Healthcare workforce shortages in Greater Manchester and across the UK present a significant challenge in delivering high-quality care in neurological conditions. The demand for specialist services is increasing due to an ageing population, rising incidence, and evolution in the management of complex, long term conditions.

Traditional, medically focused workforce models must now evolve to ensure the NHS can meet these growing challenges. Advanced Clinical Practice (ACP) is a key solution to modernising care pathways, enhancing workforce capability and resilience, and improving patient outcomes.

By investing in ACP roles, neurological services can future-proof their workforce, provide more effective and efficient care, to help save lives and reduce disability. ACP is not just a response to workforce shortages—it is a transformative approach to delivering high-quality care now.

This resource page is designed to support:

• NHS managers considering implementing ACP roles in their services
• Healthcare professionals exploring ACP career pathways
• Trainees undertaking ACP education
• Teams looking for real-world case studies demonstrating the impact of ACP

The content is focused on stroke but much is generalisable to other areas of neurological care. It is aligned with NHS England’s Advanced Practice Framework and the North West ACP recommendations. Each section includes key resources which are available to download at the bottom of the page.

A. What is Advanced Clinical Practice?

Advanced Practice is delivered by highly skilled, registered healthcare professionals who demonstrate:

• Autonomy and complex decision-making
• Master’s level knowledge and skills
• Capability across four pillars:
  • Clinical practice – managing complex cases, leading patient care
  • Leadership and management – driving service improvements
  • Education – supporting professional development and training
  • Research – applying evidence-based practice for better outcomes

ACP roles enable practitioners to work across traditional professional boundaries, enhance workforce capacity, and improve patient care pathways.

Key resource: NHS multi professional framework

B. What are the benefits for stroke care?

Stroke care is becoming more complex, requiring a highly skilled workforce to manage hyper acute treatment, rehabilitation, and long-term support. Current workforce challenges include:

• Shortages of stroke specialists in all disciplines
• Increased demand – rising admissions and greater rehabilitation needs
• High staff turnover and burnout – increased workload leading to retention issues

ACPs can help address these gaps by expanding the capability of the existing workforce, reducing reliance on traditional staffing models, and ensuring high-quality care is delivered consistently.

Advancements will require agile, multi-skilled professionals who can:

• Lead rapid clinical decision-making in hyper acute settings
• Provide specialist stroke rehabilitation and recovery care
• Educate and support stroke survivors and their families
• Develop evidence-based approaches to improve long-term outcomes

ACP roles allow for greater integration across the stroke pathway, ensuring seamless transitions from acute care to rehabilitation and community support.

Key resource: Advanced Practice credential specification for neurological rehabilitation (including stroke)

C. How can ACP transform stroke services?

ACP roles can support transformation by:

• Enhancing patient outcomes – providing expert-led, timely interventions
• Improving service efficiency – reducing bottlenecks in stroke pathways
• Supporting workforce sustainability – addressing staff shortages and career progression
• Promoting integrated working – bridging gaps between disciplines

Key resources: ACP work breakdown, ACP workplan examples #1 & 2, Case study highlight – Non-Medical Consultant, Case study highlight – SLT ACP

D. How would I implement ACP in my service?

Service managers exploring ACP roles should consider:

• Service needs analysis – identifying workforce gaps and opportunities
• Developing ACP Roles – aligning job descriptions with NHS ACP frameworks
• Education and training – supporting staff to undertake ACP qualifications
• Supervision of trainee ACPs and mentorship of newly qualified ACPs
• Impact – measuring improvements in patient care and service efficiency

Key resource: Advanced Practitioner template business case

E. ACP training and career development

• Entry requirements: registered professionals with relevant experience
• Pathways: Master’s level study and workplace-based training
• Funding and support: NHS-funded programmes are available

Key resources: ACP courses, ACP portfolio paperwork, HEE A guide to implementing and funding Advanced Practice across the NW, HEE NW ACP readiness checklist

F. Additional resources

• NHS ACP framework – national guidelines for ACP roles
• Centre in Advanced Clinical Practice – working to build a recognised and visible Advanced Practitioner workforce
• Stroke-specific ACP competencies – skills and knowledge needed for stroke care
• Workforce development support – guidance for organisations adopting ACP roles

Get involved and find out more

Do you have questions about ACP? Want to share your experiences? Contact our Network Facilitator leading this work at farheen.akhtar@nca.nhs.uk.

You can join our ACP Community of Practice to connect with peers, share learning, and shape the future of ACP in stroke services.