Introduction: In the United Kingdom [UK], Advanced Clinical Practice (ACP) roles are being developed to improve access to high-quality patient care, where healthcare services are struggling to meet steadily increasing service demands. Increasingly, ACP hand therapists are assessing and treating acute closed hand fractures. However, the knowledge and skills required of these roles has not been identified or standardised.

Methods: Consensus recommendations were developed from an expert panel of medical doctors and hand therapists using an electronic Delphi process. Participants were recruited from purposive and snowball sampling. Delphi questions were developed from a literature review and clinician survey and included rating of items open text responses. Consensus was defined as ≥75% agreement. Summary feedback was provided after each round.

Results: There were 20 panellists (12 medical doctors and 8 hand therapists), of which 18 (90%) completed all rounds. 23 competencies were consistently identified as very important; there was less agreement on how to evidence these competencies.

Conclusion: These findings can be used to develop ACP hand therapist roles and provide a framework to guide individual therapists to base their own learning and development. They underpin safe, efficient and costeffective patient care.

Keywords: Advanced clinical practice; competencies; fracture bone; hand; hand therapy.

© The Author(s) 2025.

简介： 在英国（UK），高级临床实践 (ACP) 角色正在被开发，以改善高质量患者护理的可及性，在医疗服务难以满足持续增长的服务需求的情况下。越来越多地，ACP 手疗师正在评估和治疗急性闭合性手部骨折。然而，这些角色所需的知识和技能尚未被识别或标准化。

方法： 从内科医生和手疗师组成的专家小组中通过电子德尔菲过程开发了共识推荐意见。参与者通过目的性和滚雪球抽样方式招募。德尔菲问题来自文献回顾和临床医生调查，包括对项目开放文本回答的评分。共识定义为 ≥75% 的同意率，在每一轮结束后提供总结反馈。

结果： 有 20 名小组成员（12 名内科医生和 8 名手疗师），其中 18 名（90%）完成了所有轮次。共一致确定了 23 项非常重要的能力；在如何证明这些能力方面，存在较少的一致意见。

结论： 这些发现可用于开发 ACP 手疗师角色，并为指导个别治疗师进行自身学习和发展提供框架。它们支持安全、高效和成本效益的患者护理。

关键词： 高级临床实践；能力；骨折骨；手部；手疗法。