Qualitative study of factors perceived by senior health service staff as influencing the development of Advanced Clinical Practice roles in mental health services

Abstract
Introduction
Advanced Clinical Practice (ACP) roles are increasingly being developed internationally. Identifying factors perceived as affecting the development of ACP can support effective implementation.

Aim
To understand the views of senior health service staff as to factors influencing the development of ACP roles in mental health services.

Method
Focus group and semi structured interviews. Participants were directors of nursing (n = 10) and other senior staff from roles important to workforce development (n =10).

Results
Content analysis suggested 7 categories: understanding the role and national guidelines, attitudes to the role, learning from implementing other roles, understanding pre-requisites for development, challenges, opportunities, and future support/actions.. Prerequisites for success would include early engagement with stakeholders. Medical attitudes towards ACP roles were perceived as generally more positive than previously.

Discussion
The study provides unique information regarding perspectives of senior staff regarding the implementation of ACP roles in mental health services. A wide range of mental health services were perceived as potentially benefiting from ACPs, with the importance of role clarity being highlighted and long-term developmental pathways for staff.

Implications for practice
Successful Implementation of ACP roles may require clear role definition, early engagement with stakeholders and processes to evaluate role outcomes.

Accessible summary
What is known on the subject?
• Advanced Clinical Practitioners (ACPs) are, typically, non-medical healthcare professionals, who possess advanced clinical skills, a master’s level qualification and evidence of leadership, management and research abilities.
• Most ACPs are nurses and new ACP roles are increasingly being established around the world.
• The views of senior staff towards new mental health nursing roles in organisations is likely to influence their introduction and sustainability
• Research on mental health nursing ACP roles is sparse.

What the paper adds to existing knowledge
• The paper uniquely provides specific information as to factors perceived by senior staff as affecting the implementation of ACP roles in mental health services.
• A wide range of mental health services were perceived as potentially benefiting from ACPs
• Establishing role clarity for MHN ACPs is perceived as being as essential to successful introduction of the role, as has been found for other specialities

What are the implications for practice?
• Participants identified a need for early engagement with service users and professions about new ACP roles and for processes that can evaluate ACP roles once they established.
• Some mental health nurses may require long-term developmental pathways to help prepare them to take on a master’s level course and then the ACP role.

This is the peer reviewed version of the following article: Qualitative study of perceptions of senior health service staff as to factors influencing the development of Advanced Clinical Practice roles in mental health services, which has been published in final form at https://onlinelibrary.wiley.com/doi/10.1111/jpm.12792. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.