Advanced practice roles in primary care: a critical discussion of the policy and practice implications.

Political influence on service delivery in the NHS has been significant in recent years with a drive for modernisation and service improvement. One consequence of this influence is the emergence of new roles and new ways of working. Supported by examples of three advanced practices roles (first contact care practitioner, medical care practitioner, advanced nurse practitioner), this paper will illustrate the policy drivers behind the developments and address the practice implications both for the practitioner and for the service. Healthcare practitioners undertaking these new roles will have specific learning and development needs and meeting these will be a challenge for education and health care alike. The paper will consider how work based learning models can be integral to the support infrastructure for role re-design and service improvement in the new NHS. It will also recognise the organisational development that is prerequisite to service innovation. [ABSTRACT FROM AUTHOR]