RCN Competences · RCN Core career and competence framework...

Integrated core career andcompetence framework for

registered nurses

RCN CompetencesRCN Competences

We would like to thank all those who have supported thedevelopment of the competence document, and inparticular we would like to recognise the followingpeople who have contributed significantly to thedevelopment of the initial competence framework:

Nikki Hale – Programme Manager: Competences, Skills for Health

Gary Kirwan – Senior Employment Relations Adviser,Employment Relations, Royal College of Nursing

Kim Manley – Learning & Development Manager:Resources for Learning & Improving, Learning &Development Institute, Royal College of Nursing

Linda McBride – Learning and Development Facilitator,Representing & Influencing Team, Royal College ofNursing.

Acknowledgements

RCN Legal Disclaimer

This publication contains information, advice and guidance to help members of the RCN. It is intended for use within the UK but readers areadvised that practices may vary in each country and outside the UK.

The information in this publication has been compiled from professional sources, but its accuracy is not guaranteed. Whilst every effort hasbeen made to ensure the RCN provides accurate and expert information and guidance, it is impossible to predict all the circumstances in whichit may be used. Accordingly, to the extent permitted by law, the RCN shall not be liable to any person or entity with respect to any loss ordamage caused or alleged to be caused directly or indirectly by what is contained in or left out of this information and guidance.

Published by the Royal College of Nursing, 20 Cavendish Square, London, W1G 0RN

© 2009 Royal College of Nursing. All rights reserved. Other than as permitted by law no part of this publication may be reproduced, stored in aretrieval system, or transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise, without priorpermission of the Publishers or a licence permitting restricted copying issued by the Copyright Licensing Agency, Saffron House, 6-10 KirbyStreet, London EC1N 8TS. This publication may not be lent, resold, hired out or otherwise disposed of by ways of trade in any form of bindingor cover other than that in which it is published, without the prior consent of the Publishers.

R O Y A L C O L L E G E O F N U R S I N G

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Integrated core career and competenceframework for registered nursesApproved by the RCNAccreditationUnit from June 2009 to June 2012

Foreword 2

Introduction 3

Context 3

National Occupation Standards and NationalWorkforce Competences 3

Skills for Health 3

1. RCN core career and competence framework 4

Levels of practitioner 4

Levels of practice and agenda for pay banding 4

2. How to use the framework 5

As an individual practitioner 5

To support team and service development 5

3. KnowledgeandSkills Frameworkoutline summaries 6

Practitioner (competent nurse – level 5) 7

Senior practitioner/specialist practitioner(experienced proficient nurse – level 6) 8

Advanced practitioner (expert nurse – level 7) 9

Consultant nurse (level 8) 10

4. CoreKnowledgeandSkills Frameworkdimensions 11

Core dimension 1: Communication 11

Core dimension 2: Personal and peopledevelopment 14

Core dimension 3: Health, safety and security 17

Core dimension 4: Service improvement 21

Core dimension 5: Quality 24

Core dimension 6: Equality and diversity 27

5. Specific Knowledge and Skills Frameworkdimensions 30

Health and wellbeing (HWB) 30

HWB1: Promotion of health and wellbeing andprevention of adverse effects on health andwellbeing 30

HWB2:Assessment of care planning to meethealth and wellbeing needs 33

HWB3: Protection of health and wellbeing 38

HWB4:Ability to address health andwellbeing needs 43

HWB5: Provision of care to meet health andwellbeing needs 46

HWB6:Assessment and treatment planning 49

HWB7: Interventions and treatments 53

Information and knowledge (IK) 57

IK1: Information processing 57

IK2: Information collection and analysis 60

IK3: Knowledge and information resources 64

General (G) 66

G1: Learning and development 66

G2: Development and innovation 70

G3: Procurement and commissioning 72

G4: Financial management 74

G5: Service and project management 76

G6: People management 78

G7: Capacity and capability 80

G8: Public relations and marketing 83

6. References 84

7. Appendices 85

Appendix 1: Role level descriptors 85

Appendix 2: Core competences for nursing 87

Contents

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R C N C O M P E T E N C E S – R E G I S T E R E D N U R S E S

Foreword

The RCN Integrated core career and competence framework for seniornurses working at bands five to eight makes the contribution of nursing tohealth care across the career framework explicit. It applies to the NationalHealth Service (NHS) and the independent sector.

Work is now underway to develop a set of core competences for health careassistants at bands two to four.We are also looking at the pathways emergingfromModernising Nursing Careers that relate to post-registrationframeworks.

The framework brings together the core and specific dimensions of theKnowledge and Skills Framework (KSF) that are relevant to nursing. Itpositions nursing practice at its heart (Appendix 1), and links to the othergeneric functions necessary to ensure safe and effective quality care andservices:

� quality, improvement and innovation

� learning and development

� knowledge and information

� managing care and services.

This framework provides the basis for other specialist competences that havebeen developed by RCNmembership groups working in collaboration withpatients, users and other colleagues. It is based on many years of mappingagainst different policy agendas and other key influences, and developed inclose collaboration with Skills for Health.

The framework will help nurses and health care assistants guide their owndevelopment as well as capture evidence that will:

� support the development of KSF profiles

� demonstrate the readiness for career progression

� support ongoing registration with the Nursing and Midwifery Council(NMC).

The RCN’s e-portfolio,which is available through the Learning Zone (LZ),enables RCNmembers to capture evidence and download it. The new LZplatform and e-portfolio is designed to link seamlessly.

We anticipate that this competence framework will evolve as nursingcontinues to lead developments in patient care in a constantly changinghealth and social care context.

KimManley

RCN Learning and Development Manager: Resources for Learningand Improving


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Introduction

Competence can be defined as:“The state of having theknowledge, judgement, skills, energy, experience andmotivation required to respond adequately to thedemands of one’s professional responsibilities”(Roach, 1992).

Context

The constantly evolving health care agenda and the needfor greater flexibility in nursing roles have been discussedinModernising nursing careers: setting the direction (DH,2006).Modernising nursing careers proposes thedevelopment of careers for nurses built around patientpathways. These career paths will be based on competenceto create greater flexibility and transferability acrosstraditional organisational and career boundaries.

Other factors have highlighted the need for nurses, alongwith other health care workers and professionals, tocontinue to maintain and develop their competence. Theseinclude the requirement to maintain a personalprofessional portfolio to meet the NMC’s Post-registrationeducation and practice (PREP) standards (NMC, 2006), theimplementation of the NHS knowledge and skillsframework (DH, 2004) and latterly the review of theregulation of non-medical health care professions (DH,2007).

The competences developed by the RCN are designed tosupport the development of registered nurses and toenable them to gain recognition for their knowledge, skillsand competence in their daily roles. They reflect all thedomains in which registered nurses may be required topractice. The competences apply to all registered nursesregardless of area of employment.

Presented as KSF outlines, the competences includeindicators of the required level of knowledge and skills andsuggestions of how nurses would apply the identified levelof knowledge and skills in their day to day practice. To aidspecific development, the reader is directed to NationalOccupational Standards/NationalWorkforce Competences(NOS/NWC).These NOS/NWCs can be used to developindividuals, colleagues and teams.

National Occupational Standardsand National WorkforceCompetences

NOS and NWCs are statements of competence required toperform specific functions of health care. These functionsinclude aspects of health care such as assessingindividuals for specific procedures, obtaining physiologicalmeasurements, communicating with individuals, teamsand services.

NOS and NWCs used in health care are developed byexpert practitioners who identify the requirements interms of knowledge, understanding and performancerequired for competent practice in their particular field.The competences focus purely on the function of healthcare required and do not identify the specific role orprofessional who will perform the function. The decisionabout who undertakes specific health care functions ismade at local and organisational level. The key focus is theapplication of consistent standards of competence.

NOS and NWCs apply to the NHS across the UK and toindependent and voluntary health care.NOS and NWCsdeveloped for the health care sector are owned by Skills forHealth.

Skills for Health

Skills for Health is one of 25 sector skills councils coveringthe UK workforce. Sector skills councils were set up by theDepartment for Innovation,Universities and Skills(formerly the Department for Education and Skills) towork with stakeholders to develop the resources and toolsto support the development of the workforce within theirsector. Skills for Health tools and resources are availablefrom their website www.skillsforhealth.org.uk.

RCN Core careerand competenceframeworkThe RCN Core career and competence framework, originallybased on the work of Benner (1984) andMaking adifference... (DH,1999),has been developed to reflect the leveldescriptors of the Career framework for health (Skills forHealth,2006). It is designed to support the development of asenior nurse by identifying the extent of knowledge and skillrequired for that level of practitioner.The frameworkrecognises that to deliver effective nursing care,practitionersmust be competent to fulfil the functions of health care. Inaddition, it is essential that nurses expand their area ofcompetence to enhance care by developing the breadth anddepth of their knowledge,and their skill and expertise.

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1Levels of practitioner

This document refers to registered nurses working atpractitioner (competent nurse), seniorpractitioner/specialist practitioner (experienced/proficientnurse), advanced practitioner (expert nurse) andconsultant nurse levels. These roles have been mapped tothe descriptors defined by Skills for health (DH, 2006)using the Career framework for health as a guide. Thisframework reflects the extent of knowledge and skillsneeded to function at the defined level. It also describesthe regulatory and supervisory framework within whichthey work and the European Qualification framework forlifelong learning. The Core career and competenceframework is still being refined, and the descriptors are auseful tool to clarify the levels of nurses referred to (seeAppendix 1).

Levels of practice and agenda forchange pay banding

The levels of practice used here differ from agenda forchange bandings. This is because they take into accountother factors that influence a job’s pay band and the jobevaluation weighting. They include freedom to act, theunpleasantness of the individual’s work surroundings andfinancial management. Therefore, although there aresimilarities there is no direct link.

The role of matron is a good example to illustrate this.Amatron has a wide responsibility over a number of clinicalareas, but would not necessarily maintain a level of clinicalexpertise in every aspect of specialist practice within thearea of managerial responsibility. The agenda for changebanding would reflect aspects of the role that relate to thewide-ranging responsibilities of the job.However, thiscompetence framework may place the role lower than thatof an advanced practitioner (expert nurse).

Professionalregistration

Figure 1: Development of increasing depth and breadth ofknowledge, skill and expertise (Hale, 2008).

© Reproduced with kind permission of Practice Nursing,appeared in Practice Nursing, 2008, vol. 19 (4), pp.202-204.

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How to use theframework

The framework is divided into the topics covered by theNHS KSF (DH, 2004) dimensions. They apply to all nursesregardless of their employment arrangements.

As an individual practitioner

Nurses working outside the NHS should use thedescriptors to decide which level of practitioner applies totheir job. They can then identify the dimensions that fit themain aspects of their role. The KSF outline summarysheets can also help them to identify the most appropriatedimensions and related levels of practice.

The KSF outline summaries can also be used by NHSnurses to identify the corresponding dimensions andlevels of the framework that apply to them. In someinstances the levels in the framework may vary, and nursesmay have competences frommore than one level ofpractice depending on locally agreed needs.

The first six core dimensions cover:

� communication

� personal and people development

� health, safety and security

� service improvement

� quality, equality and diversity.

The rest of the document focuses on the specialistdimensions of the framework from which the relevantareas of practice can be selected. In the majority of casesmost nurses would have four or five specific dimensions,in addition to the six core dimensions. It would beexceptional to have more than seven specific dimensions.

Nurses can use the NOS/NWCs to support the assessmentof competence in practice, and to identify the knowledgeand understanding needed.They can also be helpful whenplanning future educational and learning needs.

RCNmembers can use the framework to record evidencealongside many other specialist RCN resources.Memberscan find them on the RCN’s e-portfolio via the LZ on theRCN website. The portfolio is constantly evolving, andRCNmembers can use it to generate reports using theevidence logged in the portfolio. This includes KSF

progress reports for personal development reviews andappraisals, job applications and NMC re-registration.

To support team and servicedevelopment

Nursing leaders can use the framework to support thedevelopment of their nursing teams across departmentaland organisational boundaries. This will ensure consistentstandards of competence in health care functions.

NOS/NWCs are applicable across the UK and to all healthcare providers, and provide a consistent benchmark ofpractice and development. The framework can also beused with workforce development tools from Skills forHealth (see www.skillsforhealth.org.uk) to build role andteam profiles.

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Knowledge andSkills Frameworkoutline summaries

The KSF outline summaries identify all the NHS KSFdimensions included in this core career competenceframework. Each summary classifies all the possibledimensions that may apply to nursing for a particularpractitioner level.

To use the framework a nurse should focus on thedimensions and levels that reflect the main or key aspectsof their role. These will include all six of the coredimensions and up to a maximum of seven of the specificdimensions.Most nursing roles will have four or fivespecific dimensions.

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Post title:

Practitioner (competent nurse – level 5)NHS Knowledge and Skills Framework summary outline


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NHS KSF dimensions Applicable Level for post

1 2 3 4

Core dimensions (applies to all NHS posts)

1. Communication Yes

2. Personal and people development Yes

3. Health, safety and security Yes X

4. Service improvement Yes X

5. Quality Yes X

6. Equality and diversity Yes X

Specific dimensions

Health and wellbeing

HWB1: Promotion of health and wellbeing and prevention of adverse effects to healthand wellbeing

Yes X

HWB2: Assessment and care planning to meet people’s health and wellbeing needs Yes

HWB3: Protection of health and wellbeing Yes X

HWB4: Ability to address health and wellbeing needs Yes X

HWB5: Provision of care to meet health and wellbeing needs Yes

HWB6: Assessment and treatment planning Yes X

HWB7: Interventions and treatments Yes X

HWB8: Biomedical investigation and intervention

HWB9: Equipment and devices to meet health and wellbeing needs

HWB10: Products to meet health and wellbeing needs

Estates and facilities

EF1: Systems, vehicles and equipment

EF2: Environments and buildings

EF3: Transport and logistics

Information and knowledge

IK1: Information processing

IK2: Information collection and analysis Yes

IK3: Knowledge and information resources Yes

General

G1: Learning and development Yes

G2: Development and innovation

G3: Procurement and commissioning

G4: Financial management

G5: Services and project management

G6: People management

G7: Capacity and capability

G8: Public relations and marketing

Individual nurses should access only those dimensions and levels that apply to the main aspects of their role. It would be exceptional for any practitionerto havemore than seven specific KSF dimensions for their role. In many cases the average number of specific dimensions would be four or five.

LEVEL 5

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Post title:

Senior practitioner/specialist practitioner(experienced/proficient nurse – level 6)NHS Knowledge and Skills Framework summary outline


1 2 3 4




3. Health, safety and security Yes

4. Service improvement Yes

5. Quality Yes

6. Equality and diversity Yes

Specific dimensions



Yes


HWB3: Protection of health and wellbeing Yes

HWB4: Ability to address health and wellbeing needs Yes


HWB6: Assessment and treatment planning Yes

HWB7: Interventions and treatments Yes









IK1: Information processing Yes



General


G2: Development and innovation Yes

G3: Procurement and commissioning

G4: Financial management Yes

G5: Services and project management Yes

G6: People management Yes

G7: Capacity and capability Yes



LEVEL 6


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Post title:

Advanced practitioner (expert nurse – level 7)NHS Knowledge and Skills Framework summary outline


1 2 3 4






5. Quality Yes


Specific dimensions



Yes


















General



G3: Procurement and commissioning Yes







LEVEL 7

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Post title:

Consultant nurse (level 8)NHS Knowledge and Skills Framework summary outline


1 2 3 4






5. Quality Yes


Specific dimensions



Yes


















General



G3: Procurement and commissioning Yes





G8: Public relations and marketing Yes


LEVEL 8


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The core Knowledge and Skills Framework dimensions apply to all nursing roles.

KSF core dimension 1: Communication

Level 3 Develop and maintain communication with people about difficult matters and/or in difficult situations.

Level 4 Develop and maintain communication with people on complex matters, issues and ideas and/or in complexsituations.

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Core Knowledge andSkills Framework dimensions

IndicatorsAreas of application to nursing practicewith examples (core)

Skills for Healthwww.skillsforhealth.org.ukNOS/NWC

a) Identifies the range of people likely to beinvolved in the communication, any potentialcommunication differences and relevantcontextual factors.

Communicates effectively and in an appropriatemanner with:

• patients, those important to patients, other users

• the nursing team

• the interdisciplinary team, for example: socialworkers; doctors; bed managers; modernmatrons; allied health professionals;administrative staff; housekeeping staff; andother health care professionals.

HSC31: Promote effectivecommunication for and aboutindividuals.

b) Communicates with people in a form andmanner that:

• is consistent with their level of understanding,culture, background and preferred ways ofcommunicating

• is appropriate to the purpose of thecommunication and the context in which it istaking place

• encourages the effective participation of allinvolved.

Communicates with patients/users/others in anappropriate person-centred manner consistentwith their level of understanding, culture andbackground, preferred ways of communicating andneeds. For example:

• is empathetic to patients/other users/others

• develops a good rapport withpatients/users/others

• acts as an advocate for thepatients/clients/carers according to their wishes

• enables participation.


c) Recognises and reflects on barriers toeffective communication and modifiescommunication in response.

Identifies and acts on barriers to communicationwhen communicating with people:

• who have aphasia, dementia, tracheostomies,deafness, speech and visual impairments

• other users and patients where English is nottheir first language.

Draws on speech therapists, lip readers, signersand translators.

HSC369: Support individuals withspecific communication needs (HWB4level 3).

GEN22: Communicate effectively withindividuals (core 1 level 2).

HSC371: Support individuals tocommunicate using interpreting andtranslation services.

d) Provides feedback to other workers on theircommunication at appropriate times.

Constantly evaluates own and others’ approachesto communication.

Gives feedback to members of the team regardingcommunication issues e.g. at team briefings,meetings and handovers and one-to-one feedback.

HSC43: Take responsibility for thecontinuing professional developmentof self and others (core 2 level 3).


Level 3: Develop and maintain communication with people about difficultmatters and/or in difficult situations

Back to level 5 KSF outline


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e) Keeps accurate and complete records ofactivities and communications consistentwith legislation, policies and procedures.

Maintains accurate, clear, legible records ofcommunications that provide effective care andcontinuity of care e.g. using Word, email and theinternet.

HSC434: Maintain and managerecords and reports (IK1 level 2).

f) Communicates in a manner that isconsistent with relevant legislation, policiesand procedures.

Observes local and national guidelines to ensureeffective communication practices. For example:

• maintaining confidentiality whencommunicating

• following the NMC guidelines on record keeping.





a) Identifies:

• the range of people involved in thecommunication

• potential communication differences

• relevant contextual factors

• broader situational factors, issues and risks.

Communicates with a range of differentstakeholder groups and teams at clinical tostrategic level involved in providing and usingservices across the patient’s journey, working withthe influences of each context.

Communicating appropriately in the context of thefactors relating to an individual’s situation, issuesand risks that impact on the nature and content ofthat communication.

CHS48: Communicate significant newsto individuals.

b) Communicates with people in a form andmanner which:

• is consistent with their level of understanding,culture, background and preferred ways ofcommunicating

• is appropriate to the purpose of thecommunication and its longer termimportance

• is appropriate to the complexity of the context

• encourages effective communication betweenall involved

• enables a constructive outcome to beachieved.

Places the person at the centre of allcommunication activities.

Communicates with all stakeholders using a fullarray of methods from clinical to strategic level in aperson-centred way that builds on knowledge ofthe person/stakeholder group, and those thingsimportant to them.

Involves all stakeholders as appropriate incommunication about: specific patients,maintaining confidentiality; patient groups; andservices.

Acts as an advocate for the clients, patients andcarers, according to their wishes.

Involves all stakeholders in communication aboutservice improvement enabling their participationand achievement of appropriate outcomes.

HSC410: Advocate with, and on behalfof, individuals, families, carers, groupsand communities.


Level 3: Develop and maintain communication with people about difficultmatters and/or in difficult situations


Level 4:Develop and maintain communication with people on complex matters,issues and ideas and/or in complex situations




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c) Anticipates barriers to communication andtakes action to improve communication.

Identifies and anticipates actual and potentialbarriers to communication from clinical through tostrategic level.

Constantly evaluates own approaches tocommunication using reflection enabling all withwhom one interfaces to provide feedback e.g.through 360 degree feedback.

Improves communication through evaluation of theculture, the environment and methods ofcommunication as well as the giving of feedback.

Enables a culture to develop where communicationis open, honest and direct and the giving andreceiving of feedback is encouraged by all.

d) Is proactive in seeking out different styles andmethods of communicating to assist longerterm needs and aims.

Creates opportunities for people to communicateeffectively, as well as give and receive feedback atall levels from clinical teams through to executiveand strategic levels.

Facilitates open forums.

Facilitates action learning.

Accesses board level communication strategies.

e) Takes a proactive role in producing accurateand complete records of the communicationconsistent with legislation, policies andprocedures.

Keeps records in relation to patient-related activity,maintaining confidentiality according to relevantlegislation, policies and procedures.

Keeps records relevant to health and safety inrelation to patient care, staff safety and personneldocumentation within recognised policies.

HSC41: Use and develop methods andsystems to communicate, record andreport.

f) Communicates in a manner that is consistentwith legislation, policies and procedures.

Models communication approaches that areconsistent with national and local legislation andbest practice.

Uses all modes of communication.


Level 4:Develop and maintain communication with people on complex matters,issues and ideas and/or in complex situations


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KSF core dimension 2: Personal and people development

Level 3 Develop self and contribute to the development of others.

Level 4 Develop self and others in areas of practice.



a) Reflects on and evaluates how well they areapplying knowledge and skills to meet currentand emerging work demands and therequirements of the KSF outline for their post.

Keeps up to date with clinical issues, research anddevelopments and their impact on own practice.For example:

• participates in critical analysis of own practicethrough structured reflection and peer review

• uses research evidence to inform daily work

• attends journal clubs

• participates in critiquing local guidelines

• accesses and uses NICE guidelines.

GEN12: Reflect on and evaluate yourown values, priorities, interests andeffectiveness (core 2 level 2).

b) Identifies own development needs and setsown personal development objectives indiscussion with their reviewer.

Identifies own objectives by:

• participating in personal development reviews

• actively reflecting on and critically appraisingown practice in the light of evidence

• seeking feedback from others and identifiesareas for further individual development.

GEN13: Synthesise new knowledgeinto the development of your ownpractice.

c) Takes responsibility for own personaldevelopment and maintains own personaldevelopment portfolio.

Implements and evaluates own personaldevelopment plans through:

• working with a mentor/supervisor/coach toachieve own learning contract and personaldevelopment plan

• prioritising own interventions arising from actionplanning

• using opportunities for developing ownleadership potential

• maintaining a professional portfolio

• demonstrating achievement in practice ofcompetency and standards through professionalportfolio of evidence.

LLUK_L12: Enable individual learningthrough coaching.

LLUK_L14: Support learners bymentoring in the workplace.

LLUK_L15: Support and adviseindividual learners (G1 level 3).

HSC43: Take responsibility for thecontinuing professional developmentof self and others.

HSC23: Develop your knowledge andpractice (core 2 level 1).

d) Makes effective use of learning opportunitiesinside and outside the workplace, evaluatingtheir effectiveness and feeding back relevantinformation.

Participates in the life-long learning developmentopportunities by:

• accessing and using learning materials from awide variety of sources to inform professionalpractice

• participating in rigorous reflective practice as asupervisor and supervisee

• attending mandatory training e.g. resuscitation,manual handling, infection control

• providing written and verbal feedback onlearning from study days/courses to othermembers of the team.

M&L_D7: Provide learningopportunities for colleagues.

GEN13: Synthesise new knowledgeinto the development of your ownpractice.



LLUK_L20: Support competenceachieved in the workplace (G1 level 2).


Level 3: Develop self and contribute to the development of others



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Level 3: Develop self and contribute to the development of others



e) Enables others to develop and apply theirknowledge and skills in practice.

Values, accesses and contributes towards supportand development mechanisms of team membersby:

• contributing to the personal development plansof others, particularly health care assistants andstudents

• recognising the impact of stress/stressors onthe learning of others

• alerting others to the learning resources andopportunities available locally.


LLUK_L20: Support competenceachieved in the workplace (G1 level 2).


HSC43: Take responsibility for thecontinuing professional developmentof self and others.

f) Contributes to the development of others in amanner that is consistent with legislation,policies and procedures.

Supports the development of others with referenceto local and national guidelines by:

• acting as a mentor/role-model/supervisor andcoach to new/junior staff and students

• orientating new staff and students toappropriate national and local policies andprocedures.



CJ_ZE5: Facilitate individual learningand development through mentoring(G1 level 2).

CM_F1: Provide clinical leadership andtake responsibility for the continuingprofessional development of self andothers.

g) Contributes to developing the workplace as alearning environment.

Contributes to developing an effective learningenvironment in practice for all by:

• using a range of different teaching methods toenable patient/client learning

• facilitating learning of non-professional healthcare staff and students informally and formally

• contributing to a non-blame learning culture

• contributing to and supporting sharedgovernance mechanisms that allow theimplementation of learning.


LLUK_L9: Create a climate thatpromotes learning.

LLUK_L10: Enable learning throughpresentations (G1 level 3).

LLUK_L11: Enable learning throughdemonstrations and instruction (G1level 2).





a) Evaluates the currency and sufficiencyof own knowledge and practice againstthe KSF outline for the post andidentifies own development needs andinterests.

Ensures currency of own practice by:

• keeping up-to-date with evidence-based practice,research and development within field of practice

• developing new knowledge and understandingthrough research and extending own practice in asystematic and rigorous way

• maintaining a current action plan with supervisionfrom senior member of team.

M&L_D7: Providing learning opportunitiesfor colleagues (core 2 level 3).

HSC23: Develop your knowledge andpractice (core 2 level 1).

HSC43: Take responsibility for thecontinuing professional development ofself and others (core 2 level 3).

GEN13: Synthesise new knowledge into thedevelopment of your own practice (core 2level 3).

b) Develops and agrees own personaldevelopment plan with feedback fromothers.

Constantly evaluates and challenges own practiceand performance by using the principles of 360degree feedback and continuous reflection on action.

Gains supervisory support.

Continually evaluates actions and action plans.

GEN12: Reflect on and evaluate your ownvalues, priorities, interests andeffectiveness (core 2 level 2).

c) Generates and uses appropriatelearning opportunities and applies ownlearning to the future development ofpractice.

Participates in formal supervision/action learningand shared governance mechanisms to develop andimprove the effectiveness of own practice at alltimes.

Uses own knowledge, skills and expertise toinfluence others in the workplace.

M&L_D7: Provide learning opportunitiesfor colleagues (core 2 level 3).

HSC43: Take responsibility for thecontinuing professional development ofself and others (core 2 level 3).

LLUK_CDB5: Create opportunities forlearning from practice and experience.

d) Encourages others to make realisticself assessments of their application ofknowledge and skills by challengingcomplacency and actions that are notin the interest of the public and/orusers of services.

Acts as a coach, mentor and supervisor to others,role-modelling the maintenance of an ongoingportfolio.

Develops competency frameworks relevant to thelevels of development.

LLUK_L12: Enable individual learningthrough coaching (core 2 level 3).

LLUK_L14: Support learners by mentoringin the workplace (core 2 level 3).

e) Enables others to develop and applytheir knowledge and skills.

Facilitates individuals and teams in developing theirwork effectiveness through drawing on expertise infacilitation of others’ learning.

Ensures that those practitioners being facilitated todevelop are competent to practice.

HSC3121: Contribute to promoting theeffectiveness of teams (core 5 level 2).

LLUK_L20: Support competence achievedin the workplace (G1 level 2).

CM_F1: Provide clinical leadership and takeresponsibility for the continuingprofessional development of self andothers (core 2 level 3).

f) Actively promotes the workplace as alearning environment encouragingeveryone to learn from each other andfrom external good practice.

Facilitates a culture that develops the leadershippotential of all staff.

Uses a range of strategies in practice for teachingand enabling learning.

Leads on developing a learning culture that developsthe potential of all staff and also expertise in nursingpractice.

LLUK_L9: Create a climate that promoteslearning (core 2 level 3).

LLUK_L11: Enable learning throughdemonstrations and instruction (G1 level 2).


g) Alerts managers to resource issuesthat affect learning, development andperformance.

Works with managers to ensure that education andtraining provision enables practice teams to deliveran effective service.

Delivers in-house education and training.

Facilitates work-based learning.

LLUK_L17: Evaluate and improve learningand development programmes (G1 level 4).

h) Develops others in a manner that isconsistent with legislation, policies andprocedures.

Facilitates the development of others at theappropriate level by assessing and ensuring theirfitness to practise.



Level 4: Develop self and others in areas of practice

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a) Identifies and assesses thepotential risks involved in workactivities and processes for selfand others.

Identifies and assesses potential risks tomaintaining a safe environment for patients,visitors and staff by drawing on the principles of:

• infection control, and manual handling

• safe practice in the use and maintenance ofequipment

• policies and guidelines concerning violence,mixed wards, falls etc.

HSC32: Promote, monitor and maintain health,safety and security in the working environment.

CHS6: Move and position individuals (HWB5 level2).

HSC22: Support the health and safety of yourselfand individuals (core 3 level 1).

ENTO_WRV2: Protect yourself from the risk ofviolence at work (core 3 level 3).

DEC5: Carry out sterilisation and disinfection ofre-useable medical devices (EF2 level 2).

GEN2: Prepare and dress for work inclinical/therapeutic areas (core 3 level 1).

b) Identifies how best to manage therisks.

Participates in and acts on risk assessment,identifies appropriate risk management strategies.

GEN3: Maintain health and safety in aclinical/therapeutic environment.

HCS_E2: Develop and maintain health, safety andsecurity practices in the workplace.

c) Undertakes work activitiesconsistent with:

• legislation, policies andprocedures

• the assessment and managementof risk.

Uses legislation, policies and procedures thatpromote safe practice. For example:

• infection control, hand washing, aseptictechnique, manual handling and administrationof medicine

• local policies affecting area of practice

• implementing agreed strategies to manage riskand risk improvements in the practiceenvironment

• data protection issues in relation to collection,storage and retrieval of information maintainingconfidentiality

• maintaining a safe environment for patients atall times, reporting any concerns about staffing,environment or resources to a senior colleague.

HCS_E2: Develop and maintain health, safety andsecurity practices in the workplace.


M&L_E5: Ensure your own actions reduce risks tohealth and safety (core 3 level 1).

IPC_1: Minimise the risks of spreading infectionby cleaning and maintaining environments inhealth and social care settings.

IPC_2: Perform hand hygiene to prevent thespread of infection.

IPC_3: Clean and remove spillages of blood andother body fluids.

IPC_4: Clean and store care equipment tominimise the risks of spreading infection.

IPC_5: Minimise the risks of exposure to blood-borne infections while providing care.

IPC_6: Use personal protective equipment toprevent the spread of infection.

IPC_7: Safely dispose of health care waste,including sharps, to prevent the spread ofinfection.

IPC_8: Minimise the risk of infection whentransporting and storing health care waste.

IPC_9: Minimise the risks of spreading infectionwhen removing used linen.

KSF core dimension 3: Health, safety and security

Level 2: Monitor and maintain health, safety and security of self and others


Level 2 Monitor and maintain health, safety and security of self and others.

Level 3 Promote,monitor and maintain best practice in health, safety and security.

Level 4 Maintain and develop an environment and culture that improves health, safety and security.





d) Takes the appropriate action tomanage an emergency,summoning assistanceimmediately when this isnecessary.

Recognises and acts on common medicalemergencies. For example:

• recognising cardiac arrest, anaphylactic shockand breathing difficulties

• using basic airway management and lifesupport skills

• acting on fire, major incident, intruder andviolence procedures.

CHS35: Provide first aid to an individual needingemergency assistance (HWB7 level 2).

CHS36: Provide basic life support (HWB7 level 3).

HSC32: Promote, monitor and maintain health,safety and security in the workplace.

e) Reports actual or potentialproblems that may put health,safety and security at risk andsuggest how they might beaddressed.

Reports aspects of the care environment that posepotential health risks to health care professionals,their patients and visitors by:

• documenting incidents according to local policy

• reporting faults immediately and ensurescorrect procedures are followed.

HSC22: Support your health and safety and that ofother individuals (core 3 level 1).

HSC32: Promote, monitor and maintain health,safety and security in the workplace.


f) Supports others in maintaininghealth, safety and security.

Supports others in providing a safe environmentthat protects vulnerable patients and is conduciveto safe practice by:

• liaising and collaborating with different groupsthat exist to manage health, safety and security

• supporting others to observe health, safety andsecurity policies

• ensuring patients are advised of the need tolock away valuables

• challenging people who are not readilyidentifiable

• sharing good practice with colleagues and thewider nursing family.

M&L_D2: Develop productive workingrelationships with colleagues and stakeholders(core 5 level 3).

GEN31: Initiate, and participate in networks anddiscussion groups (core 1 level 3).

HSC22: Support the health and safety of yourselfand individuals (core 3 level 1).

SS05: Support and control visitors to services andfacilities (G3 level 2).


Level 2: Monitor and maintain health, safety and security of self and others

18



19

IndicatorsAreas of application to nursingpractice with examples (core)


a) Identifies:

• the risks involved in work activities andprocesses

• how to manage the risks

• how to help others manage risk.

Undertakes and acts on risk assessments toensure practice is safe.

Acts as a role model in promoting health,safety and security in the workplace and forclients e.g. infection control, manual handling.

Ensure self and others are up-to-date withmandatory training such as manual handlingand resuscitation.

Share good practice with colleagues and thewider nursing family.

HSC232: Protect yourself from the risk ofviolence at work.

CHS6: Move and position individuals (HWB5level 2).

b) Undertakes work activities consistentwith:

• legislation, policies and procedures

• the assessment and management ofrisk.

Assesses and manages risk in accordance withlocal/national directives.

Contributes to improving the working lives ofcolleagues e.g. facilitating a no blame culture.

Ensure safe practice.

HSC3117: Conduct an assessment of risks in theworkplace.

HSC3118: Respond to work related violentincidents.

c) Monitors work areas and practices andensures that they:

• are safe and free from hazards

• conform to health, safety and securitylegislation, policies, procedures andguidelines.

Monitors culture and context of care to ensuresafe practice.

Facilitates a culture that promotes health andsafety and security.

Ensures that all needles are disposed of in linewith policies.

Promote cleanliness such as good handwashing and use of aseptic techniques.

HSC42: Contribute to the development andmaintenance of healthy and safe practices in theworking environment.

IPC1: Minimise the risks of spreading infectionby cleaning and maintaining environments inhealth and social care settings (core 3 level 1).

IPC2: Perform hand hygiene to prevent thespread of infection (core 3 level 1).

IPC3: Clean and remove spillages of blood andother body fluids (core 3 level 1).

IPC4: Clean and store care equipment tominimise the risks of spreading infection (core 3level 1).

IPC5: Minimise the risks of exposure to blood-borne infections while providing care (core 3level 1).

IPC6: Use personal protective equipment toprevent spread of infection (core 3 level 1).

IPC7: Safely dispose of health care waste,including sharps, to prevent the spread ofinfection (core 3 level 1).

IPC8: Minimise the risk of infection whentransporting and storing health care waste (core3 level 1).

IPC9: Minimise the risks of spreading infectionwhen removing used linen (core 3 level 1).

d) Takes the necessary action in relation torisks.

Actions any issues that arise from riskassessments and any hazards as they occur.

Ensure all staff are aware of emergencyprocedures.

Ensure all staff are aware of working status ofequipment.

M&L_E6: Ensure health and safety requirementsare met in your area of responsibility.

AG5: Implement policies to manage risks toindividuals and third parties.

e) Identifies how health, safety andsecurity can be improved and takesaction to put this into effect.

Effectively actions any risk issues.

Uses critical incident analysis to action anyidentified health, safety and security issues.

Uses patient assessment to put in placemeasures to prevent risk such as pressure soreprevention and malnutrition.

Learn from good practice examples.

CHS4: Identify the individual at risk of skinbreakdown and undertake appropriate riskassessment (HWB2 level 3).

CHS92: Monitor and review a patient’snutritional wellbeing (HWB2 level 3).


Level 3: Promote, monitor and maintain best practice in health, safetyand security



a) Evaluates the extent towhich legislation, policiesand procedures areimplemented in theenvironment, culture andpractices of own sphere ofactivity.

Develops mechanisms in collaboration with otherkey stakeholders to monitor and evaluate theimplementation of policies and procedures. Forexample:

• evidence-based guidelines

• infection control principles

• best practice.

ENTO_WRV5: Implement policy and procedures to reducethe risk of violence at work.

M&L_E7: Ensure an effective organisational approach tohealth and safety.

b) Identifies processes andsystems that do notpromote own and others’health, safety and security.

Leads on developing a culture of safe practice incollaboration with clinical teams.

Audits practice to ensure safe practice.

Ensures currency of own and team knowledgerelevant to health, safety and security.

ENTO_WRV3: Assess the risk of violence to staff.

M&L_E6: Ensure health and safety requirements are metin your area of responsibility (core 3 level 3).

c) Regularly assesses risksto health, safety andsecurity using the resultsto promote and improvepractice.

Regularly reviews risks and risk assessmentprocesses that may influence patient/staff safetyand the maintenance of a safe environment, andact on them.

Encourages others to undertake risk analysis.

Share good practice with colleagues and the widernursing family.

HSC3117: Conduct a risk assessment in the workplace(core 3 level 3).

d) Takes the appropriateaction when there arehealth, safety and securityconcerns.

Acts on risk assessments concerning health, safetyand security promptly in own field of practice, andfollowing up appropriately.

Engages with other teams to improve riskysituations such as infection control.

HSC42: Contribute to the development and maintenanceof healthy and safe practices in the workplace (core 3 level3).

IPC1: Minimise the risks of spreading infection by cleaningand maintaining environments in health and social caresettings (core 3 level 1).

IPC2: Perform hand hygiene to prevent the spread ofinfection (core 3 level 1).

IPC3: Clean and remove spillages of blood and other bodyfluids (core 3 level 1).

IPC4: Clean and store care equipment to minimise therisks of spreading infection (core 3 level 1).

IPC5: Minimise the risks of exposure to blood-borneinfections while providing care (core 3 level 1).

IPC6: Use personal protective equipment to preventspread of infection (core 3 level 1).

IPC7: Safely dispose of health care waste, includingsharps, to prevent the spread of infection (core 3 level 1).

IPC8: Minimise the risk of infection when transporting andstoring health care waste (core 3 level 1).

IPC9: Minimise the risks of spreading infection whenremoving used linen (core 3 Level 1)

e) Investigates any potentialor actual breaches oflegal, professional ororganisationalrequirements and takesthe necessary action todeal with themappropriately.

Leads investigations as designated into anybreaches of legal, professional or organisationalrequirements in relation to own practice, or as toother fields of practice.

Ensures that personal knowledge in this area iscurrent. For example, child protection issues,mental health legislation, equality and diversityregulation.

ENTO_WRV9: Investigate and evaluate incidents ofviolence at work.

AG5: Implement policies to manage risks to individualsand third parties (core 3 level 3).


Level 4:Maintain and develop an environment and culture that improveshealth, safety and security

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a) Discusses and agrees with the work team:

• the implications of direction, policies andstrategies on their current practice

• the changes that they can make as a team

• the changes s/he can make as an individual

• how to take the changes forward.

Participates in policy and service developmentdiscussions aimed at improving patientcare/services by:

• demonstrating a willingness to engage inservice/practice development and embracechange

• contributing to the development and scope ofnursing practice as an individual and in the team.

M&L_C1: Encourage innovation in yourteam (core 4 level 3).

M&L_C6: Implement change.

GEN31: Initiate, and participate in,networks and discussion groups (core1 level 3).


b) Makes constructive approved changes to ownwork in the agreed timescale seeking supportas and when necessary.

Incorporates agreed changes in own practice.

Participates in clinical supervision, peer review andaddresses personal development plans.



GEN13: Synthesise new knowledgeinto the development of your ownpractice (core 2 level 3).

c) Supports others in understanding the needfor and making agreed changes.

Facilitates others to create a culture of changedriven by the needs of patients with, for example,health care assistants, administrative staff andlearners.

M&L_B9: Develop the culture of yourorganisation (core 4 level 4).


d) Evaluates own and other's work whenrequired to do so completing relevantdocumentation.

Evaluates own and others’ work systematically as abasis for developing practice through:

• undertaking guided reflective practice on ownpractice and contributing to the peer review ofothers

• documenting patients’ care plans and localaction plans so that evaluation can take place.



e) Makes constructive suggestions about howservices can be improved for users and thepublic.

Makes constructive suggestions about howservices can be improved for users and the publicby taking part in team meetings, case conferences,clinical audit and local shared governancemechanisms.

GEN 31: Initiate, and participate innetworks and discussion groups (core1 level 3).

HSC3121: Contribute to theeffectiveness of teams (core 5 level 2).

f) Identifies issues in a constructive mannerwith direction, policies and strategies in theinterests of users and the public.

Identifies issues that influence/impact on person-centred and clinically effective care in the contextof team reviews and local governancemechanisms.

M&L_B8: Ensure compliance withlegal, regulatory, ethical and socialrequirements (core 5 level 3).

GEN 31: Initiate, and participate innetworks and discussion groups (core1 level 3).


KSF core dimension 4: Service improvement

Level 2: Contribute to the improvement of services


Level 2 Contribute to the improvement of services.

Level 3 Appraise, interpret and apply suggestions, recommendations and directives to improve services.

Level 4 Work in partnership to develop, take forward and evaluate direction, policies and strategies.



IndicatorsAreas of application to nursing practice withexamples (core)


a) Identifies and evaluates areas for potentialservice improvement.

Identifies situations where the scope of practice needs tobe expanded to improve the service and subsequenteducational needs.

Plans, implements and evaluates the improvement of arange of services or programmes.

M&L_C1: Encourage innovationin your team.

M&L_C2: Encourage innovationin your area of responsibility.

b) Discusses and agrees with others:

• how services should be improved as a resultof suggestions, recommendations anddirectives

• how to balance and prioritise competinginterests

• how improvements will be taken forward andimplemented.

Develops a common vision of person-centred andevidence-based services, and creates systems andprocesses to achieve this.

M&L_C5: Plan change.

c) Undertakes own role in improving services asagreed and to time in a constructive way,supporting others effectively during times ofchange and working with others to overcomeproblems and tensions as they arise.

Uses corporate and local governance structures andprocesses to achieve developments in service provision.

BA3: Contribute to thedevelopment of organisationalpolicy and practice.

d) Maintains and sustains direction, policies andstrategies until they are firmly embedded inthe culture inspiring others with values and avision of the future while acknowledgingtraditions and background.

Creates a culture of effectiveness.

Works with many stakeholder groups towards achievingcommon understandings of concerns and issues.

Anticipates how corporate, local and national politicalagendas impact on the provision of service.

M&L_C2: Encourage innovationin your area of responsibility.

e) Enables and encourages others to:

• understand and appreciate the influences onservices and the reasons why improvementsare being made

• offer suggestions, ideas and views forimproving services and developing direction,policies and strategies

• alter their practice in line with agreedimprovements

• share achievements

• challenge tradition.

Leads on the nursing contribution to service improvement.

Influences corporate, local and national political agendasthat relate to the provision of a clinical service.

Communicates and disseminates innovations in practiceat local, national and international level.

M&L_C4: Lead change.

WP9: Contribute to developingand implementing a workforceplan.

f) Evaluates with others the effectiveness ofservice improvements and agrees that furtheraction is required to take them forward.

Evaluates the impact of local and national policy agendason the effectiveness of service provision.

Identifies strategies to improve the service and addressservice deficiencies collaboratively.

Establishes systems to enable horizon scanning andcontinuous modernisation.

Involves staff in developing, implementing and evaluatingservice objectives and contributing to achievement ofcorporate objectives.

Contributes to the strategic research agenda byidentifying areas for research in relation to the clientgroup and service.

M&L_F11: Manage theachievement of customersatisfaction.

M&L_F12: Improveorganisational performance(core 4 level 4).

g) Appraises draft policies and strategies fortheir effect on users and the public, andmakes recommendations for improvement.

Links local objectives to organisational strategicobjectives.

Enables service to develop so that it meets current healthcare policy.

Works with an understanding of the political environmentin which they work.

WP6: Contribute to assessingworkforce demand and supply.


Level 3: Appraise, interpret and apply suggestions, recommendationsand directives to improve services

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a) Engages the public, users of services andother interested parties in an open andeffective discussion on values, direction,policies and strategies for theorganisation/services.

Establishes mechanisms for engaging users incontributing to and informing service developmentand improvement by:

• accessing forums and voluntary agencies.

M&L_B2: Map the environment inwhich your organisation operates(IK2 level 3).

M&L_F10: Develop a customer-focused organisation.

b) Works effectively with others to define values,direction and policies clearly. This includesguidance on how to respond when these areunder pressure or interests are in conflict.

Leads and facilitates the development of acommon vision for the focus and futuredevelopment of services. This should involve allstakeholders to achieve mutual understanding andconflict resolution by:

• undertaking values clarification exercises withstakeholder groups.

M&L_B7: Provide leadership for yourorganisation.

CfA407: Inform and facilitatecorporate decision-making.

CfA408: Evaluate internal and externalfactors and promote partnershipworking.

PHP_44: Sustain and share a vision ofimproving health and wellbeing.

c) Works effectively with others to reviewvalues, direction and policies continually inthe light of changing circumstances.

Collaborates with all key stakeholders in theimplementation and continuous review of strategicdirection to:

• ensure local and national changes areconsidered in the short and long term.

CfA406: Monitor and review theimplementation of corporateobjectives, strategies and policies.

d) Works effectively with others to formulatestrategies and associated objectives that:

• are consistent with values, direction andpolicies

• are attainable given available resources andtimescales

• contain sufficient detail for the operationalplanning of services, projects andprogrammes

• take account of constraints

• balance competing interests and tensionswhile maintaining values and direction.

Facilitates the development of strategic directionand realistic milestones with key stakeholders by:

• being aware of resource limitations.

PSL8: Develop joint operationalpolicies and care pathways.

PSL9: Implement and evaluate jointoperational policies and carepathways.

PHS_12: Plan and target services andprogrammes to reduce health andwellbeing.

e) Communicates values, direction, policies andstrategies effectively to relevant people andenables them to:

• appraise and apply them to their area ofresponsibility

• feed in their views and suggestions forchange.

Enables stakeholders concerns, claims and issuesto be central to communication, engagement andevaluation strategies by:

• modelling this process at team and strategiclevels.

GEN29: Promote an informationculture.

f) Works effectively with everyone affected bydirection, policies and strategies to evaluatetheir impact and effectiveness and feed thisinformation into ongoing improvements.

Works strategically and with all stakeholders todevelop and achieve a strategic research agendathat encompasses evaluation of effectiveness andinforms continuing improvement by:

• developing a research and evaluation cultureacross the service and organisation, involving allstakeholders in its development

• contributing to research and developmentactivity, evaluation and research governance incollaboration with other stakeholders.

PHS_13: Plan, implement, monitor andevaluate programmes, services andinterventions to address health andwellbeing needs.

PHS_14: Assess the impact of policiesand shape and influence them toimprove health and wellbeing andreduce inequalities.


Level 4:Work in partnership to develop, take forward and evaluate direction,policies and strategies



Indicators Areas of application to nursing practice with examples (core)Skills for Healthwww.skillsforhealth.org.ukNOS/NWC

a) Acts consistentlywith legislation,policies,procedures andother qualityapproaches andencourages othersto do so.

Acts on and raises awareness in others of local and national political agendas thatimpact on own area of practice and client group. For example:

• incorporates the key components of current legislation and ethical considerationsinto practice such as Human Rights Act, NMC standards of record keeping

• uses national targets, patient-focused benchmarking and national serviceframeworks in own sphere of practice

• maintains a professional image and recognises how this impacts on the public’sperception of nursing

• uses a customer care approach in practice

• draws on evidence to inform own decision-making.

HCS_CE3: Comply with internal andexternal requirements and regulations.

GEN2: Prepare and dress for work inclinical/therapeutic areas (core 3level 1).

ICS9: Give customers a positiveimpression of yourself and yourorganisation.

b) Works within thelimits of owncompetence, levelsof responsibilityand accountabilityin the work teamand organisation.

Practises professional accountability and responsibility complying with thepublished code of professional practice.

Recognises own level of competence and their limits.

Maintains and develops levels of competence appropriate for practice andprofessional role to provide a seamless patient journey.

GEN63: Act within the limits of yourcompetence and authority.

GEN12: Reflect on and evaluate your ownvalues, priorities, interests andeffectiveness (core 2 level 2).

GEN13: Synthesise new knowledge intothe development of your own practice(core 2 level 3).

c) Works as aneffective andresponsible teammember.

Participates as a team member, interacts and collaborates with other teammembers to provide effective care for patients by:

• using different members of the multidisciplinary team effectively such as theinfection control nurse, dietician, physiotherapist

• contributes to team reviews.

HSC3121: Contribute to promoting theeffectiveness of teams.

M&L_D2: Develop productive workingrelationships with colleagues andstakeholders (core 5 level 3).

GEN31: Initiate and participate innetworks and discussion groups (core 1level 3).

HSC241: Contribute to the effectivenessof teams (core 5 level 1).

d) Prioritises andorganises ownworkload to reducerisks to quality.

Prioritises and manages own workload to promote quality in the workingenvironment by:

• managing self and own patients/user workload

• draws attention to changes in the workload that may need additional resources

• recognises the impact of stress on own practice and the practice of others andtakes action to reduce it.

M&L_A1: Manage your own resources(core 2 level 1).

HSC244: Manage and organise time andactivities to support individuals in thecommunity (core 5 level 1).

e) Uses andmaintainsresources efficientlyand effectively andencourages othersto do so.

Uses resources effectively in everyday practice by:

• being aware of the costs of everyday supplies and equipment

• working within the service budget

• drawing on information sources available that informs effective care

• uses different quality groups/personnel across the organisation.


f ) Monitors thequality of work inown area and alertsothers to qualityissues.

Monitors the quality of work undertaken by self and others by:

• using patient-focused benchmarks to improve the patient experience

• draws on a range of evidence to inform the need for change

• participates in and contributes to the audit process

• evaluates continuously own and others’ interventions

• communicates across organisational boundaries

• contributes to achieving the strategic quality agenda

• participates in clinical governance mechanisms

• uses integrated care pathways to improve the patient experience.

M&L_D6: Allocate and monitor theprogress and quality of work in yourarea of responsibility (G6 level 3).

CHS124: Manage and support theprogress of individuals through patientpathways (HWB4 level 3).

KSF core dimension 5: Quality

Level 2:Maintain quality in own work and encourage others to do so

24



Level 2 Maintain quality in own work and encourage others to do so.

Level 3 Contribute to improving quality.

Level 4 Develop a culture that improves quality.


25


a) Acts consistentlywith legislation,policies, proceduresand other qualityapproaches andpromotes the value ofquality approaches toothers.

Uses knowledge of local and national policies and procedures to promote aquality service.

Provides local expertise to the team on aspects of patient-focusedbenchmarks and appropriate national service frameworks.

Incorporates current prescribing legislation into team practice.

Incorporates legal and ethical frameworks into team clinical practice andcare management, justifying the decisions made.

HSC3119: Promote the values andprinciples underpinning best practice.

M&L_B8: Ensure compliance with legal,regulatory, ethical and socialrequirements.

HI7: Comply with an external audit ofdata and information.

b) Understands ownrole in the organisationand its scope andidentifies how this maydevelop over time.

Is self aware and links with organisational structures.

Is part of a shared governance structure.

Takes all opportunities to increase leadership and consultancy skills.

Acknowledges levels of competence in self and others.

M&L_A2: Manage your own resourcesand professional development (core 2level 1).

c) Works as aneffective andresponsible teammember and enablesothers to do so.

Supports team members in providing a conducive environment for patients.

Promotes discussion about ethical and legal aspects of care provision in theteam.

Facilitates the delivery of effective customer care by the team.

Develops and maintains effective internal and external networks.

Challenges other team members in a supportive and constructive manner.

Listens effectively, provides feedback in a supportive and constructivemanner.

Contributes towards building an effective team by enabling team membersto develop a common vision and direction.

Celebrates successes and takes informed risks.

Enables team members to contribute to different stages of the researchprocess.

HSC451: Lead teams to support a qualityprovision.

BF5: Lead teams to provide a qualityprovision.

M&L_A3: Develop your personalnetworks.

M&L_D1: Develop productive workingrelationships with colleagues.

M&L_D2: Develop productive workingrelationships with colleagues andstakeholders.

d) Prioritises ownworkload andorganises and carriesout own work in amanner that maintainsand promotes quality.

Works as part of a team to promote quality in a systematic, organisedmanner.

Questions practice and critiques research to identify research questionsabout team practice and specific care of client group.

Role-models systematic critique about the development and use ofevidence in and from practice.

M&L_D2: Develop productive workingrelationships with colleagues andstakeholders.

CHS170: Develop clinical protocols fordelivery of services.

CHS173: Develop care pathways forpatient management.

e) Evaluates thequality of own andothers’ work and raisesquality issues andrelated risks with therelevant people.

Evaluates service provided.

Develops and uses audit tools.

Ensures regular team audit and action planning.

Introduces evaluation approaches that provide feedback on the patientexperience and team activity.

Maintains local action plans for reviewing as part of the audit andevaluation process.

CHS171: Develop procedures for deliveryof services.

CHS172: Develop and optimise methodsand techniques for delivery of services.

f) Supports theintroduction andmaintenance of qualitysystems and processesin own work area.

Contributes to the development and implementation of quality systems.

Contributes to developing and refining integrated care pathways.

Uses experiences of the patient journey and other evaluations to improvethe care pathway.

Ensures supplies and services are maintained for safe and effective care bythe team.

Role-models effective partnership working.

CHS170: Develop clinical protocols fordelivery of services.CHS171: Develop procedures for deliveryof services.CHS172: Develop and optimise methodsand techniques for delivery of services.CHS173: Develop care pathways forpatient management.HI7: Comply with an external audit ofdata and information.

g) Takes appropriateaction when there arepersistent qualityproblems.

Identifies areas of the environment that require improvement for patientsand staff in collaboration with senior colleagues.

Analyses the evidence base and identifies gaps in practice.

CHS172: Develop and optimise methodsand techniques for delivery of services.


Level 3: Contribute to improving quality





a) Acts consistently in accordance withlegislation, policies, procedures and otherquality approaches and alerts others to the needfor improvements to quality.

Leads on developing a strategy for collating andmonitoring a profile of data about serviceeffectiveness that informs the need for qualityimprovement by:

• using patient and staff stories as a means ofgenerating evidence of the quality serviceprovided.


HSC436: Promote and manage aquality provision.

CfA413: Promote innovation andchange (core 4 level 4).

b) Works effectively in own team and as part ofthe whole organisation.

Contributes to and facilitates team effectivenessusing mechanisms for regular review of bothperformance and outcomes by:

• feeding this information into strategic humanresource policies.

BA5: Support effective governance.

M&L_B7: Provide leadership for yourorganisation (core 4 level 4).

c) Prioritises, organises and carries out ownwork effectively.

Provides evidence of how work is prioritised,organised and delivered as well as strategies forimprovement by:

• undertaking skill mix analysis.

d) Enables others to understand, and addressrisks to quality.

Uses formal risk analysis collaboratively to identifyand minimise risks through specific actions by:

• engaging with all the team to enable this tohappen

• facilitating the development of an open culturewhere risks are openly acknowledged by teammembers and discussed such as critical incidentanalysis.

e) Promotes quality actively in all areas of work. Works with the service and staff to identify theindicators of a quality service as well as agreeingstrategies to achieve them and evaluationmechanisms by:

• leading on benchmarking with otherstakeholders.

BC4: Assure your organisation deliversquality services.

f) Initiates and takes forward the introductionand maintenance of quality and governancesystems and processes across the organisationand its activities.

Leads in facilitating the implementation of systemsand processes that sustain person-centredness,clinical effectiveness, evidence-based practice andshared clinical governance by:

• leading in the development of a practice andservice culture of continuous practice andservice development

• using evidence from audit, evaluation andpractice critique to promote, model and useeffective action plans that address areas forimprovement and enable staff to takeresponsibility for actions and continuousimprovement.

PHS_07: Assess the evidence andimpact of health and health careinterventions, programmes andservices and apply the assessments topractice.

PHS_08: Improve the quality of healthand health care interventions andservices through audit and evaluation.

M&L_F12: Improve organisationalperformance (core 4 level 4).

g) Monitors quality continuously and takeseffective action to address quality issues andpromote quality.

Leads on building a culture of effectiveness,positive change and innovation in response to achanging health care context.

M&L_B7: Provide leadership for yourorganisation (core 4 level 4).

M&L_B9: Develop the culture of yourorganisation (core 4 level 4).


Level 4:Develop a culture that improves quality

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a) Recognises the importance of people’s rightsand acts in accordance with legislation,policies and procedures.

Ensures that confidentiality is maintained at alltimes when obtaining and passing on information.

HSC3116: Contribute to promoting aculture that values and respects thediversity of individuals (HWB1 level 2).

b) Acts in ways that:

• acknowledges and recognises people’sexpressed beliefs, preferences and choices

• respects diversity

• values people as individuals.

Identifies with patients’/clients’ relevant social,cultural and religious factors that may influencethe patient/client and relatives in maintaininghealth.

Accesses appropriate facilities and diet for patientswith specific cultural and religious beliefs.

Guides and directs patients and users to guidanceand advice services such as voluntaryorganisations, PALS (Patient Advice and LiaisonServices) and human resources.


HSC234: Ensure your own actionssupport the equality, diversity, rightsand responsibilities of individuals(core 6 level 2).

c) Takes account of own behaviour and its effecton others.

Role-models person-centred care that promotesequality and diversity.



d) Identifies and takes action when own orother’s behaviour undermines equality anddiversity.

Identifies when patients/carers and others arebeing discriminated against and takes appropriateaction with support.

Challenges behaviour that infringes the rights ofothers.

Contributes to evaluation that promotes equalityand values diversity in recruitment processes andother areas of health care activity andenvironments.


KSF core dimension 6: Equality and diversity

Level 2: Support equality and value diversity


Level 2 Support equality and value diversity.

Level 3 Promote equality and value diversity.

Level 4 Develop a culture that promotes equality and values diversity.



a) Interprets equality, diversity and rights inaccordance with legislation, policies, proceduresand relevant standards.

Identifies with patients’/clients’ relevant social,cultural and religious factors that may influencethe patient/client and relatives in maintaininghealth.

Ensures that confidentiality is maintained at alltimes when obtaining and passing on information.

Accesses appropriate facilities and diet for patientswith specific cultural and religious beliefs.



b) Evaluates the extent to which legislation isapplied in the culture and environment of ownsphere of activity.

Works with others to evaluate the extent to whichlegislation requirements are applied in own area ofpractice. For example:

• disability legislation in relation to access tosuitable facilities and access to your service

• confidentiality and data security relating toaccess to patient records

• recruitment and selection practices

• employment legislation relating to flexibleworking.

HSC35: Promote choice, wellbeing andthe protection of all individuals.

HSC3111: Promote the equality,diversity, rights and responsibilities ofindividuals.



c) Identifies patterns of discrimination andtakes action to overcome discrimination andpromote diversity and equality of opportunity.

Identifies when patients/carers and others arebeing discriminated against and takes action withsupport.


CJ_AA1: Promote equality and valuediversity.

d) Enables others to promote equality anddiversity and a non-discriminatory culture.

Role models person-centred care that promotesequality and diversity.

HSC3111: Promote the equality,diversity, rights and responsibilities ofindividuals.


e) Supports people who need assistance inexercising their rights.

Challenges behaviour that infringes the rights ofothers.

Advocates on behalf of people whose rights havebeen/or may be compromised such as supportingindividuals with sight or hearing difficulties tomake informed consent.

Guides and directs patients and users to guidanceand advice services e.g. voluntary organisations,PALS (Patient Advice and Liaison Services) andhuman resources.

HSC395: Contribute to assessing andact on risk of danger, harm and abuse(HWB3 level 2).

HSC367: Help individuals identify andaccess independent representationand advocacy (HWB4 level 3).

HSC330: Support individuals toaccess and use services and facilities(HWB4 level 3).

M&L_B11: Promote equality ofopportunity and diversity in your areaof responsibility.


Level 3: Promote equality and value diversity

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a) Interprets legislation to inform individuals’rights and responsibilities.

Uses a working knowledge of legislation and codesof ethics to protect rights and responsibilities by:

• acting as an advocate for individuals.

HI7: Comply with an external audit ofdata and information (core 5 level 3).

b) Promotes equality and diversity actively. Actively promotes equality and diversity by:

• role-modelling expertise and leadership indeveloping a culture that places equality,diversity and rights at its centre.

HSC44: Develop practice thatpromotes the involvement, wellbeingand protection of children and youngpeople.

c) Identifies and highlights methods andprocesses to resolve complaints as aconsequence of unfair and discriminatorypractice.

Identifies processes to resolve complaints.

Encourages a culture of openness and honesty.

Promotes a no blame culture.

d) Supports people whose rights have beencompromised consistent in accordance withlegislation, policies and procedures and goodand best practice.

Develops a culture that works to ethical and legalprinciples in a transparent way.

Act as an advocate for people who have beencompromised.

HSC45: Develop practices thatpromote choice, wellbeing andprotection of all individuals.

e) Challenges individual and organisationaldiscrimination actively.

Openly challenges discrimination.

Is prepared to articulate values and beliefs relatedto discrimination.

M&L_B12: Promote equality ofopportunity and diversity in yourorganisation.

f) Evaluates the effectiveness of equality anddiversity policies and procedures in theservice/agency, and contributes to thedevelopment of good and best practice.

Contributes to and evaluates good practice.

Uses observations of care, staff and patient storiesto determine equality and diversity practice issues.

HSC452: Contribute to thedevelopment, maintenance andevaluation of systems to promote therights, responsibilities, equality anddiversity of individuals.


Level 4: Develop a culture that promotes equality and values diversity






a) Identifies factors that have apositive and negative affect onhealth and wellbeing and howpositive effects can be promoted,and adverse effects prevented.

Provides health promotion in a way thatempowers the patients/users. Also, to helppeople to become aware of the factors thatnegatively and positively contribute to theirhealth and strategies to manage them.

HSC3103: Contribute to raising awareness of healthissues.

HSC419: Provide advice and information to people whoenquire about mental health needs and related services(HWB2 level 2).

b) Enables people to view healthand wellbeing as a positive aspectof their lives.

Enables patients and users to identify health-related goals that are important to them.Support people to build their own strategies formaintaining their health.

GEN14: Provide advice and information to individualson how to manage their condition (HWB4 level 3).

HSC3112: Support individuals to identify and promotetheir own health and social wellbeing.

c) Enables people to take part inactivities and to make their owndecisions about them consistentwith people’s views and beliefs.

Addresses any issues that people may have andobtains informed consent before any activitiesthat include assessment.

Identifies strategies with patients and users forachieving their own health promotion goals.

CHS76: Obtain informed consent for interventions andinvestigations (HWB5 level 3).

HSC3112: Support individuals to identify and promotetheir own health and social wellbeing.

HT2: Communicate with individuals about promotingtheir health and wellbeing.

d) Undertakes planned activitieswith people with their agreementin accordance with legislation,policies and procedures.

Aware of the specific legal and ethicalimplications of specialist interventions,treatments and therapies supported by amentor/clinical supervisor.

CHS76: Obtain informed consent for interventions andinvestigations (HWB5 level 3).

HT3: Enable individuals to change their behaviour toimprove their health and wellbeing.

e) Records and reports back fullyon the activities undertaken. Alertsothers in the team to any issuesthat arise during the activities.

Keeps accurate care records and alerts themultidisciplinary team to any issues that occur.

HSC434: Maintain and manage records and reports (IK1level 2).

KSF core dimension HWB1: Promotion of health and wellbeing and prevention of adverse effects onhealth and wellbeing

Level 1: Contribute to promoting health and wellbeing and preventing adverseeffects on health and wellbeing

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Health and wellbeing specific dimensions (HWB)

Specific dimension HWB1:Promotion of health and wellbeing and prevention of adverse effectson health and wellbeing

Level 1 Contribute to promoting health and wellbeing and preventing adverse effects on health and wellbeing.

Level 3 Plan, develop, implement and evaluate programmes to promote health and wellbeing and prevent adverse effectson health and wellbeing.

Level 4 Promote health and wellbeing and prevent adverse effects on health and wellbeing through contributing to thedevelopment, implementation and evaluation of related policies.

5

Specific Knowledge and SkillsFramework dimensions


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a) Engages and works effectively with a widerange of diverse people to identify theirconcerns about health and wellbeing andthe target groups for any programmes.

With all stakeholders identify the needs of thelocal population with regard to health andwellbeing and programmes of supportrequired e.g. hold patient forums.

Address concerns of stakeholders involved inthe programme.

PHP_16: Work in partnership to promotehealth and wellbeing and reduce risks inhealth care settings.

b) Proactively identifies the purpose of theprogrammes and the issues they aredesigned to address.

Works with stakeholders to identify thepurpose of the programme specific to theneeds of the patients, for example:

• use questionnaires to identify areas toaddress

• undertake a values clarification exercise.

PHP_28: Work in partnership to plan,implement and review programmes andprojects to improve health and wellbeing.

c) Involves people from the target groupactively in priority-setting, programmedesign, planning and implementation.

Involves patients in planning their on-goingcare.

Uses team exercises to involve all.

PHP_22: Work in partnership withcommunities to assess their health andwellbeing and related needs.

MH60: Enable groups, communities andorganisations to determine and plan how toaddress their issues and concerns.

d) Identifies:

• trends in people’s health and wellbeing

• other resources that people in the targetgroup have available to them

• how these resources might be better usedby the people concerned

• the contribution that the programmemight make.

Identifies all resources that would benefit theprogramme.

Uses health promotion theory to inform clinicalpractice.

Provides programmes that are geared to thepatients/clients in the local area.

PHP_22: Work in partnership withcommunities to assess their health andwellbeing and related needs.

e) Works with others to produce and record adetailed plan for the health improvementprogrammes that are appropriate for thetarget groups and take into account:

• relevant policies and strategies

• the different levels at which theprogramme needs to operate

• specific activities within each of thoselevels

• how the programme will be co-ordinated

• the evidence that will be used to judge it’seffectiveness

• legislation, policies and procedures.

Works with all stakeholders to produce anappropriate plan suitable for the patient group.

Involves all stakeholders in the plan by holdingopen forums.

Encourages people to identify their own needsenabling the programmes to be focused at theright level.

Uses patient stories to evaluate effectiveness.

Works in accordance with local and nationalguidelines.

PHP_17: Work in partnership to prevent theonset of adverse effects on health andwellbeing in populations.

f) Works with others to implementprogrammes effectively for the targetgroup.

Works with stakeholders to achieve theprogramme together with community carersand voluntary agencies.

Uses the skills of other professionals toprovide the best programme.


PHS_19: Develop, sustain and implement avision and objectives for improving health andwellbeing.

g) Evaluates with people from the targetgroup and those involved in running theprogramme its effectiveness in improvinghealth and wellbeing.

Evaluates the programmes using feedbackfrom stakeholders. For example:

• 360 degree feedback

• observations of care

• patient stories

• staff stories.



Level 3: Plan, develop, implement and evaluate programmes to promote healthand wellbeing and prevent adverse effects on health and wellbeing






a) Evaluates the content and thrust of policiesand identifies:

• the impact they will have on health andwellbeing

• their consistency

• their inclusiveness

• evidence of effectiveness.

Addresses concerns of stakeholders involved inthe programme.

PHP_32: Work in partnership tomonitor and review strategies forimproving health and wellbeing.

PHP_38: Monitor trends anddevelopments in policies for theirimpact on health and wellbeing.

b) Alerts decision-makers to issues that:

• will affect health and wellbeing

• are inconsistent with evidence

• and offers constructive solutions to tacklethese issues.

With stakeholders identifies the purpose of theprogramme by, for example, undertaking a valuesclarification exercise.

PHP_29: Work in partnership todevelop and agree priorities andtargets for improving health andwellbeing.

c) Produces clear and concise arguments fordecision-makers that outline the benefits ofimproving health and wellbeing and the risksof not doing so.

Uses team exercises to involve everyone. PHP_39: Present information andarguments to others on how policiesaffect health and wellbeing.

PHP_35: Advise how healthimprovement can be promoted inpolicy development.

d) Drafts inputs to policy documents that areconsistent with evidence and relevantlegislation and help decision-makers moveforward.

Provides programmes that are geared to localpatients/clients.

Contributes to policy development in own area ofpractice that impact on the health and wellbeing ofthe patient group.

PHP_40: Evaluate and recommendchanges to policies to improve healthand wellbeing.

PHP_36: Contribute to the formulationof policy specifically focused onimproving health and wellbeing.

e) Uses a range of different methods that arecapable of achieving change in others’policies.

Works with all stakeholders to produce anappropriate plan suitable for the patient group.

PHP_29: Work in partnership todevelop and agree priorities andtargets for improving health andwellbeing.

f) Agrees how to take forward theimplementation of policies at a local level andundertake own role effectively.

Uses the skills of other professionals to provide thebest programme.

PHP_30: Work in partnership to planhow to put strategies for improvinghealth and wellbeing into effect.

PHP_31: Work in partnership toimplement strategies for improvinghealth and wellbeing.

PHS_03: Plan, implement, monitorand evaluate strategies for promotingthe health and wellbeing of thepopulation.

g) Evaluates the impact of policies on improvingthe health and wellbeing of the targetpopulation.

Evaluates the programmes using feedback fromstakeholders such as 360 degree feedback,observations of care, patient and staff stories.

PHP_33: Work in partnership to makea preliminary assessment of theimpact of policies and strategies onhealth and wellbeing.

PHP_34: Work in partnership toundertake a full assessment of theimpact of policies and strategies onhealth and wellbeing.

PHP_37: Evaluate and review theeffects of policies on healthimprovement.

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Level 4: Promote health and wellbeing and prevent adverse effects on healthand wellbeing through contributing to the development,implementation and evaluation of related policies


33



a) Plans the assessment of people’shealth and wellbeing needs andensures that it takes place.

Obtains informed consent prior to all activities includingassessment, having addressed any issues that peoplemay have.

Ensures patients are cared for in an environment suited totheir physical, psychological and social needs.

Assesses the ability and motivation of the patient andcarer to self-manage care.

Identifies the physiological, psychological, social, cultural,developmental, sexual and spiritual needs of the personwhen planning care.

Identifies the individual’s coping and adjustmentstrategies, their motivation and support mechanisms.

CHS76: Obtain informed consent forinterventions or investigations (HWB5level 3).


AHP25: Assist in the assessment ofthe need for, and the provision ofenvironmental and social support inthe community (HWB2 level 2).

EUSC_01: Take a presenting historyfrom an individual to informassessment (HWB6 level 3).

HSC414: Assess individual needs andpreferences (HWB2 level 3).

AF2: Carry out assessment to identifyand prioritise needs (HWB2 level 3).

HSC382: Support individuals toprepare for, adapt to and managechange (HWB4 level 3).

b) Explains clearly to people:

• own role, responsibilities andaccountability

• the information that is needed fromthe assessment and who might haveaccess to it

• the benefits and risks of theassessment process and alternativeapproaches.

Takes accountability and responsibility for actions whenassessing and planning care.

Ensures continuity of care and that patients and usersknow who is responsible for that care.

Ensures patients allergies are documented and issues redname bands if appropriate.

Assesses patient’s ability to self-medicate.

Provides advice to client group on the effects and side-effects of commonly used drugs.


c) Respects people’s dignity, wishes andbeliefs, involves them in shareddecision making and obtains theirconsent.

Enables the person’s own informed decision–making.

Acts in ways that acknowledge an individual’s right tomake own decisions and recognises their responsibilities.

Demonstrates moral integrity in relationship with patientsand the people who are important to them.

Obtains valid informed consent.

CHS76: Obtain informed consent forinvestigations or treatments (HWB5level 3).


KSF core dimension HWB2: Personal and people development

Level 3: Assess health and wellbeing needs and develop, monitor and reviewcare plans to meet specific needs


Specific dimension HWB2:Assessment and care planning to meet health and wellbeing needs

Level 3 Assess health and wellbeing needs and develop,monitor and review care plans to meet specific needs.

Level 4 Assess complex health and wellbeing needs and develop,monitor and review care plans to meet those needs.



34






d) Uses assessment methods andprocesses of reasoning that:

• are based on available evidence

• are appropriate for the peopleconcerned

• obtain sufficient information forinformed decision-making

• they have the knowledge, skills andexperience to use effectively

• are consistent with legislation,policies and procedures.

Assesses and records baseline observation on a patient’sadmission, reporting anything out of normal range such asnutritional status, blood sugar, blood pressure and heartrate.

Acts on feedback derived from a range of sources includingthe patient’s own preferences, evidence-based guidelinesand patient-centred standards/benchmarks.

Uses an evidence-based and person-centred assessmentapproach to identify health care and education needs.

Undertakes a holistic assessment in partnership with thepatient to determine accurately actual and potentialproblems that might require intervention.

Adjusts assessment and history taking to the life span,gender and cultural background of the person.

Assesses patient’s level of vulnerability because of disabilityor age.

Acts on the specific legal and ethical implications ofspecialist interventions, treatments and therapies supportedby a mentor/clinical supervisor.

Uses knowledge of the side-effects and risks associated withimplementing drug interventions, treatments and therapiescommonly used with client group.

Evaluates drug, treatment and therapy strategies in line withlocal and national policies and clinical guidelines.

Implements actions and knowledge arising from ownreflections and clinical supervision.

Implements local action plans for patient-focusedbenchmarking.


EUSC_02: Obtain supportinginformation to inform patientassessment (HWB6 level 3).

CHS92: Monitor and review a patient’snutritional wellbeing.

CHS4: Identify the individual at risk ofskin breakdown and undertakeappropriate risk assessment.

CHS60: Assess individuals with long-term conditions.

e) Considers and interprets all of theinformation available and makes ajustifiable assessment of people’shealth, wellbeing and relatedneeds. Explains the outcomes tothose concerned.

Recognises and acts on patterns of signs and symptoms inpatients with similar health and wellbeing needs, integratingthis with knowledge of the specific patient.

Uses patients own preferences as one of the sources ofevidence to inform decision-making.


EUSC_02: Obtain supportinginformation to inform patientassessment (HWB6 level 3).

EC_11A: Investigate and diagnose anindividual who presents foremergency assistance withbreathlessness (HWB6 level 4).( This isunder review).

CHS4: Identify the individual at risk ofskin breakdown and undertakeappropriate risk assessment.


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f) Develops and records care plans that areappropriate to the patient and:

• are consistent with the outcomes ofassessing their health and wellbeing needs

• identify the risks that need to be managed

• have clear goals

• involve other practitioners and agencies whenthis is necessary to meet people’s health andwellbeing needs and risks

• are consistent with the resources available

• note people’s wishes and needs that it wasnot possible to meet.

Documents clear and accurate information aboutthe patient arising from the assessment and careplanning process. Communicates this informationto others.

Begins appropriate discharge and/or rehabilitationplan after discussion with patient andmultidisciplinary team.

AG1: Develop, implement and reviewcare plans for individuals (HWB2 level3).

EUSC_07: Prioritise individuals forfurther assessment, treatment andcare (HWB6 level 3).

AG2: Contribute to care planning andreview (HWB2 level 2).

GEN16: Inform an individual ofdischarge arrangements (core 1 level2).

CHS87: Agree rehabilitation plans withindividuals, families, carers and otherprofessionals (HWB2 level 3).

HSC428: Develop, implement andreview programmes of support forcarers and families.

HSC450: Develop risk managementplans to support individual’sindependence to live in their ownhome.

CHS61: Co-ordinate the care ofindividuals with long-term conditions.

g) Monitors the implementation of care plansand makes changes to meet people’s needs.

Prioritises care required within available resourcesensuring patient’s needs are met.

Acts as a key worker by co-ordinating themonitoring and evaluation of care plans.

Maintains continuity of care and makes necessarychanges in consultation with the multidisciplinaryteams such as pain assessment, fluid andnutritional input and output.

MH26: Implement specific parts ofindividualised care programmes(HWB7 level 2).

CHS89: Evaluate treatment plans withindividuals and those involved in theircare.



36




a) Explains clearly to people:

• own role, responsibilities and accountability

• the information that is needed from the assessment ofhealth and wellbeing needs, and who might have accessto it

• the benefits and risks of the assessment process andalternative approaches

• the outcomes of assessment

• options in care plans and associated benefits and risks.

Considers and applies legal, ethical andprofessional perspectives when planning carestrategies.

HSC45: Develop practices thatpromote choice, wellbeing andprotection of all individuals(core 6 level 4).

b) Respects people’s dignity, wishes and beliefs, involvesthem in shared decision-making and obtains theirconsent.

Acts as a catalyst by creating harmony andunderstanding. Enables new ways of working,and influences colleagues’ practice by:

• knowing the patient

• demonstrating moral integrity.

CHS76: Obtain informedconsent for interventions orinvestigations (HWB5 level 3).

c) Plans and uses assessment methods that are appropriatefor complex needs, and uses processes of reasoning that:

• are appropriate for the complex needs of the peopleconcerned

• they have the knowledge, skills and experience to useeffectively

• are based on available evidence

• obtain sufficient information for decision-making thatincludes assessment information from otherpractitioners.

Uses holistic practice knowledge to developreferral pathways for patients requiring otherinterventions. Enables patient-focusedbenchmarks to be integrated into patientassessment and care planning processes.

CHS99: Refer individuals tospecialist sources of assistanceto meet their health care needs(HWB6 level 3).

EUSC_01: Take a presentinghistory from an individual toinform assessment (HWB6 level3).

EUSC_02: Obtain supportinginformation to inform theassessment of an individual(HWB6 level 3).

EUSC_03: Co-ordinate anindividual’s furtherassessments and investigationsprior to the start of treatment(HWB6 level 3).

d) Follows reasoning processes that:

• balance additional information against the overall pictureof the individual’s needs to confirm or deny developinghypotheses

• are capable of justification given the available informationat the time

• are likely to result in the optimum outcome.

Demonstrates clear lines of accountability indelivering services in established practice bydemonstrating skilled know-how. Displayscreative, innovative and challengingbehaviour appropriate to the boundaries ofprofessional conduct.

e) Interprets all available information and makes ajustifiable assessment of:

• people’s health and wellbeing

• their related complex needs and prognosis

• risks to their health and wellbeing in the short and longerterm.

Transfers and applies their skills and knowledge to addressthe complexity of people’s needs.

Uses expert knowledge to inform relevantcare provision that will enhance theexperience of the user. For example, liaiseswith all stakeholders to ensure that allinformation is used to plan the care provided.

Gets quickly to the heart-of–the-matter byinterpreting all information in aknowledgeable way using skills of differentialdiagnosis.

HSC427: Assess the needs ofcarers and families.

CHS40: Establish a diagnosis ofan individual’s health condition(HWB6 level 4).


Level 4:Assess complex health and wellbeing needs and develop, monitor andreview care plans to meet those needs




37



f) Develops and records care plans that areappropriate to the people concerned and:

• are consistent with the outcomes ofassessing their complex health and wellbeingneeds

• identify the risks that need to be managed

• have clear goals

• involve other practitioners and agencies tomeet people’s complex health and wellbeingneeds and risks

• are consistent with the resources available

• note people’s wishes and needs that it wasnot possible to meet.

Uses analytical skills to understand and use datain clinical practice.

HI19: Assess clinical information andevidence critically (IK2 level 2).

g) Co-ordinates the delivery of care plans,feeding in relevant information to supportwider service planning.

Co-ordinates care planning by developingcomputer literacy.

Co-ordinates the delivery of the planned care.

Feed relevant information to inform thedevelopment of, for example, care pathways,clinical protocols.

HSC41: Use and develop methods andsystems to communicate record andreport (core 1 level 4).

CHS170: Develop clinical protocols forthe delivery of services (core 5 level 3).

CHS173: Develop care pathways forpatient management (core 5 level 3).

h) Monitors the implementation of care plansand makes changes to better meet people’scomplex health and wellbeing needs.

Monitors the quality of care plans to ensure theservice user is being provided with person-centred,effective, evidence-based care.

Monitor the quality of care implemented.

Evaluate care delivered and review care plans toensure complex health and wellbeing needs aremet.

CHS85: Review and evaluate caremanagement plans with individualsdiagnosed with long-term conditions(HWB6 level 3).


Level 4:Assess complex health and wellbeing needs and develop, monitor andreview care plans to meet those needs


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a) Identifies signs that people are at risk andthat there might be a need for protectivemeasures.

Identifies patients who are at risk such as peoplewho are suffering from pressure sores,malnutrition, drug abuse, falls, depression andabuse.

HSC240: Contribute to theidentification of the risk of danger toindividuals and others.

HSC335 Contribute to the protectionof individuals from harm and abuse(HWB3 level 2).b) Reports any suspicions of risk to the

appropriate people and/or organisations inaccordance with legislation, policies andprocedures.

Reports any potential risks identified above toteam leader or others, and jointly identifystrategies to minimise then.

c) Records and reports any information that isavailable on the risks.

Records accurately all aspects of care that affectrisks such as manual handling needs and theactions taken to minimise them.

KSF core dimension HWB3: Protection of health and wellbeing

Level 1: Recognise and report situations where there might be a needfor protection


Specific dimension HWB3:Protection of health and wellbeing

Level 1 Recognise and report situations where there might be a need for protection.

Level 2 Contribute to protecting people at risk.

Level 3 Implement aspects of a protection plan and review its effectiveness.

Level 4 Develop and lead on the implementation of an overall protection plan.


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a) Contacts individuals who are at risk, takingthe necessary action if difficulties areencountered.

Has protocols in place to ensure people at-risk arenot excluded from follow-up care when dischargedfrom secure environments.

HSC335: Contribute to the protectionof individuals from harm and abuse.

AB3: Contribute to the prevention andmanagement of abusive andaggressive behaviour.

HSC337: Provide frameworks to helpindividuals to manage challengingbehaviour.

HSC395: Contribute to assessing andact on risk of danger, harm and abuse.

b) Explains to people the purpose for thecontact, relevant regulatory powers, whetherinformation will be confidential or disclosed.Involves them in shared decision-making.

Ensures that all information is given to the personto enable shared decision-making.


c) Prepares for, and contributes to protectiveinterventions in a manner that:

• is consistent with legislation, policies andprocedures

• is appropriate to the people concerned

• is appropriate for the setting

• maintains the health and safety of theindividual concerned, self and others.

Has knowledge and understanding of policies andprocedures such as guidance around childprotection issues and sectioning under the MentalHealth Act.



d) Takes appropriate and immediate action inresponse to emergencies.

Knows what emergency plans are in place and whoto contact in case of emergency.

e) Records and reports the interventions inaccordance with legislation and relevantpolicies and procedures.

Keeps records of all incidents and reports oncorrect documentation to the appropriate person.


Level 2:Contribute to protecting people at risk


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a) Works in partnership to identifyand assess the nature, locationand seriousness of theparticular risks.

Works in partnership to identify the nature,location and seriousness of the particularrisks. This should include the individual, theircarers, the wider health care team and socialservices.

Participates in risk assessment and alertsappropriate individuals and agencies. Seekssupport and guidance as necessary.

PHP_19: Work in partnership to plan investigations toprotect the public’s health and wellbeing from specificrisks.

PHP_20: Work in partnership to identify how to applyplans that protect the public’s health and wellbeing fromspecific risks.

PHP_21: Undertake own role in a partnership to protectthe public’s health and wellbeing from specific risks.

HSC335: Contribute to the protection of individuals fromharm and abuse (HWB3 level 2).

b) Prioritises own work in line withareas of highest risk, co-ordinating own actions withcolleagues.

Prioritises own work in relation to the highestrisks.

Work effectively with others in responding tothe identified risk.

Actions issues arising from risk assessmentsand document all changes.

HSC395: Contribute to assessment of danger, and act onrisk, harm and abuse (HWB3 level 2).

c) Contacts people who are at risk,taking necessary action if thereare difficulties.

Contacts those who are at risk, addressingissues/difficulties as they arise.

Reports issues when they are outside ownarea of responsibility and sphere of influence.

PHP_18: Work in partnership to contact, assess andsupport individuals that are at risk from identifiedhazards to health and wellbeing.

d) Explains to people the purposefor the contact, anyrequirements for statutoryenforcement, what people arerequired to do to comply withthe statutory enforcement andwhat will happen if they fail tocomply and involves them inshared decision-making.

Informs people, who are at risk, why they arebeing contacted, and ensures that theyunderstand.

Ensures shared decision-making in relation tocompliance with statutory enforcement, andexplains consequences for failing to comply.

HSC430: Support the protection of individuals, keypeople and others.

e) Prepares for, and undertakesthe protective interventions thatthey are responsible for in theprotection plan in a mannerthat:

• is consistent with evidence-based practice, legislation,policies and procedures

• is appropriate for individuals

• is appropriate for the setting

• maintains health and safety.

Assesses and implements appropriateprotective interventions that apply to area ofpractice and responsibility.

Adheres to guidelines and evidence-basedpractice. For example, radiation protection,manual handling regulations and infectioncontrol.

HSC337: Provide frameworks to help individuals tomanage challenging behaviour (HWB3 level 2).

IPC1: Minimise the risks of spreading infection bycleaning and maintaining environments in health andsocial care settings (core 3 level 1).

IPC2: Perform hand hygiene to prevent the spread ofinfection (core 3 level 1).

IPC3: Clean and remove spillages of blood and otherbody fluids (core 3 level 1).

IPC4: Clean and store care equipment to minimise therisks of spreading infection (core 3 level 1).

IPC5: Minimise the risks of exposure to blood-borneinfections while providing care (core 3 level 1).

IPC6: Use personal protective equipment to preventspread of infection (core 3 level 1).

IPC7: Safely dispose of health care waste, includingsharps, to prevent the spread of infection (core 3 level 1).

IPC8: Minimise the risk of infection when transportingand storing health care waste (core 3 level 1).

IPC9: Minimise the risks of spreading infection whenremoving used linen (core 3 level 1).

Gen2: Prepare and dress for work in clinical/therapeuticareas (core 3 level 1).

CHS6: (HWB5 level 2).


Level 3: Implement aspects of a protection plan and review its effectiveness


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f) Undertakes own work in ways that managerisk and are consistent with statutoryenforcement.

Undertakes risk management.

Follows policies and procedures designed tomanage risks, such as health and safety andradiation protection.

HSC430: Support the protection ofindividuals, key people and others.

HSC395: Contribute to assessing andact on risk of danger, harm and abuse(HWB3 level 2).

g) Works with other members of the protectionteam to plan, monitor and review theeffectiveness of the protection plan.

Reviews changes and evaluates outcomes of theprotection plan with protection team members,taking into account the patient point of view.

PHP_19: Work in partnership to planinvestigations to protect the public’shealth and wellbeing from specificrisks.

PHP_20: Work in partnership toidentify how to apply plans thatprotect the public’s health andwellbeing from specific risks.

PHP_21: Undertake own role in apartnership to protect the public’shealth and wellbeing from specificrisks.

h) Records and reports on the legislation,policies and procedures that relate to theoverall protection plan for which s/he isresponsible.

Keeps accurate up-to-date records that areaccessible by all agencies involved in theprotection plan.



Level 3: Implement aspects of a protection plan and review its effectiveness



a) Works in partnership to identify and assess:

• nature, location and seriousness of risks

• problems that need to be addressed

• factors that might be causing the problems

• priorities

• legislative, policy and proceduralrequirements.

Works in a governance framework to address riskissues that reflect local and national requirements.

HSC431: Support individuals whereabuse has been disclosed(HWB3 level 3).

b) Identifies and agrees a range of options foraddressing agreed priorities with others.Selects those that have the best chance ofsuccess.

Presents collaborative action plans that set outpriorities.

c) Develops an overall protection plan with thehelp of others.

Initiates and facilitates others to develop healthprotection plans.

PHS_05: Plan, implement, monitorand evaluate strategies for protectingthe health and wellbeing of thepopulation.

PHS_04: Plan, implement, monitorand evaluate disease prevention andscreening programmes to improve thepopulation’s health and wellbeing.

d) Considers each specific case in the context ofthe overall protection plan and decides withothers how to proceed.

Works in collaboration to action health protectionthe plans.

EC_31: Manage major emergencysituations (under review).

e) Identifies and agrees in partnership:

• who will be involved in the management ofspecific risks

• how the risks can be best managed

• who needs to be kept informed.

Involves and informs all key stakeholders aboutthe implementation of risk strategies.

f) Co-ordinates with everyone involved tomanage risks effectively and to facilitate swiftand effective communication and support.

Knows who to contact in case of emergency suchas when help is needed to support people at risk ofself-harm.

g) Undertakes any protective interventions thatare necessary to manage complex risks forwhich s/he holds responsibility.

Ensures competence to deal with risk situationssuch as tackling violent and aggressive behaviour.

HSC430: Support the protection ofindividuals, key people and others(HWB3 level 3).

PHP_21: Undertake own role in apartnership to protect the public’shealth and wellbeing from specificrisks (HWB3 level 3).

h) Maintains an ongoing accurate record of risks,the actions taken and other investigationsthat have been put into effect.

Maintains up-to-date records of all actions andinterventions such as completion of appropriateaccident/incident forms.


i) Reviews the effectiveness of protection planswith others and any issues aboutimplementation. Makes the necessarychanges as a result.

Reviews and evaluates all responses and actionstaken with those involved.

42



Level 4:Develop and lead on the implementation of an overall protection plan




43



a) Offers information to the team on how tomeet people’s health and wellbeing needs,and effective ways of doing this based onobservations and own experience.

Identifies and meets the information needs ofindividual patients/users through team briefings,case conferences and clinical governanceprocedure.

HSC241: Contribute to theeffectiveness of teams (core 5 level 1).

b) Respects people’s dignity, wishes and beliefs,and involves them in shared decision-making.Obtains their informed consent.

Supports patients to become self-sufficient indecision-making, including setting benchmarksand considering important issues such as ‘do notresuscitate’ orders.

CHS76: Obtain informed consent forinterventions or investigations (HWB6level 3).

c) Prepares and undertakes activities to enablepeople to meet their ongoing needs inaccordance with the care plan, legislation,policies and procedures.

Acts as a resource to the patient/client family,carers and health care assistants throughout thepatient’s journey.

Provides specific information to individualpatients, families and carers on everyday healthcare issues such as the side-effects of medication,dietary information, rehabilitation and themanagement of chronic illness.

Enables patients to access other resources forspecialist information that is relevant to the clientgroup and their rights.


HSC27: Support individuals in theirdaily living.


d) Alerts the team to any risks promptly. Shows awareness of who to alert when there arerisks to address.

e) Reports and records activities undertakenand how health and wellbeing needs arechanging. Feeds back on the appropriatenessof the activities for the people concerned.

Uses person-centred records to inform theimmediate clinical team about key health andwellbeing activities as well as ongoing progress.Does this within confidentiality guidelines.



Specific dimension HWB4:Ability to address health and wellbeing needs

Level 2 Enable people to meet ongoing health and wellbeing needs.

Level 3 Enable people to address specific needs in relation to health and wellbeing.

Level 4 Empower people to realise and maintain their potential in relation to health and wellbeing.

KSF core dimension HWB4: Ability to address health and wellbeing needs

Level 2:Enable people to meet ongoing health and wellbeing needs



a) Respects people’s dignity, wishes and beliefs,and involves them in shared decision making.Obtains their informed consent.

Uses a full range of strategies to relieve thepsychological and spiritual impact of ill health onindividuals, family and supporters.

HSC351: Plan, agree and implementdevelopment activities to meetindividual needs.

HSC369: Support individuals withspecific communication needs.

b) In partnership with clients identifies:

• goals for specific activities in the overall careplan and their health and wellbeing needs

• the form that the activities should take

• the involvement of other people and/oragencies

• relevant evidence-based guidelines.

Involves everyone in planning care based on bestevidence and patient choices.

GEN14: Provide advice andinformation to individuals on how tomanage their own condition.

HSC350: Recognise, respect andsupport the spiritual wellbeing ofindividuals.

c) Enables people to address their specificneeds in accordance with legislation, policiesand procedures, and acts as a resource asand when clients need it.

Advocates on behalf of patients to enable choicewithin local guidelines.

HSC366: Support individuals torepresent their own needs and wishesat decision-making forums.

HSC330: Support individuals toaccess and use services and facilities.

d) Takes the appropriate action to address anyissues or risks.

Undertakes risk assessments and acts on anyissues arising.

HSC450: Develop risk managementplans to support individual’sindependence and daily living in theirhome (HWB2 level 3).

e) Reviews the effectiveness of specific activitiesas they proceed, and makes any necessarymodifications.

Reviews the actions taken and changes practiceaccordingly through team briefings andmultidisciplinary case reviews.

CHS124: Manage and support theprogress of individuals throughpatient care pathways.

f) Provides feedback to the person responsiblefor the overall care plan on its effectiveness,and the health and wellbeing and needs ofclients.

Feeds back to named nurse all care provided. CHS124: Manage and support theprogress of individuals throughpatient care pathways.

g) Makes accurate records of the activitiesundertaken and any risks.

Keeps accurate care records in accordance withlocal guidelines.


44



Level 3: Enable people to address specific needs in relation to health andwellbeing




45



a) Respects people’s dignity, wishes and beliefs,and involves them in shared decision making.Obtains their informed consent.

Uses knowledge and experience to provide person-centred care.

HSC429: Work with groups to promoteindividual growth, development andindependence.


• goals for specific activities in the overall careplan and their complex health and wellbeingneeds

• the form different activities should take


• relevant evidence-based guidelines

• risks.

Implements and facilitates joint care planning withall health professionals and other stakeholders,and bases care on best practice.

CM_D7: Empower individuals withlong-term conditions to represent theirviews and organise their own support,assistance or action.

CHS60: Assess individuals with long-term conditions (HWB2 level 3).

c) Enables people to realise and maintain theirhealth potential in a manner that is consistentwith:

• evidence-based practice

• legislation, policies and procedures

• the management of risk.

Applies own skills, knowledge and experienceand uses considered judgement to supportpeople’s needs.

Facilitates person-centred care that empowers therecipient to take responsibility, with supervision asneeded.

HSC426: Empower families, carers andothers to support the individual.

HSC432: Enable families to address anindividual’s behaviour.

CHS61: Co-ordinate the care ofindividuals with long-term conditions(HWB2 level 3).


Undertakes risk assessments. For example, whenencouraging patients to self-administermedication.

Ensures safe practice using, for example, criticalincident analysis to assess risk and action asneeded.

e) Evaluates the effectiveness of work withpeople and makes any necessarymodifications.

Evaluates all sources of evidence-based care.

Monitors effectiveness constantly by using patientstories, for example.

f) Provides effective feedback to inform theoverall care plan.

Uses all opportunities to feedback on care. Forexample, through team briefings.

Use multidisciplinary opportunities to feedbacksuch as multi-professional ward rounds thatinclude the patient.

g) Makes complete records of the workundertaken, people’s health and wellbeing,needs and related risks.

Records all activity in a clear concise manner andon appropriate documentation such as localincident forms.



Level 4:Empower people to realise and maintain their potential in relation tohealth and wellbeing





a) Respects people’sdignity, wishes andbeliefs, and involvesthem in shared decision-making. Obtains theirinformed consent.

Places the person at the centre of health care in a way that meets patient-centred benchmarks and other matters important to the patient.

Enables the person’s own informed decision-making.

Acts in ways that acknowledge a person’s right to make own decisions, andrecognises their responsibilities.

Obtains informed consent prior to all activities, including assessment, andaddresses any issues that people may have.

CHS76: Obtain informedconsent for interventions orinvestigations (HWB2 level 3;HWB5 level 3; and HWB6 level3).

HSC234: Ensure your ownactions support the equality,diversity, rights andresponsibilities of individuals(core 6 level 2).

b) In partnership withclients identifies:

• goals for specificactivities in the overallcare plan and their healthand wellbeing needs

• the nature of thedifferent aspects of care

• the involvement of otherpeople and/or agencies

• relevant evidence-basedpractice and/or clinicalguidelines.

Liaises with the multidisciplinary team, participating in ward rounds, caseconferences, and clinical governance procedures.

Contributes to decision-making and disseminates changes to other membersof the team as appropriate.

Uses patients own preferences as one of many sources of evidence to informdecision-making.

M&L_D1: Develop productiveworking relationships withcolleagues (core 5 level 3).

HSC241: Contribute topromoting the effectiveness ofteams (core 5 level 2).

c) Prepares appropriatelyfor the care to beundertaken.

Uses a full range of nursing strategies to relieve the physical, psychologicaland spiritual impact of the physical and emotional aspects of illness onindividuals and families.

Uses technology to measure and monitor health care, and provide healthcare interventions, education and promotion.

Ensures patients are cared for in an environment suited to their physical,psychological and social needs.

GEN4: Prepare individuals forclinical/therapeutic activities(HWB7 level 1).

46


KSF core dimension HWB5: Provision of care to meet health and wellbeing needs

Level 3: Plan, deliver and evaluate care to meet people’s health andwellbeing needs


Specific dimension HWB5:Provision of care to meet health and wellbeing needs

Level 3 Plan, deliver and evaluate care to meet people’s health and wellbeing needs.

Level 4 Plan, deliver and evaluate care to address people’s complex health and wellbeing needs.



47



d) Undertakes care in a manner that isconsistent with:

• evidence-based practice and/orclinical guidelines

• multidisciplinary team working

• his/her own knowledge, skills andexperience


Undertakes general interventions expected of a registerednurse that are consistent with evidence-based practice, ownscope of practice and legislation. Applies skills andknowledge to meet peoples changing needs.

Undertakes specialist interventions, treatments andtherapies for the client group in partnership withmentor/clinical supervisor.

Demonstrates working knowledge of the key specialistinterventions, treatments and therapies appropriate to theclient group.

Acts on the specific legal and ethical implications ofspecialist interventions, treatments and therapies supportedby a mentor/clinical supervisor.

Recognises and acts on signs and symptoms of commonconditions in patients in the same client group.

Uses and acts on knowledge of normal and disorderedphysiology when caring for patients in client group.

Acts on knowledge of the key interventions, treatments andtherapies appropriate to the client group.

Provides advice to patients on the effects and side-effects ofcommonly used drugs.

EUSC_49: Provide care for individualsas they recover from invasiveinterventions (under review).

CHS124: Manage and support theprogress of individuals through patientcare pathways (HWB4 level 3).

CHS5: Undertake agreed pressurearea care (HWB5 level 2).

CHS6: Move and position individuals(HWB5 level 2).

CHS46: Undertake a risk assessmentfor a defined heath need (HWB6level 3).

e) Takes the appropriate action toaddress any issues or risks.

Contributes to local action plans for feedback from patient-focused benchmarking.

Uses knowledge of the side-effects and risks associated withimplementing drug and technical interventions, treatmentsand therapies commonly used with the client group.

CHS19: Undertake physiologicalmeasurements (HWB6 level 1).

f ) Reviews the effectiveness ofspecific activities as they proceedand makes any necessarymodifications.

Evaluates a care plan for and with the client group, using anevidence-based and patient-centred approach.

Evaluates drug and technical interventions, treatments andtherapies in line with local and national policies and clinicalguidelines.

Implements actions and learning arising from ownreflections and clinical supervision.


CHS89: Evaluate treatment plans withindividuals and those involved in theircare (HWB2 level 3).

CHS53: Evaluate the delivery of careplans to meet the needs of individuals(HWB2 level 3).

CHS97: Organise a programme ofsupport following withdrawal fromtreatment.

CHS122: Prepare a discharge plan withindividuals (HWB6 level 3).

g) Provides feedback on theeffectiveness of the care plan andthe health and wellbeing and needsof clients to the person responsible.

Liaises with named nurse/key worker in relation to changesin care planning and ongoing assessment.

HSC25: Carry out and providefeedback on specific plan of careactivities (HWB5 level 1).

h) Makes accurate records of theactivities undertaken and any risks.

Documents care planning changes, ongoing assessment andevaluation.



Level 3: Plan, deliver and evaluate care to meet people’s health andwellbeing needs



a) Respects people’s dignity, wishes andbeliefs, and involves them in shareddecision-making. Obtains theirinformed consent.

Provides person-centred care anddemonstrates moral integrity.

CHS76: Obtain informed consent for interventions orinvestigations (HWB2 level 3; HWB5 level 3; andHWB6 level 3).

HSC234: Ensure your own actions support theequality, diversity, rights and responsibilities ofindividuals (core 6 level 2).


• goals for specific activities in theoverall care plan and their complexhealth and wellbeing needs

• the nature of the different aspects ofcare needed to meet their complexneeds

• the involvement of other peopleand/or agencies

• relevant evidence-based practiceand/or clinical guidelines

• how to manage possible risks.

Gets quickly to the heart-of-the-matter byproviding expert specialist multi-skilledinterventions, treatments and therapies.

Prescribes either as independent orsupplementary prescriber, or from patientgroup directives.

CHS97: Organise a programme of support followingwithdrawal from treatment.

CHS84: Develop and agree care management planswith individuals diagnosed with long-termconditions (HWB6 level 3).

M&L_D1: Develop productive working relationshipswith colleagues (core 5 level 3).

HSC241: Contribute to promoting the effectivenessof teams (core 5 level 2).

c) Undertakes care in a manner that isconsistent with:

• evidence-based practice and/orclinical guidelines


• his/her own knowledge, skills andexperience


Applies own skills, knowledge andexperience, and uses consideredjudgment to meet people’s different careneeds.

Uses holistic practice knowledge byapplying analytical skills to understand anduse data in clinical practice.

Displays creative, innovative andchallenging behaviour appropriately in theboundaries of professional conduct.

Acts as a catalyst by creating harmony andunderstanding. Enables new ways ofworking, and influences colleagues.

GEN4: Prepare individuals for clinical/therapeuticactivities (HWB7 level 1).

CHS5: Undertake agreed pressure area care (HWB5level 2).

CHS6: Move and position individuals (HWB5 level 2).

d) Takes the appropriate action toaddress any issues or risks.

Undertakes risk assessments and acts onthem.

CHS19: Undertake physiological measurements(HWB6 level 1).

CHS46: Undertake a risk assessment in relation to adefined heath need (HWB6 level 3).

e) Evaluates the effectiveness of care andmakes any necessary modifications.

Evaluates the care provided and changescare as required using knowledge andexpertise to inform clinical decision-making.

CHS53: Evaluate the delivery of care plans to meetthe needs of individuals (HWB6 level 3).

CHS97: Organise a programme of support followingwithdrawal from treatment.

CHS89: Evaluate treatment plans with individualsand those involved in their care (HWB2 level 3).

CHS122 Prepare a discharge plan with individuals(HWB6 Level 3).

f) Provides effective feedback to informthe overall care plan.

Involves the team and patient to inform thecare planning process.

HSC25: Carry out and provide feedback on specificplan of care activities (HWB5 level 1).

CHS61: Co-ordinate the care of individuals with long-term conditions (HWB2 level 3).

g) Makes complete records of the workundertaken, people’s health andwellbeing, needs and related risks.

Maintains accurate records of care.

Develops computer literacy.

HSC434: Maintain and manage records and reports(IK1 level 2).

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Level 4:Plan, deliver and evaluate care to address people’s complex health andwellbeing needs





49



a) Evaluates relevant information to plan therange and sequence of assessment required,and determines the:

• specific activities to be undertaken

• risks to be managed

• urgency with which assessments are needed.

Undertakes a complete analysis of all informationavailable to determine assessments required.

EUSC_01: Take a presenting historyfrom an individual to informassessment.

EUSC_02: Obtain supportinginformation to inform the assessmentof an individual.

EUSC_04: Determine an individual’sstate of physical health and fitness.

b) Selects appropriate assessment approaches,methods, techniques and equipment, in linewith:

• individual needs and characteristics

• evidence of effectiveness

• the resources available.

Uses a range of assessment tools and approachesin relation to patient needs such as pain, wounds,nutritional status and sleep.

EUSC_03: Co-ordinate furtherassessments and investigations of anindividual prior to initiation of anintervention.

c) Respects people's dignity, wishes and beliefs,and involves them in shared decision-making.Obtains their informed consent.

Involves patients in the decisions being made inthe assessment and planning process, taking in toaccount their wishes and using the principles ofinformed consent.

CHS76: Obtain informed consent forinterventions or investigations (HWB2level 3; and HWB5 level 3).

d) Prepares, carries out and monitorsassessments in line with evidence-basedpractice, legislation, policies and procedures,and/or established protocols, theories andmodels.

Adheres to local and national evidence-basedguidelines and protocols such as infection controland administration of medicine.


e) Monitors individuals during assessments andtakes the appropriate action in relation to anysignificant changes or possible risks.

Monitors changes in the patient duringassessment and provides appropriate care asrequired such as conscious level, breathing,allergic reaction, mood and comfort.

CHS46: Undertake a risk assessmentin relation to a defined heath need.


f ) Evaluates assessment findings/results andtakes appropriate action when there areissues.

Evaluates and acts on the physical, psychologicaland social assessment process.

EUSC_07: Prioritise individuals forfurther assessment, treatment andcare (G5 level 3).

g) Considers and interprets all of the informationavailable using systematic processes ofreasoning to reach a justifiable assessment.Explains the outcomes to those concerned.

Involves others in the goal-planning for the patient.

Explains the meaning of the assessment to thepatient.

Agrees the outcomes of the assessment processwith the patient, relatives and the multidisciplinaryteam.



KSF core dimension HWB6: Assessment and treatment planning

Level 3: Assess physiological and/or psychological functioning and develop,monitor and review related treatment plans


Specific dimension HWB6: Assessment and treatment planning

Level 3 Assess physiological and/or psychological functioning and develop,monitor and review related treatment plans.

Level 4 Assess physiological and/or psychological functioning when there are complex and/or undifferentiatedabnormalities, diseases and disorders and develop,monitor and review related treatment plans.




h) Determines and records diagnosis andtreatment plans according to agreedprotocols/pathways/models:

• consistent with the outcomes of theassessment

• consistent with the individual's wishes andviews

• including communications with otherprofessions and agencies

• involving other practitioners and agencieswhen this is necessary to meet people'shealth and wellbeing needs and risks

• consistent with available resources

• noting people's wishes and needs that it wasnot possible to meet.

Justifies and documents a care plan in light of theassessment, identifying specific interventions andgoals.

Adheres to protocols and guidelines for recordingin care plans, and maintains a person-centredfocus.

AG1: Develop, implement and reviewcare plans for individuals(HWB2 level 3).

i) Monitors and reviews the implementation oftreatment plans and makes changes withinagreed protocols/pathways/models forclinical effectiveness, and to meet people'sneeds and views.

Implements and monitors all changes to care andits effectiveness, drawing on the patient’s ownexperience and feedback from the multidisciplinaryteam.

AG1: Develop, implement and reviewcare plans for individuals(HWB2 level 3).

EUSC_07: Prioritise individuals forfurther assessment, treatment andcare.

j) Identifies individuals whose needs falloutside protocols/pathways/models andmakes referrals to the appropriatepractitioners with the necessary degree ofurgency.

Refers to other agencies when required and indiscussion with the patient and multidisciplinaryteam.

CHS99: Refer individuals to specialistsources of assistance in meeting theirhealth care needs.

50



Level 3: Assess physiological and/or psychological functioning and develop,monitor and review related treatment plans


51



a) Identifies and evaluates :

• particular factors that contribute to thecomplex nature of the cases

• evidence from similar cases that may informthe approach to be taken

• nature and urgency of the case.

Uses evidence from multiple sources tounderpin decisions made aboutindividuals.

EC_11A: Investigate and diagnose an individualpresenting for emergency assistance withbreathlessness (under review).

EC_11B: Investigate and diagnose an individualpresenting for emergency assistance withbleeding and fluid loss (under review).

EC_11C: Investigate and diagnose an individualpresenting for emergency assistance with pain(under review).

CM_A3: Investigate and diagnose an unwellindividual as part of the clinical management oflong-term conditions.

b) Determines and plans the range andsequence of assessments that evidencesuggests are most likely to provide answersto the clinical questions, including:

• specific activities to be undertaken

• any modification to standardprocedures/protocols

• methods, techniques and equipment to beused

• risks to be managed.

Uses knowledge to plan care based onclinical decision-making skills.

EUSC_05: Review presenting conditions anddetermine the appropriate intervention for theindividual.

CM_A3: Investigate and diagnose an unwellindividual as part of the clinical management oflong-term conditions.

EUSC_52: Assess an individual’s needs forpsychological, emotional or social rehabilitation(under review).

c) Respects people’s dignity, wishes and beliefs,and involves them in shared decision-making.Obtains their informed consent.

Practices in a person-centred way thatrespects the individual, involving themat all times.

CHS76: Obtain informed consent for interventionsor investigations (HWB2 level 3; HWB5 level 3;and HWB6 level 3).

d) Carries out assessments in line with evidence-based practice, legislation, policies andprocedures and/or establishedprotocols/established theories and models.Monitors individuals and adjusts the approachto care in the light of arising information andany significant changes or risks.

Uses all forms of evidence to providebest care, and monitors the effect andmakes changes accordingly.

Assess care based on best evidence andinfluence the development of local andnational guidelines to improve practice.

EUSC_52: Assess an individual’s needs forpsychological, emotional or social rehabilitation(under review).

EUSC_53: Conduct a pre-intervention assessmentof an individual (under review).

e) Considers and interprets all of the informationavailable using systematic processes andreasoning. Reaches justifiable conclusions,including making a differential diagnosis andlists and ranks possible alternatives ifappropriate. Explains the outcomes toindividuals.

Uses experience to inform diagnosisand decision-making, and informs thepatient of potential outcomes.

Use knowledge to influence differentialdiagnosis and inform the patient of allalternatives. For example, whenpatients need to make decisions aboutresuscitation interventions.

CHS40: Establish a diagnosis of an individual’shealth condition.

f) Develops and records treatment plans:

• appropriate to the clinical context

• consistent with the outcomes of assessmentand the most probable diagnosis

• identifying the risks that need to be managed

• with clear goals

• involving other practitioners and agencies asand when necessary

• consistent with available resources

• noting peoples wishes and needs that it wasnot possible to meet.

Maintains records that are patient-focused and multidisciplinary.

Ensures records are accurate and up todate.

HSC434: Maintain and manage records andreports (IK1 level 2).


Level 4:Assess physiological and/or psychological functioning when there arecomplex and/or undifferentiated abnormalities, diseases anddisorders and develop, monitor and review related treatment plans





g) Co-ordinates the delivery of treatment plansfeeding in relevant information to supportwider service planning.

Leads the team that is providing care.

Co-ordinates the patient’s journey by usingpathways.

EUSC_03: Co-ordinate furtherassessments and investigations of anindividual prior to initiation of anintervention (HWB6 level 3).

CHS124: Manage and support theprogress of individuals throughpatient care pathways (HWB4 level 3).

h) Monitors the implementation of treatmentplans and makes changes as a result ofemerging information.

Monitors changes and alters care accordingly by,for example, monitoring pain and changes tomedication based on guidelines and patient groupdirectives.

Monitors the implementation of care andtreatment plans, making necessary changesappropriate to the patient’s needs and informationgathered from assessments.

EUSC_05: Review presentingconditions and determine theappropriate intervention for theindividual.



i) Identifies individuals whose needs falloutside own expertise and makes referrals tothe appropriate practitioners with thenecessary degree of urgency.

Involves other practitioners who will help thepatient such as physiotherapists, occupationaltherapists, pharmacists and social workers.

Identifies where the individual’s needs fall outsideown sphere of expertise and competence.

Refers patients to appropriate practitioners tomeet identified need with the required degree ofurgency.

CHS99: Refer individuals to specialistsources of assistance in meeting theirhealth care needs (HWB6 level 3).

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Level 4:Assess physiological and/or psychological functioning when there arecomplex and/or undifferentiated abnormalities, diseases anddisorders and develop, monitor and review related treatment plans




53



a) Respects individual's dignity, wishes andbeliefs, and involves them in shared decision-making. Obtains their informed consent.

Uses a person-centred approach whenimplementing the agreed plan in partnership withthe patient, respecting their dignity, privacy andchoices.

Agrees the goals with the patient and alsoappropriate time frames.

CHS76: Obtain informed consent forinterventions or investigations (HWB2level 3; HWB5 level 3; and HWB6 level3).



• goals for specific activities in the overalltreatment plan and the individual'sphysiological and/or psychologicalfunctioning

• the nature of the different aspects of theintervention/treatment


• relevant evidence-based practice and/orclinical guidelines

• any specific precautions or contraindicationsto the proposed interventions/treatments,and takes the appropriate action.

Identifies with the patient the factors that mightinfluence achievement of the treatment plan suchas mobility, mood, continence and fears.

Liaises with other agencies in relation to achievingthe plan and minimising the risks. For example,GPs, district nurses, discharge planners,physiotherapists and occupational therapists.



c) Prepares appropriately to undertake theintervention/treatment.

Prepares the environment and the patientphysically and psychologically for thetreatment/intervention.

GEN4: Prepare individuals forclinical/therapeutic activities (HWB7level 1).


GEN2: Prepare and dress for work inclinical/therapeutic areas (core 3 level1).

EUSC_03: Co-ordinate furtherassessments and investigations of anindividual prior to initiation of anintervention (HWB6 level 3).

d) Undertakes the intervention/treatment in amanner that is consistent with:

• evidence-based practice and/or clinicalguidelines/established theories and models


• their own knowledge and experience

• legislation, policies and procedures and/orestablished protocols.

Applies standard precautions drawing onevidence-based protocols and guidelines tominimise treatment side-effects.

CHS124: Manage and support theprogress of individuals throughpatient pathways (HWB4 level 3).

KSF core dimension HWB7: Interventions and treatments

Level 3: Plan, deliver and evaluate interventions and/or treatments


Specific dimension HWB7: Interventions and treatments

Level 3 Plan, deliver and evaluate interventions and/or treatments.

Level 4 Plan, deliver and evaluate interventions and/or treatments when there are complex issues and/or serious illness.



e) Monitors individuals' reactions tointerventions/treatments and takes theappropriate action to address any issues orrisks.

Monitors and acts on changes in the patient duringthe treatment/intervention. For example,conscious level, breathing, allergic reaction, fluidbalance, anxiety, comfort and mood.

PCS5: Assist in the support andmonitoring of patients in theperioperative care environment(HWB7 level 2).

EUSC_49: Provide care for individualsas they recover from invasiveinterventions (HWB5 level 3 - underreview).


CHS36 Provide basic life support.

f) Reviews the effectiveness of theinterventions/treatments as they proceed andmakes any necessary modifications.

Evaluates interventions continually in partnershipwith the patient and multidisciplinary team,making changes as appropriate.



CHS97: Organise a programme ofsupport following withdrawal fromtreatment (HWB5 level 3).

g) Provides feedback on the effectiveness of theoverall treatment plan and the health andwellbeing and needs of clients to the personresponsible.

Provides feedback to named nurse/key worker andmultidisciplinary team on treatment plan andchanges.


h) Makes accurate records of theinterventions/treatments undertaken andoutcomes.

Records interventions, treatments, dosages andoutcomes in patient documentation.


i) Responds, records and reports any adverseevents or incidents relating to theintervention/treatment with an appropriatedegree of urgency.

Records and reports adverse reactions in patientrecords according to local policy and respondspromptly with appropriate action. For example, toallergic reaction to blood, sudden change in mood,conscious level and decreased respirations.

EUSC_49: Provide care for individualsas they recover from invasiveinterventions (HWB5 level 3 - underreview).

54



Level 3: Plan, deliver and evaluate interventions and/or treatments


55



a) Respects individuals’ dignity, wishes andbeliefs, and involves them in shared decision-making. Obtains their informed consent.

Uses person-centred approaches to care. CHS76: Obtain informed consent forinterventions or investigations (HWB5 level3; HWB2 level 3; and HWB6 level 3).

HSC234: Ensure your own actions supportthe equality, diversity, rights andresponsibilities of individuals (core 6 level 2).


• goals for specific activities in the overalltreatment plan and the individual'sphysiological and/or psychologicalfunctioning

• the nature of the differentinterventions/treatments given thecomplexity of the issues and/or theseriousness of the illness

• relevant care pathways


• relevant evidence-based practice and/orclinical guidelines/theories and models

• any specific precautions or contraindicationsto the proposed interventions/treatment, andtakes the appropriate action

• how to manage potential risks.

Provides appropriate intervention,treatments and therapies for a specific clientgroup.

Provides expert specialist multi-skilledinterventions, treatments and therapiesrelevant to the specialism.


CHS89: Evaluate treatment plans withindividuals and those involved in their care(HWB2 level 3).

c) Undertakes interventions/treatments in amanner that is consistent with:

• evidence-based practice and/or clinicalguidelines/theories and models


• his/her own knowledge, skills and experience


Applies own skills, knowledge and experienceand using considered judgment to meetindividual’s complex needs.

Prescribes either as an independent orsupplementary prescriber from patientgroup directives or local protocol.

CM_A7: Prescribe medications forindividuals with a long-term condition.

CHD_HK1: Prepare prescriptions forprescription-only medicines.

GEN4: Prepare individuals forclinical/therapeutic activities (HWB7 level 1).


GEN2: Prepare and dress for work inclinical/therapeutic areas (core 3 level 1).

CHS124: Manage and support the progressof individuals through patient pathways(HWB4 level 3).


Acts on issues arising from riskassessments.

EUSC_17: Manage emergency situations thatoccur as a result of an EUSC (emergency,urgent or scheduled care) intervention.

CHS123: Perform advanced life support foran adult.

PCS5: Assist in the support and monitoringof patients in the perioperative careenvironment (HWB7 level 2).

EUSC_49: Provide care for individuals asthey recover from invasive interventions(HWB5 level 3 - under review).

CHS19: Undertake physiologicalmeasurements (HWB6 level 1)

CHS36: Provide basic life support (HWB7level 3).


Level 4:Plan, deliver and evaluate interventions and/or treatments when thereare complex issues and/or serious illness





e) Evaluates the effectiveness of theintervention/treatments and makes anynecessary modifications.

Evaluates nursing care interventions.

Provides and evaluates interventions in relation tobody systems and functions.


CHS97: Organise a programme ofsupport following withdrawal fromtreatment (HWB5 level 3).

f) Provides effective feedback to inform theoverall treatment plan.

Uses team briefings/ward rounds to providefeedback.


g) Makes complete records of theinterventions/treatments undertaken,people’s health and wellbeing, needs andrelated risks.

Keeps accurate, up-to-date records of care. HSC434: Maintain and managerecords and reports (IK1 level 2).

h) Responds to, records and reports any adverseevents or incidents relating to theintervention/treatment with an appropriatedegree of urgency.

Manages any adverse event/emergency arising asa result of, or during the intervention/treatment.

Records all adverse incidents appropriately andfollows up the incident with action to remedy theissue.

EUSC_17: Manage emergencysituations that occur as a result of anEUSC intervention.

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Level 4:Plan, deliver and evaluate interventions and/or treatments when thereare complex issues and/or serious illness



57



a) Inputs, amends, deletes and modifies dataand information accurately and completelyconsistent with legislation, policies andprocedures.

Keeps data according to the data protection actand local guidelines.

HSC3115: Receive, analyse, process,use and store information.

b) Establishes requirements and finds requesteddata/information using agreed proceduresand appropriate sources.

Maintains confidentiality and gathers informationas needed from appropriate sources such as GPs.

c) Collates, structures and presentsdata/information as requested using agreedsystems and formats.

Keeps accurate data required in the context ofpractice such as bed occupancy.

CfA214: Use word processing software(IT users).

CfA224: Produce documents.

d) Maintains the integrity of data/informationconsistent with legislation, policies andprocedures.

Only accesses the data required, and only sharesinformation once consent is given.

HSC434: Maintain and managerecords and reports.


e) Assures the quality of data duringmodification, structuring and presentation.

Ensures that the quality of information is good forexample hand written records are legible.

ES_DB2: Database software at level 2.


f) Stores data and information safely and in away that allows for retrieval in appropriatetimescales.

Stores all data appropriately. For example, doesnot leave information regarding individualsanywhere that other people could access.

CfA209: Store, retrieve and archiveinformation


g) Keeps the data/information system up todate.

Maintains up-to-date records either written or oncomputer in line with local guidelines.

HSC434: Maintain and managerecords and reports.


Specific dimension IK1: Information processing

Level 2: Modify, structure, maintain and present data and information

Information and knowledge specific dimensions (IK)


Level 2 Modify, structure,maintain and present data and information.

Level 3 Monitor the processing of data and information.

Level 4 Develop and modify data and information management models and processes.




a) Monitors and confirms that others are:

• receiving data and information in a timely way

• receiving data and information in a meaningfulformat

• providing data and information at agreed times andin agreed formats

• processing data and information accurately to anappropriate level of detail in an agreed format

• storing data and information securely

• maintaining the currency of the data/informationsystem

• transmitting data/information in a way thatmaintains its confidentiality

• complying with relevant legislation, policies andprocedures.

As an experienced nurse ensures that all membersof the team are adhering to guidelines relevant todata and information. For example, ensures that allteam members are maintaining confidentiality,

Ensures records are stored and maintained in aneasy-to-use way that allows appropriate access torelevant information about the patient’s care plan.For example, to follow organisational procedures inrelation to records accompanying patients forvarious procedures.

Ensures records in the clinical area are storage andaccess to relevant information – such as policies,procedures and protocols.

HI3: Identify and specify dataand information requirements.

CfA224: Produce documents (IK1level 2).

b) Monitors and confirms that appropriate systems,controls and processes are in place to:

• maintain the efficient flow of information

• assure the quality of processed data andinformation.

Ensures that all clients receive necessaryinformation in an appropriate format. For example,in visual, audio, written and IT formats.

LLUK_IL3/1: Provide informationand material to users.

LLUK_IL3/5: Organiseinformation and material.

CfA224: Produce documents (IK1level 2).

c) Identifies and investigates problems and queriesrelating to data/information processing andmanagement, and takes the appropriate action inresponse.

Displays the knowledge and skills to identify andaddress problems when monitoring the processingof data and information.

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Level 3: Monitor the processing of data and information



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a) Establishes data and informationrequirements for particular target audiences,confirming that these requirements:

• take full account of user needs andknowledge base

• can be met effectively and efficiently.

Provides information for groups of patients/clientsappropriately. For example, ensures thatinformation is available on communicable diseasesfor public health workers.

HI3: Identify and specify data andinformation requirements (IK1 level 3).

b) Selects sources of data and information thatwill best meet agreed needs.

Uses data and information that is current, andinforms care provision.

LLUK_IL4/2: Determine therequirements for information andmaterials.

c) Identifies and modifies existingmodels/processes that are capable ofmeeting requirements.

Ensures that data and information is provided inplain English or relevant language when necessary.

Ensures that information is available in formatsthat meet the needs of individuals who arepartially sighted and hard of hearing.

HI2: Develop models for processingnew data and information.

HI6: Monitor, evaluate and improvethe management of data andinformation.

d) Designs and develops appropriate newmodels and processes that comply withlegislation, policies and procedures.

Updates ways of working in line with legislation,policies and procedures continually.

CfA410: Create and manageinformation systems.

BE1: Establish informationmanagement and communicationsystems.

e) Tests new and modified data and informationmanagement models and processes.Confirms their fitness for purpose andestablishes them in the organisation.

Tests new ways of working such as computerisedcare plans. Ensures that they are appropriate tothe context.

ENTO_WRV11: Develop and maintainan effective management informationsystem.

f) Identifies new and emerging strategies andtechnologies for processing and managingdata and information. Evaluates theirrelevance and potential benefits to theorganisation.

Evaluates new ways of working such ascomputerised care planning.


Level 4: Develop and modify data and information management modelsand processes





a) Identifies and agrees the:

• question/issue to be addressed bythe data/information

• nature and quantity ofdata/information to be collected

• quality criteria that thedata/information should meet.

Works in partnership with colleagues to identify theinformation needed for collection such as otherprofessionals involved in care.

Identifies questions to ask about the data. For example:

• what is the patient’s experience of care?

• what is the length of stay?

• what is the re-admission rate?

• what are the standards to be audited?

Identifies the type of data necessary to provide answers.

Quantitative data such as:

• occupancy rate

• length of stay

• NHS surveys

• audit data.

Qualitative data such as:

• patients’ stories

• lifestyle

• observations.

HI3: Identify and specify data andinformation requirements (IK1 Level 3).

HI4: Collect and validate data andinformation.

b) Uses appropriate methods andsources for collecting and recordingthe data/information effectively.

Uses guidelines to ensure methods of data collection areappropriate such as care pathways.

Selects and uses evidence-based tools that inform clinicaldecision-making.

Develops standards to enable clinical audit such as patient-focused benchmarking, infection and hygiene issues, anddocumentation audit.

CfA310: Research, analyse and reportinformation (Ik2 level 3).

HSC41: Use and develop methods andsystems to communicate record andreport (core 1 level 4).

HI18: Search for clinical informationand evidence according to anaccepted methodology.

HI19: Appraise clinical information andevidence critically.

c) Confirms that the data/informationmeets the agreed quality criteria andtakes appropriate action if it doesnot.

Ensures that data and information is improved if it isinadequate. For example, ensures that care plans arewritten in an appropriate manner.

Ensures informed consent and anonymity when data isgathered and used for audit.

Acts to remove sources of error that might influence thequality of the information used to inform decision-making.

GEN62: Collate and communicateinformation to individuals (core 1level 3).

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Specific dimension IK2: Information collection and analysis

Level 2: Gather, analyse and report a limited range of data and information



Level 2 Gather, analyse and report a limited range of data and information.

Level 3 Gather, analyse, interpret and present extensive and/or complex data and information.

Level 4 Plan, develop and evaluate methods and processes for gathering, analysing, interpreting and presenting dataand information.



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d) Collates and analyses the data/informationusing methods appropriate to:

• initial questions that the data/information isintended to answer

• nature of the data/information.

Evaluates the data/information from evidence-based tools critically, and uses clinical audit toassist decision-making.

Collects, collates and reports a range of clinicaldata and other electronic information in line withbest practice.

Keeps records that inform data collection such asbed occupancy numbers.

PHP_01: Collect data and informationabout health and wellbeing and/orstressors to health and wellbeing (IK2level 3).

PHP_02: Form data and informationabout health and wellbeing and/ortheir stressors for later analysis (IK2level 3).

PHP_03: Obtain and link data andinformation about health andwellbeing and/or their stressors (IK2level 3).

R&D_9: Collate and analyse researchdata.

e) Reports the data and information at theagreed time using presentation, layout, tone,language, content and images appropriate to:

• its purpose

• the people for whom it is intended

• agreed formats and protocols.

Presents data such as patient records tocolleagues. For example, a multidisciplinary caseconference.

Presents patient-related data at case conferences,local clinical governance mechanisms and to thehealth care team.

Presents data/information on aspects of work-based research and evaluation projects to localand directorate departmental meetings.

CfA210: Research and reportinformation (IK2 level 1).

CfA318: Design and producedocuments.

f) Complies with relevant legislation, policiesand procedures.

Complies with legislation, policies and proceduresin relation to the management of information,confidentiality, privacy and dignity, equality anddiversity, anonymity and informed consent.


Level 2: Gather, analyse and report a limited range of data and information

IndicatorsAreas of application to nursing

practice with examples (core)


a) Formulates and agrees with others the:

• questions to answer and issues to address usingthe data/information

• concepts to use for data and informationcollection, management, analysis, interpretationand reporting.

Participates in practice research thatarises from questions such asfollowing action learning.

Undertakes small localevaluation/research projects in theworkplace.

BE3: Undertake research for the service and itsclients.

R&D_1: Determine a research anddevelopment topic worthy of investigation.

R&D_3: Design and formulate a research anddevelopment proposal.

PHS_22: Appraise, plan and manage researchrelated to improving health and wellbeing.

b) Identifies appropriate and valid sources that canprovide data and information of sufficient qualityand quantity.

Links to others who can provideinformation such as cross-organisational links.

c) Identifies, develops and implements a range ofvalid, reliable, cost-effective and ethical methodsto address the agreed questions and issues.Minimises disruption to the people providing thedata/ information and complies with relevantlegislation, policies and procedures.

Identifies, develops and usesevaluative processes such as audittools.

HI18: Search for clinical information andevidence using an accepted methodology (IK2level 2).

d) Defines and implements search strategies forreviewing data and information and summarisingthe results.

Maintains local action plans forreviewing actions from audit andevaluation.

PHP_02: Form data and information abouthealth and wellbeing and/or their stressors forlater analysis.

PHP_03: Obtain and link data and informationabout health and wellbeing and/or theirstressors.

e) Monitors the quality and quantity of the data andinformation and takes necessary action to dealwith any problems and maintain data quality.

Identifies the most up-to-date dataand deals with poor quality inform-ation such as illegible patient notes.

f) Collates and analyses data and information usingmethods appropriate to the:

• initial questions/issues to address

• nature of the data and information.

Keeps systematic records of patientcare and audits done.

HI4: Collect and validate data and information(IK2 level 2).

CfA310: Research, analyse and reportinformation.

HI5: Analyse data information and presentoutputs of analysis.

PHP_01: Collect data and information abouthealth and wellbeing and/or their stressors.

R&D_9: Collate and analyse research data.

g) Interprets, appraises and synthesises data andinformation appropriately and identifies:

• consistency and inconsistency in outcomes

• limitations in the analyses used

• ensures issues raised are always open to question.

Challenges the care provided if felt tobe inappropriate and when there isevidence to support the challenge.

PHP_02: Form data and information abouthealth and wellbeing and/or their stressors forlater analysis.

R&D_10: Interpret results of research anddevelopment activities.

HI19: Appraise clinical information andevidence critically (IK2 level 2).

h) Develops justifiable and realistic conclusions andrecommendations to deadline, and presents themusing format, layout, images and structureappropriate to :

• needs and interests of the intended audience(s)

• accepted conventions and protocols

• intended purpose of the presentation.

Presents conclusions and thereasons and argumentsunderpinning them.

Identify recommendations drawnfrom a logical argument.

Presents data in an appropriate wayas required by the target audienceand local/national guidelines.

SfJHI2: Develop and maintain an overview ofdevelopments in knowledge and practice.

R&D_11: Record conclusions andrecommendations of research anddevelopment activities.

R&D_12: Present findings of research anddevelopment activities in written form.

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Level 3: Gather, analyse, interpret and present extensive and/or complex dataand information



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a) Gathers and analyses sufficient informationto:

• evaluate current performance and capacity indata and information analysis andpresentation

• identify compliance with legislation, policies,and procedures

• identify current problems/issues

• predict future needs

• assess capacity to meet future needs

• identify possible solutions.

Collaborates in multi-professional researchprogrammes.

R&D_9: Collate and analyse datarelating to research (IK2 level 2).

CHS83: Interpret and report on thefindings of investigations (IK2 level 3).

CfA310: Research, analyse and reportinformation (IK2 level 3).

b) Determines and implements appropriateways of improving data and informationanalysis and presentation. Takes into accountrelevant factors.

Use the research data to improve data andinformation analysis.

c) Produces realistic and justifiable proposalsfor improving data and information analysisand presentation.

Produces proposals to improve data analysisrelevant to the work context.

d) Develops, tests and finalises proposedimprovements.

Develops, tests and finalises proposedimprovements. For example, by ensuring thatcomputerised care planning meets the needs ofthe context.

e) Ensures that data, information analysis andpresentation users are given the appropriatesupport in their effective use.

Facilitates colleagues to improve their skills.

f ) Monitors and evaluates the effectiveness ofimprovements to data and informationanalysis and presentation.

Monitors and evaluates effectiveness. For example,by using staff stories.

g) Uses own knowledge, skills and experience toinfluence how colleagues collect and manageinformation.

Ensures that personal knowledge and skills aresufficient to influence colleagues.


Level 4: Plan, develop and evaluate methods and processes for gathering,analysing, interpreting and presenting data and information




a) Organises knowledge and informationresources using agreed methods andframeworks.

Organises knowledge and information arising fromindividual patient assessment and evaluation.

Organises patient information resources availablefor all patients/users.

Organises staff learning resources, evidence-basedprotocols and guidelines, and literature related tothe care of a specific client group.

LLUK_IL3/5: Organise information andmaterial.

b) Keeps knowledge and information systemsup-to-date using set procedures.

Keeps patient classification information, healthpromotion information and educational andevidence-based resources up-to-date. Forexample, ensures that protocols and guidelines aredated and reviewed on given dates, and conductsperiodic review of learning resources.

c) Establishes users’ requirements and enablesthem to access the knowledge andinformation in line with legislation, policiesand procedures.

Assesses user’s knowledge, understanding andneeds. For example, patients, users or staff.

HI88: Enable individuals to access anduse information.

d) Provides knowledge and informationrequested by users, explaining any difficultiesin meeting their needs.

Provides knowledge and information to patients,users and staff, recognising its strengths andweaknesses. Fills in the knowledge gaps for theidentified needs of users.

LLUK_IL3/1: Provide information andmaterial to users.

GEN69: Capture and transmitinformation using electroniccommunication media.

e) Refers users to colleagues or otherinformation sources if they can meet theirneeds better.

Signposts and refers to other resources andsources of information and support whenappropriate such as charities and user groups.

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Specific dimension IK3: Knowledge and information resources

Level 2: Maintain knowledge and information resources and help others toaccess and use them



Level 2 Maintain knowledge and information resources and help others to access and use them.

Level 3 Organise knowledge and information resources and provide information to meet needs.

Level 4 Develop the acquisition, organisation, provision and use of knowledge and information.


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a) Establishes and agrees users’ requirementsfor knowledge/information.

Uses a person-centred approach to plan care forthe patient. Provides all relevant informationpersonally or collaboratively with other teammembers.

LLUK_IL4/1: Identify a strategy tomeet user’s complex informationneeds.

b) Identifies and evaluates potentially relevantknowledge and information resources, andselects those most likely to meet agreed needs.

Ensures that the information resources providedare at an appropriate level to meet the needs of thepatient.

GEN32: Search information, evidenceand knowledge resources andcommunicate the results.

c) Determines and implements the mostappropriate method of locating, extractingand presenting the requiredknowledge/information.

Evaluates the knowledge required by the patientand the methods of providing it continually.

HI10: Capture, organise anddisseminate information andknowledge.

d) Provides requested information to users,proposing suitable alternatives if their needscannot be met.

Keeps users informed of all other members of theteam that can be of help as well as voluntaryagencies such as Age Concern.

e) Facilitates access to knowledge/informationby developing and implementing appropriateand effective ways of organising resources.

Keeps up-to-date information to hand, updatesprinted literature and knows relevant web sites tocontact.

f) Acts in accordance with legislation, policiesand procedures.

Maintains confidentiality at all times and onlyinvolves others with users consent.


Level 3: Organise knowledge and information resources and provideinformation to meet needs



a) Gathers and evaluates information on theorganisations’ use and need for knowledgeand information resources. Identifies anycurrent or potential future issues andopportunities, including the extent to whichthey support legislation, policies andprocedures.

Provides resources appropriately such asevidence-based guidelines to inform care.

CJHI2: Develop and maintain astrategic overview of developments inknowledge and practice.

b) Determines and implements appropriateways of addressing issues and capitalising onopportunities.

Uses experience to identify different opportunitiesthat will develop knowledge such as work-basedlearning opportunities.

LLUK_IL4/2: Determine therequirements for information andmaterial.

c) Scans the environment to identify new andemerging knowledge/information resourcesand technologies. Evaluates their relevanceand potential benefits to the organisation.

Uses all forms of evidence to inform practice. HI11: Appraise information andknowledge resources.

d) Acquires additional knowledge/informationresources and technologies, and integratesthem appropriately into the overallsystem/service.

Keeps up-to-date with knowledge and passesinformation to the rest of the team.

e) Promotes and facilitates the use ofknowledge and information throughout theorganisation.

Creates a culture that uses knowledge andinformation to inform care. For example,encourages participation in benchmarking.

HI12: Promote and facilitate the use ofinformation and knowledge.


Level 4: Organise knowledge and information resources and provideinformation to meet needs







a) Identifies with the relevantpeople the activities to beundertaken to support learningand development.

Identifies learning and development needs for self and otherswith mentor/supervisor such as healthcare assistants, studentsand other learners.

Prepares learning resources to use in practice such asequipment and evidence-based guidelines.

Uses the clinical environment as an opportunity for learning suchas teaching through the patient and role modelling.

Prepares evaluation strategies for learning activities withpatients, users and staff.

LLUK_L3: Identify individual learningaims and programmes (G1 level 3).



b) Undertakes the task effectivelyand to deadlines in line withlegislation, policies andprocedures.

Uses learning opportunities appropriately within the specifiedtime limit and resources available.

Ensures flexibility with teaching/learning approaches that suitthe situation formally or informally.



c) Reports any difficulties orproblems at an appropriate timeto a team member.

Identifies the learning needs and styles of patients, users andstaff to match them with chosen strategies.

Reports on a regular basis to team leader to enable the provisionof the best care.

Reflects and reviews the teaching/learning strategies used withpatients, users and staff through peer review and clinicalsupervision.


LLUK_L15: Support and adviseindividual learners (G1 Level 3).

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Specific dimension G1: Learning and development

Level 1: Assist with learning and development activities

General specific dimensions (G)


Level 1 Assist with learning and development activities.

Level 2 Enable people to learn and develop.

Level 3 Plan, deliver and review interventions to enable people to learn and develop.

Level 4 Design, plan, implement and evaluate learning and development programmes.


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a) Agrees the purpose, aims and content of thelearning and development with the team, andown role in the process.

Develops a common vision to determine thelearning and development needs of the team.

b) Prepares thoroughly for own role andaddresses any issues in advance.

Uses critical refection and supervision todetermine own action plan.

c) Supports learning:

• recognising individuals’ particular needs,interests and styles

• using the agreed methods and approaches

• in a manner that stimulates individual’sinterest, promotes development andencourages their involvement

• by developing an environment that supportslearning

• in line with legislation, policies, andprocedures.

Facilitates the development of a learning culturethat meets everyone’s needs.

LLUK_L9: Create a climate thatpromotes learning (core 2 level 3).


LLUK_L11: Enable learning throughdemonstrations and instruction.

LLUK_L13: Enable group learning.

LLUK_L20: Support competenceachieved in the workplace.

d) Obtains feedback from learners and others onthe effectiveness of learning anddevelopment, and their ideas forimprovements.

Facilitates an open door approach that supportsand encourages challenge, and takes all feedbackinto account.

e) Reflects on and evaluates the effectiveness oflearning and development using feedbackfrom learners and others.

Accepts feedback and acts on it continuously.

f) Discusses own evaluation with the team, andagrees how learning and development mightbe improved in the future.

Uses some form of action-learning to improve selfand as a team member.


Level 2: Enable people to learn and develop




a) Identifies the:

• purpose and aims of learning anddevelopment interventions

• learning and development needs of theindividuals involved

• time and resources available.

Facilitates others to produce personaldevelopment plans.

LLUK_L3: Identify individual learningaims and programmes.

LLUK_L13: Enable group learning (G1level 2).

b) Develops and agrees a plan of how learningand development will be facilitated.

Engages all in planning learning and developmentrelevant to enable learning and development.

LLUK_L4: Design learningprogrammes.

LLUK_L7: Prepare and developresources to support learning.

c) Undertakes own role in supporting learningand development to:

• develop an environment conducive tolearning

• recognise individual’s particular needs,interests and styles

• use the agreed learning and developmentmethods and approaches

• stimulate individual’s interest in a mannerthat promotes development and encouragestheir involvement

• comply with legislation, policies andprocedures

• support and promote others’ contribution

• reflect the significance of the work andrelated decisions.

Acts as a mentor/supervisor.

Use a variety of methods to aid learning anddevelopment such as presentations,demonstrations and instruction.

LLUK_L10: Enable learning throughpresentations.


LLUK_L15: Support and adviseindividual learners.

CJ_ZE2: Facilitate individual learningand development through mentoring(G1 level 2).

d) Makes any necessary adjustments to the planas the work proceeds. Promotes learning anddevelopment to meet learners’ needs better.

Reviews learning to ensure it meets the needs ofthe service. For example, by conducting a trainingneeds analysis.

ENTO_L16: Monitor and reviewprogress with learners.

e) Obtains feedback from learners and others onthe effectiveness of learning anddevelopment, and their ideas forimprovements.

Evaluates forms.

Conducts educational audits.

Evaluates student placements.

LLUK_L17: Evaluate and improvelearning and developmentprogrammes (G1 level 4).

f) Evaluates the effectiveness of learning anddevelopment informed by learners and othersin the team and own reflections. Uses theevaluation to inform future practice.

Uses reflective practice to promote learningconducive to the environment. For example, byfacilitating action learning sets.

LLUK_V1: Conduct internal qualityassurance of the assessment process.

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Level 3: Plan, deliver and review interventions to enable people to learnand develop



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a) Identifies with colleagues commissioninglearning and development programmes the:

• purpose and aims of programmes

• relationship of one programme to another,and to related learning needs

• starting points and learning needs of learners

• time and resources available

• any contextual factors that need to be takeninto account in learning designs.

Liaises with commissioners of learning anddevelopment programmes to ensure thatprogrammes meet the needs of patients and staff.

LLUK_L1: Develop a strategy and planfor learning and development.

LLUK_L2: Identify the learning anddevelopment needs of theorganisation.

b) Designs overall learning and developmentprogrammes that:

• are appropriate to the interests of thecommissioners and the needs of learners

• contain phased and inter-related objectives,methods and approaches

• make best use of the resources available

• are consistent with good learning practice

• identify how programmes and theircomponent parts will be evaluated

• specify relevant legislation, policies andprocedures.

Uses knowledge of context to design programmesthat are fit for purpose and appropriate learningresources. For example, makes use of work-basedlearning opportunities.

Develops patient education programmes tosupport them to develop the knowledge and skillsto manage their own health condition.

PE7: Develop learning tools andmethods for individuals and groupswith a defined health condition.

c) Details the relationships between thedifferent learning and developmentcomponents.

Details the relationship of theory to practice.

d) Agrees the designs of overall programmesand individual components with relevantcolleagues. Makes any necessarymodifications as a result.

Ensures that the programmes meet the needs ofthe target audience.

PE4: Agree a plan to enableindividuals to manage their healthcondition.

e) Agrees how programmes will be implementedwith the team, and supports them throughoutthe process responding to any issues thatarise.

Ensures that the programme meets the needs ofthose taking part in the best way. For example, byusing on-site work-based learning or traditionalteaching methods.

f) Monitors the delivery of programmes for theireffectiveness in meeting their aims andobjectives.

Monitors the delivery of the programmes to ensuretheir effectiveness.

LLUK_L16: Monitor and reviewprogress with learners (G1 level 3).

g) Evaluates the effectiveness of programmesand uses the outcomes to improve futureprogrammes.

Uses information gathered to improve practice. LLUK_L17: Evaluate and improvelearning and developmentprogrammes.


Level 4: Design, plan, implement and evaluate learning and developmentprogrammes




a) Identifies new developments made byothers that might be relevant to ownarea of work.

Benchmarks practice againstrecognised standards.

HI4: Collect and validate data and information (IK2 level2).

SfJHI2: Develop and maintain an overview ofdevelopments in knowledge and practice (IK2 level 3).

b) Evaluates and reviews developmentscritically to determine if and how theycould be applied in own area of work.

Uses all types of evidence to determinethe best practice for the service beingprovided.

HI19: Appraise clinical information and evidencecritically (IK2 level 2).

R&D_9: Collate and analyse data relating to research(IK2 level 2).

c) Proposes the adoption of relevantdevelopments in own work area torelevant decision-makers.

Encourages evidence-based practicewith the support and guidance of theteam.

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Specific dimension G2: Development and innovation

Level 1: Appraise concepts, models, methods, practices, products andequipment developed by others



a) Identifies new and emerging developmentsof potential relevance to their work.

Keeps up-to-date with ongoing changes inpractice. For example, by promoting journalclubs.

b) Appraises developments and identifies thebenefits they could bring and any potentialrisks.

Informs practice of currentchanges/developments and the consequences ofnot providing evidence-based care.

GEN32: Search information, evidence andknowledge resources and communicatethe results (IK3 level 3).

CfA310: Research, analyse and reportinformation (IK2 level 3).

HI5: Analyse data and information andpresent outputs of analysis (IK2 level 3).

c) Determines with others those developmentsthat are worthy of testing and how this canbe achieved.

Uses expertise to determine best practice. R&D_1: Determine a research anddevelopment topic worthy of investigation(IK2 level 3).

R&D_2: Identify and recommend sourcesof funding for selected research anddevelopment topics (IK2 level 3).

R&D_3: Design and formulate a researchand development proposal (IK2 level 3).


Level 3: Test and review new concepts, models, methods, practices, productsand equipment



Level 1 Appraise concepts,models,methods, practices, products and equipment developed by others.

Level 3 Test and review new concepts,models,methods, practices, products and equipment.

Level 4 Develop new and innovative concepts,models,methods, practices, products and equipment.




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d) Tests and reviews developments in a waythat:

• is ethically and methodologically sound

• enables a rigorous evaluation of theirfeasibility, benefits and risks

• involves all relevant parties in the process

• complies with legislation, policies andprocedures.

Puts the rights of the patient first, ensuring safepractice and engages in new developmentsappropriate to the environment.

R&D_8: Conduct investigations inselected research and developmenttopics (G5 level 2).

R&D_14: Translate research anddevelopment findings into practice.

e) Evaluates the outcomes of testing and reportsthem in the correct format to the people whoneed them.

Evaluates on an ongoing way all changes made. R&D_15: Evaluate and report on theapplications of research anddevelopment findings in practice.

f) Makes recommendations to appropriatepeople regarding the implementation ofdevelopments.

Informs the multidisciplinary team of anyrecommended changes.

R&D_15: Evaluate and report on theapplications of research anddevelopment findings in practice.


Level 3: Test and review new concepts, models, methods, practices, productsand equipment



a) Scans the environment to identify new andemerging developments of potentialrelevance to their work and priorities forfurther development.

Keeps up-to-date with developments such astaking part in a benchmarking project.

SfJHI2: Develop and maintain astrategic overview of developments inknowledge and practice (IK2 level 3).

b) Designs, develops and tests new andinnovative concepts/models/methods/practices/products/equipment in a way that:

• is ethically, technically and methodologicallysound for the nature of the innovation

• enables a rigorous evaluation of theirfeasibility, benefits and risks

• involves all relevant parties in the process

• complies with legislation, policies andprocedures.

Uses knowledge to initiate and facilitatedevelopment such as evidence-based guidelinesthat are fit for purpose.

R&D_8: Conduct investigations inselected research and developmenttopics (G5 level 2).

R&D_9: Collate and analyse datarelating to research (IK2 level 2).

R&D_14: Translate research anddevelopment findings into practice(G2 level 3).

c) Evaluates the outcomes of testing andmodifies innovations to improve their quality.

Evaluates the benefits of using such guidelines andprotocols, and how they effect care.

R&D_15: Evaluate and report on theapplication of research anddevelopment findings in practice(G2 level 3).

d) Publicises the innovations in the appropriateplaces to inform the development of others’knowledge and practice.

Promotes good practice by publication andpresentations and provides information locally.

R&D_12: Present findings of researchand development activities in writtenform (IK2 level 3).

R&D_13: Present oral findings ofresearch and development activities(core 1 level 3).

e) Evaluates feedback on the innovations anduses it to improve future developments.

Uses feedback for further developments.


Level 4: Develop new and innovative concepts, models, methods, practices,products and equipment




a) Maintains effective communication with thoseresponsible for the overall commissioning andprocurement process.

Maintains communication with appropriatepeople/stakeholders.

b) Undertakes delegated activities effectivelyand in line with legislation, policies andprocedures.

Participates in commissioning of educationalprogrammes to support a learning culture andwork based learning opportunities.

Participates in planning and developmentlocal/national educational events and relevantcourses in collaboration with local university.

ECITB_PM25: Review and selecttenders.

ECITB_PM26: Verify contractarrangements are in place.

c) Monitors the delivery of goods/services thatare under his/her control at regular intervalsusing appropriate methods

Monitors stock and reports to management ordelegates the task to another.

d) Identifies problems with the delivery ofprocured goods/services and takesappropriate action.

Acts when goods are not received and services notprovided.

e) Maintains accurate, legible and completerecords of the commissioning, procurementand delivery of goods/services. Makes themavailable to the relevant people.

Keeps accurate records of goods and services.

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Specific dimension G3: Procurement and commissioning

Level 2 Assist in commissioning, procuring and monitoring goods and/or services.

Level 4 Develop, review and improve commissioning and procurement systems.


Level 2: Assist in commissioning, procuring and monitoring goodsand/or services



73



a) Works in partnership to identify and agreeappropriate aspects of commissioning andprocurement systems that:

• are supportive of the direction, strategies andpolicies of the organisation

• are in line with legislation, policies andprocedures

• take account of the context in which thecommissioning and procurement takes place.

Works strategically using governance frameworksto identify and agree aspects of commissioningand procurement systems.

ECITB_PM22: Select and agree aprocurement strategy andprocedure(s).

b) Negotiates and agrees with relevantcolleagues clear and effective plans for takingforward commissioning and procurement.

Develops a common vision to take forward theseplans.

c) Negotiates with colleagues to put sufficientsupporting mechanisms in place to ensurethat commissioning and procurement takesplace effectively.

Supports colleagues in this process.

d) Works with others to take forward theimplementation of effective commissioningand procurement.

Maintains a constant focus on provision ofeffective service provision.

e) Obtains sufficient information on theeffectiveness and efficiency of commissioningand procurement to make adjustments asnecessary.

Adjusts plans according to need.

f) Evaluates the effectiveness and efficiency ofcommissioning and procurement at keyintervals to identify the need for furtherfundamental improvements.

Improves service provision by using evaluation. GEN50: Monitor and evaluate thequality, outcomes and cost-effectiveness of health care services(G3 level 3).


Level 4: Develop, review and improve commissioning and procurement systems




a) Monitors expenditure against agreed budgetsto support effective financial management inline with legislation, policies and procedures.

Works within the service allocated budget. Forexample, when engaging bank nursing staff.

BG5: Making and recording payments.

b) Identifies any actual or potential deviationsfrom budgets and reports these to theappropriate person.

Reports to manager any budget issues as theyarise such as when financing study days for staff.

c) Provides information to the relevant personon the current spend against budget.

Keeps manager up-to-date with spending patterns.

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Specific dimension G4: Financial management

Level 1 Monitor expenditure.

Level 2 Co-ordinate and monitor the use of financial resources.

Level 3 Co-ordinate,monitor and review the use of financial resources.


Level 1: Monitor expenditure



a) Gives relevant people opportunities toprovide information on the use of financialresources.

Engages service staff in budget-setting andpriorities.

b) Makes and presents recommendations aboutfinancial resource use to relevant colleaguesthat:

• take account of relevant past experience

• take account of trends and developments

• are consistent with sound financialmanagement

• are in line with legislation, policies andprocedures.

Works within the service budget.

Monitors expenditure against budget such as instaffing and using agency nurses.

c) Plans and schedules how to use agreedbudgets.

Keeps budget records and action issues. M&L_E1: Manage a budget.

d) Identifies any actual or potential deviationsfrom budgets and recommends correctiveaction to the appropriate person.

Reports to budget holder when changes to budgetare required.


Level 2: Co-ordinate and monitor the use of financial resources





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a) Gives relevant colleagues opportunities toprovide information on the use of financialresources.

Collaborates with key people to provideinformation on financial resources.

BE4: Supply information formanagement control.

b) Presents recommendations and requests torelevant colleagues about the use of financialresources that:

• take account of relevant past experience

• take account of trends and developments

• are consistent with organisational objectivesand policies

• are realistic, justifiable and of clear benefit

• are sufficient to support the activities inhis/her control.

Presents relevant recommendations and requestsfor the services provided for a particular clientgroup. Works to organisational objectives.

BE6: Prepare reports and returns.

c) Negotiates and agrees the allocation offinancial resources.

Allocates financial resources with colleagues towhere they are most needed such as trainingbudgets.

CfA405: Negotiate and agree budgets.

d) Supports and encourages budget holders tomake efficient and effective use of financialresources.

Suggests areas that would benefit from financialresource input.

M&L_F3: Manage business processes(G7 level 3).

e) Plans, schedules, controls and monitors theuse of financial resources against agreedbudgets.

Guides resource allocation to appropriate areassuch as where it is most needed.

BG6: Maintain financial records andprepare accounts.

M&L_E2: Manage finance for the areaof responsibility.

f) Identifies any actual or potential deviationsfrom budgets and works with the budgetholder to find effective ways of handling it.

Works with practitioners to use resourcesefficiently. For example, by raising awareness ofcosts.

g) Reviews the allocation and use of financialresources and agrees appropriateimprovements.

Ensures finances do not always get allocated on afirst-come, first-served basis, but on need.

GEN55: Obtain and monitor the use ofthe funds needed to implement plansto meet local health care serviceneeds.

h) Provides appropriate support to colleagues toimprove their knowledge and understandingof financial resource management.

Role models financial budgeting to colleagues. M&L_E1: Manage a budget(G4 level 2).


Level 3: Co-ordinate, monitor and review the use of financial resources



a) Identifies and assesses for operationalplanning:

• the ways in which services/projectscontribute to the achievement oforganisational/partnership direction, aimsand objectives

• what needs to be achieved inservices/projects

• the relationships between different partsincluding critical paths

• who needs to be involved in the planning andimplementation of services/projects

• potential risks

• priorities and targets

• the impact of legislation, policies, procedures

• methods and processes for reporting,controlling and communicating.

Prioritises care for a group of patients.

Works in collaboration with patients and otherteam members to make decisions about prioritiesof care for a range of patients.

Monitors the assessment and care planningprocesses provided by the team for a range ofpatients in a client group.

Identifies and acts on the information technologyimplications for new service interventions andways of working.

Works with others to ensure continuity of serviceprovision across professional boundaries.

M&L_F1: Manage a project.

BC5: Manage a service that achievesbest possible outcomes for thepatient.

HSC412: Ensure individuals andgroups are supported appropriatelywhen experiencing significant lifeevents and transitions.

HSC413: Manage requests for healthand care services.

HSC415: Produce, evaluate andamend service delivery plans to meetindividual needs and preferences.

HSC435: Manage the developmentand direction of a provision.

PHS_24: Manage the developmentand direction of work.

PHS_25: Manage services that areaimed at improving health andwellbeing.

b) Enables people delivering services/projectsto understand their role and its relationship toothers.

Supports team members in providing a conduciveenvironment for patients and staff.

Facilitates and develops groups to develop ashared vision/value base across organisationalboundaries.

M&L_B5: Provide leadership for yourteam (G6 level 2).

M&L_D5: Allocate and check work inyour team (G6 level 2).

HSC48: Demonstrate a style ofleadership that ensures anorganisational culture of open andparticipatory management andpractice.

c) Provides advice and support to people onday-to-day priorities, risks and issues.

Ensures supplies and services are maintained forsafe and effective care by the team.

Identifies areas of the environment that requireimprovement for both patients and staff incollaboration with senior colleagues.

Supports team members on identified risks andissues.

HSC48: Demonstrate a style ofleadership that ensures anorganisational culture of open andparticipatory management andpractice.

d) Gathers enough information to monitor thedelivery of the service/project against overallplans and promptly identifies andinvestigates any issues.

Maintains an action plan to address plans toidentify and address issues.

HSC413: Manage request for healthcare services.

e) Determines and implements the mostappropriate ways of addressing issues takingaccount of any relevant factors.

Implements action plan and revisits on a regularbasis.

Uses local guidelines to address issues of serviceand project management.

HSC415: Produce, evaluate andamend service delivery plans to meetindividual needs and preferences.

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Specific dimension G5: Services and project management

Level 3 Prioritise and manage the ongoing work of services and/or projects.

Level 4 Plan, co-ordinate and monitor the delivery of services and/or projects.


Level 3: Prioritise and manage the ongoing work of services and/or projects




77



f) Obtains feedback on how to improveservice/project delivery and uses it toimprove future practice.

Asks for team feedback relevant to serviceimprovement, and acts on this.

Reviews and analyses the information gained anduses it to evaluate the service.

Is involved in developing action plans to meet thedesired/required improvements.

HSC435: Manage the developmentand direction of provision.

g) Provides information about services/projectswhich appear to be ineffective or inefficient inmeeting requirements to the people withoverall responsibility.

Liaises with all stakeholders to keep informed ofservice provision.

Liaises with manager/project lead to advise onmanagement issues.


Level 3: Prioritise and manage the ongoing work of services and/or projects



a) Works with colleagues to identify andproduce plans that contain all the necessarydetail for managing and delivering servicesand/or projects that are:

• in line with legislation, policies andprocedures

• supportive of the organisation’s/partnership’sdirection, strategy and objectives.

Assesses local demand for health care critically. Developsa service that is responsive to local needs, nationallegislation and policy initiatives in primary and secondarycare.

Works collaboratively to produce/facilitate thedevelopment of a project plan with key objectives, timeframes and evaluation points based on a common visionof the operation of new service roles.

Enables colleagues to understand the links between theproject/new role and organisational objectives.

BC1: Develop, negotiate andagree proposals to offerservices and products.

b) Negotiates and agrees with colleagues how toput in place sufficient supporting mechanismsto ensure that services and/or projects aremanaged and delivered effectively.

Works collaboratively to develop mechanisms to achieveproject accountability, support those involved andminimise risk.

M&L_B10: Manage risk.

GEN65: Makerecommendations for the useof physical resources.

c) Works with colleagues to put in placemethods, processes and systems forimplementing service/project plans.

Works collaboratively to agree project plans and reviewmechanisms.

Plans and co-ordinates the delivery of nursing services tomeet agreed service/project plans.

CfA411: Manage projects.

M&L_B1: Develop andimplement operational plansfor the area of responsibility(G6 level 2).

d) Monitors the delivery and management ofservices and/or projects to:

• evaluate performance against plans

• identify issues

• predict future needs and shortfalls

• identify trends and developments

• assess capacity to meet future needs.

Facilitates the identification of indicators of projectachievement and progress by which the project will bejudged.

CfA411: Manage projects.

GEN30: Manage patient flow.

e) Reviews plans, methods, processes andsystems for managing services and/or projectsand modifies them to improve effectiveness.

Reviews periodically progress and makes changesinformed by evaluation.

f) Provides appropriate support to colleagues toimprove their knowledge and understandingof service and/or project management.

Supervises and supports others in the project planningprocess.

Supervises and supports colleagues to develop projectmanagement skills across the service.


Level 4: Plan, co-ordinate and monitor the delivery of services and/or projects





a) Gives people opportunities to contribute tothe planning and organisation of their work.

Engages team members in working towardsachieving corporate and service objectives such asthrough team meetings.

M&L_B5: Provide leadership for yourteam (G6 level 2).

M&L_B6: Provide leadership in yourarea of responsibility (G6 level 3).

b) Develops and explains plans and workactivities to people. Enables them to carry outtheir work effectively in accordance withlegislation, policies and procedures.

Monitors and evaluates the care provided by theteam to a range of patients working tolocal/national guidelines such as through auditand patient surveys.



c) Gives people support and opportunities toassess their own work and gives them clear,sensitive and appropriate feedback in a waythat helps them improve and develop.

Acts as a role model, is self aware and motivatesothers.

Contributes towards building an effective team byenabling team members to develop a commonvision and direction. Celebrates successes andtakes informed risks.

Develops a shared vision for the team and service.

Develops the leadership potential of teammembers.

Celebrates achievements of others.

CM_F1: Provide clinical leadership andtake responsibility for the continuingprofessional development of self andothers (core 2 level 3).

d) Supports people effectively during the NHSKSF development review process.

Listens effectively, provides feedback supportivelyand constructively to enable the review process.

Provides safe and effective supervision to teammembers.


e) Reports poor performance to a relevantperson for them to take action.

Provides feedback from various sources on teamactivity and acts on poor performance such asindividual performance reviews.

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Specific dimension G6: People management

Level 1 Supervise people’s work.

Level 4 Plan, develop,monitor and review the recruitment, deployment and management of people.


Level 1: Supervise people’s work


79



a) In consultation with relevant colleagues,develops clear plans for the recruitment,deployment and management of staff that:

• support the organisation’s vision, values,strategies and objectives

• take account of current and potential futureconstraints and opportunities

• comply with legislation, policies andprocedures.

Uses local policies to recruit new staff and retainthose in post by offering appropriate developmentopportunities that meet the needs of the individualand the service.

M&L_D4: Plan the workforce.

WP6: Contribute to assessingworkforce demand and supply (core 4level 3).

WP9: Contribute to developing andimplementing a workforce plan (core 4level 3).

b) Implements methods, processes and systemsfor recruiting, deploying and managing staffthat:

• support the organisation’s vision, values,strategies and objectives

• comply with legislation, policies andprocedures.

Adheres to the vision of the organisation andguides processes when reviewing the vision. Forexample, by conducting a values clarificationexercise.

M&L_B1: Develop and implementoperational plans for your area ofresponsibility (G6 level 2).

HSC444: Contribute to the selection,recruitment and retention of staff todevelop a quality service (G6 level 2).

M&L_D3: Recruit, select and keepcolleagues (G6 level 3).

c) Monitors the recruitment, deployment andmanagement of staff to:

• evaluate performance in these areas

• identify current problems/issues

• identify trends

• predict future needs

• assess capacity to meet future needs.

Monitors staff movement and is involved with exitinterviews when staff leave posts.

d) Reviews plans, methods, processes andsystems related to the recruitment,deployment and management of people andmodifies them to improve their effectiveness.

Reviews staff movement and addresses issuesthrough reflective practice/critical incidentanalysis.

M&L_D6: Allocate and monitor theprogress and quality of work in thearea of responsibility (G6 level 3).

e) Provides appropriate support to colleagues toimprove their knowledge and understandingof people management.

Acts as a role model when recruiting, deployingand managing staff.

M&L_B6: Provide leadership in thearea of responsibility (G6 level 3).


Level 4: Plan, develop, monitor and review the recruitment, deployment andmanagement of people






a) Understands and values others’ roles andcontributions enabling them to make effectivecontributions working in line with legislation,policies and procedures.

Develops collaborative ways of working that link allcontributors such as multidisciplinary teammeetings.

M&L_D1: Develop productive workingrelationships with colleagues (core 5level 3).

b) Acknowledges the nature and context inwhich others work and live and the value oftheir differing perspectives and experiences.

Accepts the differences of individuals and be non-judgemental.

c) Shares and takes account of own and others’culture, knowledge, skills, experiences andvalues.

Develops and maintains effective networks bothinternal and external to the organisation to informpractice.

M&L_A3: Develop your personalnetworks (core 5 level 2).

d) Takes the appropriate action to build onothers’ knowledge, skills, experiences andvalues. Builds them into the development ofjoint ideas, practice and work so that capacityand capability can be sustained.

Develops a culture that encompasses all views andbuilds on their values and beliefs.



80



Specific dimension G7: Capacity and capability

Level 1 Sustain capacity and capability.

Level 2 Facilitate the development of capacity and capability.

Level 4 Work in partnership to develop and sustain capacity and capability.


Level 1: Sustain capacity and capability


81



a) Identifies and promotes the purpose,advantages and disadvantages of developingcapacity and capability.

Demonstrates formal skills in the consultancyprocess and its stages to include contracting,evaluating and so on.

M&L_F3: Manage business processes(G7 level 3).

b) Appraises different options for facilitatingcapacity and capability development in linewith legislation, policies and procedures.

Facilitates the development programmes for staffin relation to changing strategic objectives andnational drivers.

MH79: Enable workers and agenciesto work collaboratively.

c) Discusses and agrees the most appropriateoptions with the people concerned, takingaccount of the particular context and thespecific purpose of the development.

Facilitates and develops groups to develop ashared vision/value base across organisationalboundaries.

Identifies and establishes an appropriateworkforce for safe and effective service provision.

Acts as a resource to the organisation in relation tospecialist needs of the client group.

Provides specialist consultancy to the organisationon specialist services.

CJAD1: Develop and sustain effectiveworking relationships with staff inother agencies.

MH5: Enable support networks todevelop their effectiveness.

d) Identifies and seizes opportunities to developand improve relationships with others.

Demonstrates an ability to build, develop andmanage effective relationships across teams andthe service.

Uses team building skills to achieve effectiveteams across the service.

Provides process consultancy to teams to enablethem to become self-sufficient in their ownproblem-solving.

CJAD1: Develop and sustain effectiveworking relationships with staff inother agencies.

GEN27: Develop, sustain and evaluatecollaborative working with otheragencies.

e) Takes forward capacity and capabilitydevelopment approaches effectively and asagreed.

Provides expert and process consultancy on theestablishment and strategic development ofservices in and across organisations/pathways.

LLUK_CDB5: Create opportunities forlearning from practice and experience.

f) Accepts joint responsibility for any problemsand tensions that arise modifying approachesas a result.

Creates and sustains support mechanisms inclinical settings.

g) Evaluates with colleagues the effectiveness ofthe approaches and the extent to which theyhave contributed to the development ofcapacity and capability.

Evaluates with all stakeholders the effectiveness ofapproaches.

h) Agrees the next steps with people and whowill take them forward.

Develops action plans with all concerned.


Level 2: Facilitate the development of capacity and capability




a) Works collaboratively to identify and agree:

• anticipated future demands that make itnecessary to build capacity and capability

• an analysis of the current position

• the purpose of capacity and capabilitydevelopment

• appropriate processes

• relevant legislation, policies and procedures.

Works strategically with colleagues to analyse thecapacity and capability of the service provision.

CJAD1: Develop and sustain effectiveworking relationships with staff inother agencies (G7 level 2).

GEN27: Develop, sustain and evaluatecollaborative working with otheragencies (G7 level 2).

b) Works collaboratively to produce plans tomeet the purpose of capacity and capabilitydevelopment. Uses innovative solutionswhere these are appropriate.

Works strategically to produce appropriate plans. M&L_F3: Manage business processes(G7 level 3).

c) Negotiates with others to put in placeresources and mechanisms to implement andsupport effective capacity and capabilitydevelopment.

Works strategically to put in mechanisms andresources.

PHS_21: Develop capacity andcapability to improve health andwellbeing (G7 level 3).

d) Obtains sufficient information on theeffectiveness of the capacity and capabilitydevelopment to make adjustments as andwhen they are necessary.

Obtains information to ensure that demands aremet.

e) Evaluates the effectiveness of capacity andcapability development with colleagues andagrees the way forward.

Evaluates the effectiveness of the changes made.

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Level 4: Work in partnership to develop and sustain capacity and capability



83



a) Analyses information on public relations andmarketing and identifies relevant factors forfuture work.

Analyses relevant factors in the specialty that willbenefit from public relations and marketing.

M&L_F9: Build your organisation’sunderstanding of its market andcustomers.

b) Works with others to develop and recordrealistic promotion and marketing plans thatare in line with:

• organisational strategy, policies and direction


Works with key stakeholders to develop marketingplans such as with voluntary agencies to promotecare of older people services.

LLUK_IL4/6: Market and promote theservice (G8 level 3).

M&L_F4: Develop and review aframework for marketing.

c) Ensures that plans and agreements aredisseminated promptly to the relevantpeople.

Communicates all plans and agreements promptlywith all stakeholders.

d) Agrees with the public relations andmarketing team how plans will beimplemented. Supports them throughout,responding to issues that arise.

Works with colleagues in key positions that willenhance public relations and marketing.

e) Monitors the delivery of plans for theeffectiveness in meeting their aims.

Monitors effectiveness.

f) Evaluates with the team and other relevantcolleagues the effectiveness of publicrelations and marketing. Uses the outcomesto improve future plans.

Evaluates effectiveness.


Specific dimension G8: Public relations and marketing

Level 4 Plan, develop,monitor and review public relations and marketing for a service/organisation.

Specific dimension G8: Public relations and marketing

Level 4: Plan, develop, monitor and review public relations and marketing for aservice/organisation


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References

Benner P (1984) Novice to expert. Excellence and power inclinical nursing practice, Boston MA:Addison-Wesley.

Department of Health (1999)Making a difference,London: DH.

Department of Health (2004) The NHS Knowledge andSkills Framework (NHS KSF) and the development reviewprocess, London: DH.

Department of Health (2006)Modernising nursingcareers: setting the direction, London: DH.

Department of Health (2007) Trust, assurance and safety:the regulation of health professionals in the 21st Century,London: DH.

Hale N (2008) Support for developing your competence,Practice Nursing, 19 (4), pp. 202-204.

Nursing and Midwifery Council (2006) The PREPhandbook, London: NMC.

Roach S (1992) The human act of caring: a blueprint forthe health profession (revised edition), Ottawa: CanadianHospital Association Press.

Skills for Health (2006) Career framework for healthmethodology testing report, London: Skills for Health.www.skillsforhealth.org.uk/uploads/page/93/uploadablefile4.pdf (Accessed 14th July 2008) (Web).

6


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7

Appendices

Appendix 1: Role level descriptors

Role level descriptors have been taken from:

Skills for Health (2006) Career framework for health methodology testing report,DH: London.

Level Skills and knowledge Supervision Regulation, professional andvocational competence

1 Recall basic general knowledge and usebasic skills to carry out simple tasks.

Complete work or study tasks underdirect supervision and demonstratepersonal effectiveness in simple andstable contexts.

Not regulated, but usually subject topolice check if working with children.

Accept guidance on learning.

Demonstrate awareness of proceduresfor solving problems.

2 Recall and comprehend basic knowledgeof a field, the range of knowledgeinvolved is limited to facts and mainideas. Use skills and key competences tocarry out tasks where action is governedby rules defining routines and strategies.Select and apply basic methods, toolsand strategies.

Work under close but not continuoussupervision

Take limited responsibility forimprovement in performance in work orstudy in simple contexts and withinfamiliar, homogeneous groups.


Seek guidance on learning.

Solve problems using informationprovided.

3 Apply knowledge to a field that includesprocesses, techniques, materials,instruments, equipment, terminology andsome theoretical ideas. Use a range offield-specific skills to carry out tasks andshow personal interpretation throughselection and adjustment of methods,tools and materials.

Evaluate different approaches to tasks.

Take responsibility for completion oftasks and demonstrate someindependence in role in work or studywhere contexts are generally stable butwhere some factors change.


Take responsibility for own learning.

Solve problems using well knowninformation sources taking account ofsome social issues.

4 Use a wide range of field-specific practicaland theoretical knowledge. Developstrategic approaches to tasks that arise inwork or study by applying specialistknowledge and using expert sources ofinformation. Evaluate outcomes in termsof strategic approach used.

Manage role under guidance in work orstudy contexts that are usuallypredictable and where there are manyfactors involved that cause change andwhere some factors are interrelated.Make suggestions for improvement tooutcomes.

Supervise routine work of others andtake some responsibility for training ofothers.


Demonstrate self-directed learning.

Solve problems by integratinginformation from expert sources takingaccount of relevant social and ethicalissues.

5 Use broad theoretical and practicalknowledge that is often specialised in afield and show awareness of limits toknowledge base. Develop strategic andcreative responses in researchingsolutions to well defined concrete andabstract problems. Demonstrate transferof theoretical and practical knowledge increating solutions to problems.

Manage projects independently thatrequire problem-solving where thereare many factors some of which interactand lead to unpredictable change.Show creativity in developing projects.

Manage people and reviewperformance of self and others. Trainothers and develop team performance.

Clinical staff will be regulated health careprofessionals.

Evaluate own learning and identifylearning needs necessary to undertakefurther learning.

Formulate responses to abstract andconcrete problems. Demonstrateexperience of operational interactionwithin a field. Make judgements based onknowledge of relevant social and ethicalissues.

86


Level Skills and knowledge Supervision Regulation, professional andvocational competence

6 Use detailed theoretical and practicalknowledge of a field. Some knowledge isat the forefront of the field and will involvea critical understanding of theories andprinciples.

Demonstrate mastery of methods andtools in a complex and specialised fieldand demonstrate innovation in terms ofmethods used. Devise and sustainarguments to solve problems.

Demonstrate administrative design,resource and team managementresponsibilities in work and studycontexts that are unpredictable andrequire that complex problems aresolved where there are manyinteracting factors.

Show creativity in developing projectsand show initiative in managementprocesses that includes the training ofothers to develop team performance.


Consistently evaluate own learning andidentify learning needs. Gather andinterpret relevant data in a field to solveproblems.

Demonstrate experience of operationalinteraction in a complex environment.

Make judgements based on social andethical issues that arise in work or study.

7 Use highly specialised theoretical andpractical knowledge some of which is atthe forefront of knowledge in the field.This knowledge forms the basis fororiginality in developing and/or applyingideas. Demonstrate critical awareness ofknowledge issues in the field and at theinterface between different fields. Createa research based diagnosis to problemsby integrating knowledge from new orinterdisciplinary fields and makejudgements with incomplete or limitedinformation.

Develop new skills in response toemerging knowledge and techniques.

Demonstrate leadership and innovationin work and study contexts that areunfamiliar, complex and unpredictableand that require solving problemsinvolving many interacting factors.

Review strategic performance of teams.


Demonstrate autonomy in the direction oflearning and a high level understandingof learning processes. Solve problems byintegrating complex knowledge sourcesthat are sometimes incomplete and innew and unfamiliar contexts.Demonstrate experience of operationalinteraction in managing change in acomplex environment. Respond to social,scientific and ethical issues that areencountered in work or study.

8 Use specialised knowledge to criticallyanalyse, evaluate and synthesise new andcomplex ideas that are at the mostadvanced frontier of a field.

Extend or redefine existing knowledgeand/or professional practice in a field orat the interface between fields. Research,conceive, design, implement and adaptprojects that lead to new knowledge andnew procedural solutions.

Demonstrate substantial leadership,innovation and autonomy in work andstudy contexts that are novel andrequire the solving of problems thatinvolve many interacting factors.

Clinical staff will be regulated health careprofessionals. Demonstrate capacity forsustained commitment to development ofnew ideas or processes and a high levelunderstanding of learning processes.Critical analysis, evaluation and synthesisof new and complex ideas and strategicdecision making based on theseprocesses.

Demonstrate experience of operationalinteraction with strategic decision makingcapacity in a complex environment.Promote social and ethical advancementthrough actions.

9 Enhanced from level 8. Enhanced from level 8. Enhanced from level 8.



87

Appendix 2: Overview of core competences for nursing

Learning &development

� Personal and people development

(Core 2)

� Learning and development (G1)

Quality,improvement,innovation

� Development and innovation (G2)

� Service improvement (Core 4)

� Quality (Core 5)

Managing care &services

� Procurement and commissioning

(G3)

� Financial Management(G4)

� Services and project management

(G5)

� People management (G6)

� Capacity and capability (G7)

� Public relations and marketing (G8)

Nursing practice forsafe, effective &person-centred care

� Assessment and care planning to

meet health and wellbeing needs

(HWB2)

� Promotion of health and wellbeing

and prevention of adverse effects on

health and wellbeing (HWB1)

� Protection of health and wellbeing

(HWB3)

� Enablement to address health and

wellbeing needs (HWB4)

� Assessment and treatment planning

(HWB6)

� Provision of care to meet health and

wellbeing needs (HWB5)

� Interventions and treatments

(HWB7)

� Communication (Core 1)

� Health, safety, security (Core 3)

� Equity, diversity and rights (Core 6)

Knowledge &information

� Information processing (IK1)

� Information collection and analysis

(IK2)

� Knowledge and information

resources (IK3)

(Based on KSF dimensions)

RCN Competences for Nursing

88



Core KSF dimensions for nursing at differentcareer benchmarks

4

3

2

1

1 2 3 4 5 60

LE

VE

LS

K S F C O R E D I M E N S I O N S

Consultant nurse Advancedpractitioner(expert nurse)

Seniorpractitioner/specialist practitioner

Practitioner(competentnurse)


89


All possible KSF dimensions for nursing atdifferent career benchmarks

4

3

2

1

0

LE

VE

LS

S P E C I F I C K S F D I M E N S I O N S

HWB2

HWB1

HWB3

HWB4

HWB5

HWB6

HWB7

IK1 IK2 IK3 G1 G2 G3 G4 G5 G6 G7 G8

Consultant nurse Advancedpractitioner(expert nurse)

Seniorpractitioner/specialist practitioner

Practitioner(competentnurse)

90


The RCN represents nurses and nursing,promotes excellence in practice andshapes health policies

October 2009

RCN Onlinewww.rcn.org.uk

RCN Direct www.rcn.org.uk/direct0345 772 6100

Published by the Royal College of Nursing 20 Cavendish SquareLondon W1G 0RN

020 7409 3333

Publication code 003 053

ISBN: 978-1-906633-31-8

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