The benefits of ‘Advanced Clinical Practice’ (ACP) for key stakeholders. A systematic, mixed-method, literature review.

Aim: To identify research that had been conducted in UK settings with regard to the positive impact or potential benefits of ‘Advanced Clinical Practice’, so that the evidence base for key stakeholders in this field could be evaluated. Method: Mixed method systematic literature review to inform a narrative interpretive synthesis. Findings: 44 papers of mixed quality were identified that had used a range of methodology. Convenience sampling was a common feature with use of self-report from sub-sets of the diverse ACP community. There was an absence of longitudinal research, particularly that might evidence outcome measures such as cost effectiveness. Consensus could be found regarding the definition, barriers, and facilitators of ACP; that it can be split into ‘substitution’ and ‘supplementation’ roles, and that the clinical practice element of the role dominates. Variation is evident in the training and education, scope of practice, and regulation of ACP. Conclusion: This creates challenges for the effective implementation of ACP and realisation of its benefits for key stakeholders.