A ‘consistent national approach' on advanced practitioners is needed to prevent confusion and inconsistency of care, according to the Royal College of Occupational Therapists (RCOT).

The call followed a BMA survey that found almost half of trusts (48%) used advanced practitioners to cover doctors' rota gaps.

Director of practice, innovation and advocacy at the RCOT, Karin Orman, said:  ‘Variation in how these roles are deployed, often driven by workforce pressure rather than workforce design, is creating confusion for patients and professionals and leading to inconsistent care. Undermining these roles risks devaluing a highly skilled workforce and limiting the contribution they provide.

‘We're calling for a consistent national approach, including clear role definitions, strong governance, transparent communication and workforce planning that enables all professions to work at the top of their expertise.'

Responding to the BMA survey, Duncan Burton, chief nursing officer for England, said: ‘It's disappointing that despite the BMA's stance on the need for multidisciplinary teams, they are at risk of undermining the work of advanced practitioners, who are regulated professionals - including nurses - that have extensive clinical experience, are educated to masters level, and working hard alongside doctors.

‘Advanced practitioners will never replace doctors – and it is wrong to suggest these roles pose a risk to patient safety – patient safety is non‑negotiable, and I want to be clear that advanced practitioners enhance the quality of patient care.'

NHSE said its guidance on advanced practitioners was clear, adding: ‘These roles should not replace the role of doctors and should only be used in line with their competence and qualifications, and all staff are able to raise concerns where they are worried about patient and staff safety.'