Garry Swann and colleagues consider how the introduction of advanced clinical practitioners can shift professional boundaries in urgent care settings

Heart of England NHS Foundation Trust, which manages 250,000 patients in three emergency units each year, has created an advanced clinical practitioner (ACP) role to ensure that patients can be seen in a timely manner as demand for emergency services continues to rise. Advanced clinical practitioners are non-medical clinicians who eventually work autonomously at the level of middle-grade doctors and manage patients with all types of clinical presentations in the emergency department (ED). This article provides an overview of the development and benefits of the ACP role and outlines the phases of a programme for staff who wish to achieve senior clinician status in the ED.