Sustainable Careers for Advanced Critical Care Practitioners (ACCPs)

Advanced Critical Care Practitioners (ACCPs) are clinical professionals responsible for their contribution to patients' care during their critical care admission. They are educated to a very high standard and are highly experienced, enabling them to make high-level clinical decisions for patients on the critical care unit. Their knowledge, skills and capabilities allow ACCPs to deliver high quality, timely, personal, and effective care to all patients on the critical care unit. ACCPs are usually (but not exclusively) drawn from a background in nursing, physiotherapy, pharmacy, or paramedical science; all are registered healthcare professionals.

The role of the ACCP and the training and governance structures which underpin it were set up in 2009. A key tenet of the training system is the formal ACCP curriculum which has been developed by the Faculty of Intensive Care (FICM). The FICM describe a clearly defined training pathway which can lead to ACCP qualification and FICM ACCP Membership.

Since 2009, there has been widespread growth in ACCP personnel in critical care units across the UK as noted in the FICM Workforce Databank. With increasing numbers and ever-increasing experience of ACCPs across the UK, the FICM ACCP Subcommittee (who are responsible for the national development of the ACCP role) recognise the requirement to provide some guidance around the ACCP career pathway. This is necessary to:

• Ensure that those interested in a career as an ACCP have a full understanding of what a long-term career pathway may look like before applying for training positions.
• Ensure that qualified ACCPs have a long-term career pathway to maintain enthusiasm and provide long term career opportunities and goals.
• Avoid a glass ceiling of development and stagnation in the role which risks losing highly trained, highly valuable individuals.
• Ensure that a career as an ACCP remains sustainable with advancing age.
• Provide a long-term career framework with banding aligned with Agenda for Change and the Centre for Advanced Practice¹ for the benefit of individuals, critical care units and organisations. This will help with recruitment, retention, and departmental structure and ensures parity, fairness, and transparency across organisations.
• Ensure that time for roles outside of direct clinical care, such as research, audit, morbidity and mortality reviews and quality improvement is formally recognised, and job planned.
• Recognise that individuals have differing levels of experience, ability, skill, knowledge, and responsibility, and that these should be recognised. Ensuring clarity around what constitutes seniority and how that aligns with banding will ensure consistency and fairness between ACCPs within an organisation and between ACCPs in different organisations.
• Help to achieve parity across a multidimensional workforce- within and outside of critical care. With growing numbers of Acute Care Practitioners (ACPs) working in other acute areas of care (such as the emergency department) it is essential that parity is maintained between practitioners of similar levels in differing areas of the acute care sector.
• Help individuals achieve a work/life balance.