The lack of regulation of advanced nursing is a ‘major concern for public protection’, HSJ has been told.

The chair of the Association of Advanced Practice Educators, a network of 37 universities that train staff in advanced patient care, said some nurses who were dismissed from university courses for failing to meet standards continue to call themselves advanced nurses and remain in their jobs.

Katrina Maclaine also warned that some advanced nurses were “unconsciously incompetent”. The AAPE believes formal regulation of advanced nursing is needed to tackle the poor governance among employers.

Her comments follow the publication of research earlier this month that revealed almost 600 separate job titles are being used by nurses working in advanced practice roles, with no clear link between their education level, competence or experience.

The study, led by Professor Alison Leary from London South Bank University, also revealed how hundreds of unregistered care staff were being given job titles describing them as “advanced nurses”. This week, England’s most senior nurses told all NHS trusts to check if they were employing unqualified care staff with job titles describing them as “nurses”.

Ms Maclaine said the AAPE has become increasingly concerned about advanced nursing regulation.

She said: “A constant concern from course providers since the 1990s has been the lack of a regulatory framework. Many of us were hopeful with the Nursing and Midwifery Council proposals in 2005 as our experiences mounted of individuals coming on to our programmes who were already calling themselves ‘advanced nurse practitioners’ who were ‘unconsciously incompetent’.

“This highlighted the growing number of individuals who were using titles without any awareness of their lack of knowledge and skills. With no requirement for education, this trend has increased significantly.”

She added that another “extremely worrying” trend was “students who we discontinue due to demonstrated incompetence and lack of adequate levels of knowledge. We inform the employer; however, these students remain in their advanced practice posts in the workplace. This is a major cause of concern for public protection.

“This obviously calls employer governance into question but our members consider that regulation is the only mechanism for addressing both these very worrying circumstances.”