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Consultant level nursing

Definition of consultant level nursing 

Consultant level nursing practice describes a level which can only be delivered by registered nurses who have progressed from an advanced level within their field to reach a significantly higher level.

All consultant level registered nurses will demonstrate Level 8 (Scottish equivalent Level 12) doctoral level capabilities to act within highly abstract and complex contexts.

The concept of consultant level nursing can be applied to the full range of registered nurses’ careers and not particular roles or specific organisational contexts.

It is differentiated from other levels by: 

RCN Levels of Nursing

  • expertise, backed by the credibility gained through the consultant's own professional practice
  • strategic and enabling leadership, embracing the key skillset for systems leadership and systems transformation
  • experience of learning, developing and enhancing and improving processes and systems
  • using and embedding research and innovation into the role.

Consultant level nursing is underpinned by a comprehensive range of capabilities and integrated expertise across the four pillars of nursing: clinical practice, education, research and leadership. All four are underpinned by consultancy as the foundations of putting expertise in place across systems of health and social care to sustain quality.

These dimensions, together with critical reflection, enable the nurse working at the consultant level to function to their full potential and achieve the highest degree of autonomy possible within their context of employment.

Background to consultant level practice

The knowledge base and skills for this level of nursing is influenced by the context in which individuals practice. In 1999, the Department of Health (DH) published Making a Difference, which aimed to strengthen the nursing, midwifery and health visiting contribution to health and health care. 

Within this, a milestone was set to establish nurse, midwife and health visitor consultant posts for the first time in the UK. Prior to this the term “consultant” had predominantly been used for doctors or to describe someone providing consultancy services based on their credibility and expertise. This goal was reinforced in The NHS Plan (2000).

A primary driver for the government decision to establish the consultant role, was a seminal three-year action research study to operationalise the role of the nurse consultant, published by Professor Kim Manley CBE in 1997. Health Education England (HEE) has since published Multi-professional Consultant-level Practice Capability and Impact Framework (2020).

RCN position on consultant level nursing

Although we have not previously published a definition of consultant level nursing practice, this term was referred to as a level of practice in the  Career Pathway and Education Framework for Cancer Care (RCN, 2022).   

Here at the RCN, we strongly support the ongoing development of nurses working at the consultant level of practice across all areas related to health and social care.

We recognise that the concept of consultant level can and should be applied across all contexts in which registered nurses work. This includes clinical roles, as leaders, managers, educators and researchers, to ensure that all are valued and that their impact on the quality of patient care is acknowledged.

Definition and standards for consultant level nursing 

To support this level of practice, we have produced a report which sets out definition and core standards that differentiate registered nurses who work at consultant level. The development of the definition, standards and capabilities of consultant level nursing practice involved appraisal and synthesis of key content from relevant publications from across the UK. The Society and College of Radiographers’  Education and Career Framework for the Radiography Workforce - 4th edition (2022) was used as a professional reference point.  

The levels of practice working group developed further content for generic application across all contexts in which registered nurses work. Feedback from Professor Kim Manley and Professor Rob Crouch has been used to shape this work.

The report includes the capabilities that registered nurses working at the consultant level of practice will demonstrate, aligned to the four pillars of nursing practice. It contains further discussion and definition of terms. Access and download the Consultant Level Nursing Definition report.  

Useful resources 

Below you can find a list of related publications:

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