Over the last two decades, the Swiss educational landscape has undergone fundamental changes in the health sector. The integration of health professions into the national education system has given rise to a large number of new training pathways, with the emergence of so called advanced practice roles – first in nursing and then also in other health professions. A report commissioned by the SAMS aims to promote informed debate on this complex issue.
Since the Nursing Initiative was approved by the electorate in 2021, the Federal Council has been working on implementation measures. In May 2025, it announced its proposals for the promotion of professional development in this area.
In this dynamic and innovative domain, numerous uncertainties and misconceptions still exist with regard to the relations between the qualifications, responsibilities and areas of activity of the health professions. For this reason, the SAMS commissioned Professor Urs Brügger (methodix) to prepare a report on this matter, focusing on advanced nursing practice (ANP).
Two main professional profiles
Advanced Practice Nurses (APNs) are highly qualified nursing professionals with a Master’s degree (MSc), who can take on complex tasks thanks to enhanced clinical skills, evidence‑based practice and interdisciplinary collaboration. The APN concept involves two main profiles:
- Clinical Nurse Specialist (CNS) – focused on nursing science expertise, advice, supervision and quality development.
- Nurse Practitioner (NP) – focused on direct clinical care for patients, including the performance of certain medical activities (e.g. diagnostic procedures, prescribing).
The CNS role is already established in inpatient care in Switzerland, while the NP role is still at an early stage, primarily in the outpatient sector. Though initial cantonal regulations exist (for example, in the canton of Vaud), legislation at the national level is lacking as yet.
Both of these profiles have the potential to strengthen the quality of care and security of provision, particularly in primary, long-term and domiciliary care (Spitex services).
Report on advanced nursing practice
The integration of APNs may offer an opportunity for strengthening the nursing professions, ensuring the security of provision and promoting needs-based role assignment within interprofessional teams. However, the political process is just beginning. With the report prepared by Professor Urs Brügger, the SAMS wishes to offer a sound contribution to this important health policy debate.
Based on a literature review and a number of expert interviews, the report:
- traces the development of the non-medical health professions
- describes the situation and the tasks of APNs in Switzerland
- highlights points of disagreement and unresolved questions
- lists the steps involved in the regulatory process
- briefly discusses the other non-medical health professions
- formulates a number of recommendations.
The document presents a variety of viewpoints and helps to bring this complex matter into sharper focus. It aims to provide decision-makers with a sound factual basis for pursuing discussions on the classification, regulation and integration of APNs within the Swiss health system. The French version of the report will be published here by the end of June. An English summary is available at the beginning of the report.
The recommendations included in the report are those of the author. The SAMS, for its part, intends to explore this topic in more depth at its next retreat, to be held in October 2025. Further information will be provided via our Newsletter and published here on our website.
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