinical professions such as nursing, pharmacy, physiotherapy, paramedics, occupational therapy, dietetics and podiatry.
This level of practice is designed to transform and modernise pathways of care, enabling the safe and effective sharing of skills across traditional professional boundaries. For further information please refer to the Advanced Clinical Practitioner overview
Royal College of Nursing [RCN] position statement on Advanced Nursing Practice [February 2026]
Principles for advanced practice – The Nursing and Midwifery Council
