Health leaders hope the new resource will tackle growing cardiovascular demand and help stem nurse attrition
Scotland has unveiled a new national framework aimed at accelerating the development of specialist cardiology nurses, as rising cardiovascular cases threaten to overwhelm the system.
The Specialist Nursing in Cardiology Framework, launched this week by Public Health Minister Jenni Minto, sets out a structured path to advanced practice for nurses in cardiology. Health officials say the initiative is part of a broader effort to expand the safety-critical role of nursing across the country.
Building Advanced Skills, One Nurse at a Time
Designed collaboratively by the Scottish Government, NHS Education for Scotland, and representatives from all Scottish health boards, the framework outlines the competencies expected at both Level 6 (senior practitioner) and Level 7 (advanced practitioner).
It is aimed at:
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Registered nurses seeking to benchmark and advance their practice
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Health boards and workforce planners shaping cardiology services
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Educators and training providers developing learning programmes
“The framework not only aims to enhance patient care but also offers a structured pathway for career progression in specialty cardiology nursing,” said Leeanne Macklin, national heart disease coordinator and senior cardiology advanced clinical nurse specialist.
Responding to Cardiovascular Pressures
Scotland is grappling with increasing rates of heart disease and long waits for diagnostic and interventional care. Cardiology remains one of the most resource-intensive specialties in the NHS, and the burden is rising year-on-year.
In this context, the government hopes the framework will act as both a recruitment and retention tool — attracting more nurses into cardiology while ensuring experienced staff are supported to grow into senior roles.
“I hope that cardiology nurses across Scotland will find this to be a useful framework… and that it helps them to develop their careers and meet the increasing amount of cardiovascular demand,” said Minister Jenni Minto at the launch.
The Career Ladder, Now More Visible
The framework is seen as a significant step in clarifying how nurses can move into more senior roles in cardiology, especially amid ongoing concerns about retention, burnout, and a lack of structured advancement in the profession.
According to Macklin, the framework creates “clear routes to advanced practice roles such as clinical nurse specialist and advanced clinical nurse specialist” — a long-standing gap in cardiology workforce planning.
These roles typically involve:
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Complex patient management, including diagnostics and follow-up care
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Leadership in service delivery and quality improvement
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Teaching and mentoring of junior staff
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Independent clinical decision-making, often in coordination with cardiologists
Support from the Royal College of Nursing
RCN Scotland welcomed the new guidance, calling it a long-overdue recognition of nursing’s evolving contribution to acute and long-term cardiac care.
“Advanced practice roles recognise the safety-critical role that nursing plays and provide an opportunity for nurses to develop and have their clinical skills and expertise recognised,” said Eileen McKenna, Associate Director for Nursing, Policy, and Professional Practice at RCN Scotland.
She described the framework as a “welcome route for learning and career progression” that will help ensure cardiology nursing remains an attractive and viable path.
Regulation Still Lagging Behind
Despite momentum toward more advanced practice, regulation of advanced roles remains fragmented across the UK.
The Nursing and Midwifery Council (NMC) has only recently begun work on formal standards for advanced practice proficiency. Although the NMC announced it would begin regulating the advanced role category, implementation has now been delayed by at least two years, according to internal documents.
That delay has left many nurses in limbo — working at advanced levels without formal recognition or statutory protection of title.
The new Scottish framework attempts to bridge that gap by offering clear definitions of advanced practice in the cardiology context, even as broader regulatory structures remain uncertain.
A Step Forward — But Not the Final One
While the framework is being praised as a forward-thinking resource, many nurses and union leaders stress that frameworks alone won’t resolve the chronic workforce shortages facing the health service.
Key challenges remain:
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Lack of protected time for nurses to pursue advanced training
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Variability in how health boards support continuing professional development (CPD)
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Funding gaps for postgraduate education and advanced certification
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Absence of parity in pay and recognition for advanced roles
Still, the Scottish Government hopes the framework will send a clear signal that specialist nurses are vital — and worth investing in.
Scotland’s Growing Toolkit for Nurse-Led Care
This new cardiology framework builds on similar tools launched for other specialties in recent years, such as cancer, respiratory care, and diabetes. Each is aimed at standardising what advanced practice looks like across Scotland’s health service.
With nurses increasingly expected to lead clinics, manage long-term conditions, and provide direct diagnostics, national frameworks like this one are seen as essential to ensuring safety and consistency in care.
The long-term goal is clear: more empowered, highly skilled nurses able to take on complex clinical roles — without needing to leave the profession or retrain as doctors.
And as health systems across the UK brace for higher demand, fewer GPs, and growing multimorbidity, the pressure to formalise and fund these roles is only set to increase.
