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Factors influencing successful implementation of advanced nursing practice roles in oncology: a qualitative inquiry.

Project Description

This PhD provides a unique opportunity for a student to conduct an in-depth qualitative study exploring factors influencing the successful implementation of Advanced Nursing Practice (ANP) roles in an oncology setting.

A number of factors have contributed to the development of ANP roles in the UK and globally.1-5 These include medical workforce shortages, a need to improve care for particular patient groups, changes in government policy, inter/ intra-professional collaboration, nurse career progression, and positive evaluations of the role. There has been widespread ambiguity about the scope of ANP roles, and the regulation of titles6 Generally the ANP scope of practice includes skills and decisions traditionally undertaken by doctors.

As part of service development in cancer services in Sheffield Teaching Hospitals NHS Foundation Trust approximately 20 new ANP roles are being developed and implemented across oncology. The roles include Advanced Clinical Specialist and Nurse Practitioners in a range of clinical areas. The first ANP roles in this cohort are currently in training, with additional posts commencing over the next two years. This PhD is an opportunity for an in-depth, single site study examining factors that help and hinder ANP implementation.

The qualitative study proposed for this PhD will build on the existing limited evidence base. Recent research has provided some insight into ANP implementation in areas such as emergency departments7 but these findings have not been tested in oncology. Two models have been proposed from International research that inform ANP implementation.7-9 Again these have not been applied to a UK oncology setting. Research underpinning a recent Framework for Advanced Practice developed by Health Education England will also inform the study.1

The PhD will be conducted in close collaboration with members of the Senior Nursing Team at Weston Park Hospital, primarily Clare Warnock, who will also be clinical advisor on the supervisory panel.

The PhD will sit within an existing small cohort of PhD students funded from the Royal College of Nursing (RCN) Strategic Research Alliance (SRA). The SRA team are currently conducting wider research into ANP alongside other studies on nursing workforce issues.

Qualitative research methods will be required and we would encourage students to think creatively in adopting and developing methods that are effective as well as acceptable and accessible to participants. We are interested in methodologies that capture insight from an individual ANP perspective but also wider stakeholders, including colleagues, clinical services and organisations.

We request a provisional protocol to be submitted with the application. Potential applicants can contact Professor Angela Tod for information regarding this.

Interested candidates should in the first instance contact Professor Angela Tod ()

How to apply:
Please complete a University Postgraduate Research Application form available here:

Please clearly state the prospective main supervisor in the respective box and select “School of Nursing and Midwifery” as the department.

Funding Notes

This project is open to self-funded students only.

• First or Upper Second class honours degree in a health related subject.
• Research experience in an NHS setting, preferably in oncology
• Understanding of health services research ethics and knowledge of conducting research in an NHS setting.

• Masters in health services research or similar.
• Clinical qualification, preferably nursing.


1. Health Education England (2017) Multi-professional framework for advanced clinical practice in England. Health Education England, England.
2. Ketefian, S., Redman, R.W., Hanucharurnkul, S., Masterson, A. & Neves, E.P. (2001) The development of advanced practice roles: implications in the international nursing community. International Nursing Review, 48(3), 152-163.
3. Maier, C.B. (2015) The role of governance in implementing task-shifting from physicians to nurses in advanced roles in Europe, U.S., Canada, New Zealand and Australia. Health Policy, 119(12), 1627-35.
4. McMurray, R. (2011) The struggle to professionalize: An ethnographic account of the occupational position of Advanced Nurse Practitioners. Human Relations, 64(6), 801-822.
5. Sheer, B. & Wong, F.K.Y. (2008) The Development of Advanced Nursing Practice Globally. Journal of Nursing Scholarship, 40(3), 204-211.
6. Schober, M. & Affara, F. (2006) Advanced nursing practice, Blackwell, Oxford.
7. King R. (2019) Knowledge mobilisation in discharge decision-making by advanced nurse practitioners in a UK emergency department: an ethnographic study (Unpublished PhD thesis, University of Sheffield)
8. Serena, A., Dwyer, A., Peters, S. & Eicher, M. (2017) Feasibility of advanced practice nursing in lung cancer consultations during early treatment: A phase II study. European Journal of Oncology Nursing, 29, 106-114.
9. Serena, A., Dwyer, A.A., Peters, S. & Eicher, M. (2018) Acceptance of the Advanced Practice Nurse in Lung Cancer Role by Healthcare Professionals and Patients: A Qualitative Exploration. Journal of Nursing Scholarship, 50(5), 540-548.
10. Ritchie J, Lewis J (2013) Qualitative Health Research. Sage. London.

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