Advanced Critical Care Practitioners (ACCPs) are clinical professionals who have developed their skills and theoretical knowledge to a very high standard.  They are highly experienced and educated members of the care team who are able to diagnose and treat your health care needs or refer you to an appropriate specialist if needed. They are empowered to make high-level clinical decisions and will often have their own caseload.

It is likely that entrants into this advanced role will be from established roles in healthcare, such as nursing and Allied Health Professionals.  ACCPs can be from a nursing or physiotherapy background however the majority of trainee ACCPs at present have nursing as their primary profession. 

ACCPs can:

  • Undertake comprehensive clinical assessment of a patient’s condition
  • Request and perform diagnostic tests
  • Initiate and manage a clinical treatment plan
  • Provide accurate and effective clinical handovers
  • Undertake invasive interventions within the scope of practice
  • Provide professional leadership and support within a multi-professional team
  • Work autonomously in recognised situations
  • Demonstrate comprehensive knowledge across a range of subject areas relevant to the field of critical care
  • Critically analyse, evaluate and synthesise different sources of information for the purpose of assessing and managing the care of a critically ill patient
  • Apply the principles of diagnosis and clinical reasoning that underlie clinical judgement and decision making
  • Apply theory to practice through a clinical decision-making model
  • Apply the principles of therapeutics and safe prescribing
  • Understand the professional accountability and legal frameworks for advanced practice
  • Function at an advanced level of practice as part of the multidisciplinary team as determined by the competency framework
  • Apply the principles of evidence-based practice to the management of the critically ill patient
  • Understand and perform clinical audit

ACCPs must complete a programme leading to an appropriate Postgraduate Diploma/Masters degree with a Higher Education Institution.  Teaching within hospitals is overseen by a Local Clinical Lead (LCL) who holds an honorary appointment with the HEI and is responsible to the HEI for the delivery of the clinical components of training. The Department of Health National Education and Competence Framework for ACCPs can be found in the related downloads section below.

The ACCP Advisory Group have produced an information leaflet for patients and relatives. You can download and print a copy here. 

Mental Health Act 1983 ‘holding powers’ and Advanced Critical Care Practitioners

Critical care patients in England and Wales may on occasion need to be prevented from leaving hospital pending admission for assessment/treatment under the Mental Health Act 1983. The Act contains 'holding powers' which can be used in two ways: 

  1. The registered medical practitioner or ‘approved clinician’ can make a report in writing to the hospital managers; providing such a report allows for the detention of the patient for up to 72 hours, the expectation being that the patient will then be the subject of a full assessment for admission under the MHA 1983.   
  1. Where it is sufficiently urgent that it is not practicable for the practitioner/clinician to attend to make the report, a nurse of a prescribed class can record that fact in writing, which allows for detention for up to 6 hours pending the arrival of the practitioner/clinician.

An 'approved clinician' is defined as a member of the following professional groups: 

  • registered medical practitioners
  • registered practitioner psychologists
  • registered first level nurses, whose field of practice is mental health nursing or learning disabilities nursing
  • registered occupational therapists, and
  • registered social workers

A 'nurse of a prescribed class' is a nurse whose field of practice is mental health nursing or learning disabilities nursing.

It is important to note that qualified and trainee ACCP staff will not usually fall under either of these definitions, and ACCPS should NOT be making use of the 'holding powers' in the Mental Health Act 1983.

*The FICM Legal & Ethical Policy Unit act upon the legal decisions that require ethical and clinical guidance for the specialty. Click here for more information about LEPU's work