Generic Competency Framework for Registered and
Unregistered Practitioners
Version
4
Name of responsible (ratifying) committee
Nursing and Midwifery Learning and Development
Committee
Date ratified
02/10/2012
Document Manager (job title)
Head of Nursing and Midwifery Education
Date issued
18/10/2012
Review date
October 2015
Electronic location
Nursing and Midwifery
Related Procedural Documents
Appraisal and Performance Review Policy
Key Words (to aid with searching)
Competencies, Nursing and Midwifery, Responsibly,
Accountability.
Development and Management of Procedural Documents: Version 4 Issue Date: 18/10/2012
(Review date October 2015 (unless requirements change)
Page 1 of 21
CONTENTS
1. Introduction
2. Purpose
3. Scope
4. Definitions
5. Process
6. Duties and responsibilities
7. Training requirements
8. References and associated documentation
9. Equity impact
10. Monitoring compliance with procedural documents
11. Appendices:
Appendix A: guidelines for writing a competency
Appendix B: competency proforma (AC2)
Appendix C: generic competency framework competency achievement requirements for registered
practitioners
Appendix D: generic competency framework competency achievement requirements for non
registered practitioners
Appendix E: minimum skill set for unregistered practitioners
Appendix F: guidance on conduct for unregistered practitioners
Development and Management of Procedural Documents: Version 4 Issue Date: 18/10/2012
(Review date October 2015 (unless requirements change)
QUICK REFERENCE GUIDE
1. The policy provides a framework for the generic competencies required to be achieved and
maintained to assure safe standards of care, and those to support professional and service
development.
2. The purpose of the framework is to identify the Trust’s expectations for safe and effective
practice. It provides a systematic and robust process for ensuring that the practice of all
registered and unregistered practitioners (as stated in the scope) is consistent, safe and meets
Trust and national requirements.
3. The policy applies to registered nurses, midwives, operating department practitioners,
unregistered health care support workers, nursery nurses, associate practitioners and equivalent
staff involved in the direct provision of patient care within Portsmouth Hospitals NHS Trust
(PHT).
4. Competence and competences are job related, being a description of an action, behaviour or
outcome that a person should demonstrate in their performance.
5. The framework recognises the profession specific regulatory requirements for registered staff
and is intended to provide the process to regulate unregistered practitioners in association with
the KSF.
6. Registered and unregistered practitioners will have access to information about the Generic
Competency Framework during their induction period, and will agree priorities with their line
manager within 4 weeks of commencing employment with the Trust.
7. Registered and unregistered practitioners will only practice a specific skill when they have
been deemed competent to do so.
8. All registered practitioners who have already been deemed competent in a particular skill to at
least level 3 will offer peer review and assessment in that skill as appropriate.
9. Registered, unregistered practitioners and their managers will maintain robust and easily
accessible records of competency achievement via their learning records.
10. Staff who are involved in the development of a new competency will follow the agreed
process (Appendix A), and use the validated proforma. (Appendix B).
Development and Management of Procedural Documents: Version 4 Issue Date: 18/10/2012
(Review date October 2015 (unless requirements change)
1. INTRODUCTION
This assurance framework sets the standard of expected performance for registered nurses,
midwives, operating department practitioners, unregistered health care support workers,
nursery nurses, associate practitioners and equivalent staff involved in the direct provision of
patient care within Portsmouth Hospitals NHS Trust (PHT). The policy provides a framework for
the generic competencies required to be achieved and maintained to assure safe standards of
care, and those to support professional and service development. It is a local framework
designed to complement the national competency frameworks listed below and is not intended
as a replacement.
1.1 The NHS Knowledge and Skills Framework (KSF) (DOH 2004). The framework describes
the knowledge and skills which NHS staff, excluding doctors, dentists and some senior
managers, need to apply in their work to deliver quality services. These are described as
generic and specific dimensions and every registered and unregistered practitioner will have
those pertinent to their role identified in his or her KSF outline. This will inform their individual
performance reviews.
1.2 Specialty Specific Frameworks. These are nationally or locally determined to meet the
requirements of patients with specific needs.
2. PURPOSE
The purpose of this framework is to identify the Trust’s expectations for safe and effective
practice. It provides a systematic and robust process for ensuring that the practice of all
registered and unregistered practitioners (as stated in the scope) is consistent, safe and meets
Trust and national requirements e.g. Care Quality Commission Standards 13 and 14.
3. SCOPE
The Generic Competency Framework applies to:Registered Practitioners:
 Registered nurses, (including registered children’s nurses and registered nurses
employed by the Military of Defence)
 Registered Midwives
 Registered Operating Department Practitioners
and
Unregistered Practitioners involved in direct care: for example
 Associate/ Assistant practitioners
 Dialysis Assistants
 Health Care Support Workers/Clinic/Outpatient Support Workers/Maternity Support
Workers
 Medical Assistants employed by the Ministry of Defence
 Medical Technicians
 Nursery Nurses
 Operating Department Assistants
For the purposes of this document they will be referred to as registered and unregistered
practitioners
‘In the event of an infection outbreak, flu pandemic or major incident, the Trust recognises
that it may not be possible to adhere to all aspects of this document. In such circumstances,
staff should take advice from their manager and all possible action must be taken to
maintain ongoing patient and staff safety’
Development and Management of Procedural Documents: Version 4 Issue Date: 18/10/2012
(Review date October 2015 (unless requirements change)
4. DEFINITIONS
4.1 Competence/ Competency
As with many concepts, there is no standard definition of competence. This framework reflects
the combination of ideas as described in an article by McMullan et al (2003).
 Competence and competences are job related, being a description of an action, behaviour
or outcome that a person should demonstrate in their performance.
 Competency and competencies are person orientated, referring to a person’s underlying
characteristics and qualities that lead to effective/superior performance in their job.
Therefore the expectations of the framework relate not only to effective performance but also
to professional and skill development.
4.2 Professional Regulation
The framework recognises the profession specific regulatory requirements as stated in the
Nursing and Midwifery Council’s standards of conduct performance and ethics for nurses and
midwives (2008) and the Health Care Professions Council’s standards of conduct,
performance and ethics (2008). The Trust as an employer expects that registered practitioners
maintain their self regulatory functions in accordance with their professional bodies and utilise
the framework as evidence for professional portfolios.
4.3 Regulation of Unregistered Practitioners
This framework is intended to provide the process to regulate unregistered practitioners in
association with the KSF. The competencies provide additional specific care related standards
of expected performance and support the minimum skill set. The unregistered nursing staff,
including nursery nurses, are expected to achieve the minimum skill set as per their job
description/role. The competencies provide evidence for performance review and should be
maintained and updated by unregistered staff in a learning record/portfolio.
4.4 Accountability
4.41 Registered Practitioners are accountable to their professional bodies in accordance with
the standards for conduct, performance and ethics, to the patient and public under civil and
criminal law and their employer under employment law. Accountability to the employer is
discharged by acting in accordance with organisational policy and procedure.
4.42 Unregistered Practitioners are accountable for their actions to the patient and public
under civil and criminal law and to their employer under employment law. The expectation to
follow their contract of duty which is their job description and act in accordance with
organisational policy and procedure.
4.5 Responsibility
Responsibility is a two way process which can be both given and accepted. Both registered
and unregistered practitioners are responsible for their actions and the outcome of their actions
if they accept responsibility for an aspect of care.
4.6 Delegation
Delegation must not compromise existing care and must be directed at meeting the needs and
serving the interests of patients and clients (NMC 2007).
There is no specific guidance regarding which activities can or cannot be delegated (RCN
2006). The decision as to which activities are appropriate to delegate lies solely with the
registered practitioner who is responsible for delegating work to an unregistered practitioner.
Development and Management of Procedural Documents: Version 4 Issue Date: 18/10/2012
(Review date October 2015 (unless requirements change)
4.61 Registered Practitioners
 When a healthcare professional delegates you are authorising that person to perform
aspects of care normally within your scope of practice.
 Registered practitioners remain accountable for the appropriateness of the delegation
and for ensuring that the person who does the work is able to do it and adequate
supervision or support is provided (NMC 2007).
4.62 Unregistered Practitioners
The unregistered practitioner:
Is accountable for accepting the delegated task as well as being responsible for his/her
actions in carrying it out (RCN 2006).
 Work in accordance with the Guidance for the Conduct for Nursing and Midwifery
Support Workers
 Should understand their limitations and not proceed if circumstances within which the
task has been delegated changes.
 Meet the expectations of the minimum skill set by achieving the generic competencies
to a minimum of level 1 and maintain competence.
 Should undertake training throughout their employment to ensure their competency in
the tasks required.
4.7 Legal Duty of Care
Once a practitioner assumes responsibility for the patient or undertakes to exercise
his/her professional skills on the patient’s behalf, the practitioner owes the patient a legal
duty of care. The standard of that duty is that of an ordinary competent practitioner
(Bolitho 1988).
5. DUTIES AND RESPONSIBILITIES
5.1 Practising registered nurses, midwives and registered operating practitioners
will operate in accordance with the standards and expectations set out in this
document and:5.11 In accordance with the NMC and HCPC Standards of Performance,
Conduct and Ethics, exercise self-assessment against all relevant
competencies. Practitioners will agree relevant generic/specific
competencies according to their sphere of practice with their line manager.
5.12 Newly appointed staff will complete the generic competencies at a
minimum of level 2 within the first year of employment in time to meet the
requirements of the foundation gateway.
5.13 Use their self-assessment to agree competency achievement priorities for
their annual development plan.
5.14 Access education and learning resource opportunities to support
competency achievement as per their annual development plan.
5.15 Provide evidence that their practice meets agreed competency standards
and levels at annual appraisal.
5.16 Maintain own records/portfolio of competency achievements and submit
this for audit purposes when requested.
5.17 Review/assess peers’ and unregistered practitioners’ practice (for
competencies already achieved to at least level 3).
5.18 Only delegate tasks/ procedures that are appropriate to staff that are
competent.
7.2 Unregistered Practitioners will operate in accordance with the standards and
expectations set out in this document and:5.21 Only accept delegated responsibility for tasks/procedures in which they
are competent.
5.22 Newly appointed staff will complete the generic competencies at a
minimum of level 1 within the first year of employment in time to meet the
requirements of the minimum skill set for the foundation gateway.
5.23 Use the competencies to guide practice and development needs within
their performance reviews.
Development and Management of Procedural Documents: Version 4 Issue Date: 18/10/2012
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5.3
5.4
5.5
5.6
5.7
5.8
5.24 Access education and learning resource opportunities to support
competency achievement as per their annual development plan.
5.25 Provide evidence that their practice meets agreed competency standards
and levels at annual appraisal
5.26 Maintain own records/portfolio of competency achievements and submit
this for audit purposes when requested.
Line Managers/Professional Leads will:
5.31 Agree minimum competency requirements for their area of practice.
5.32 Adhere to Trust APDR policy.
5.33 Negotiate and agree individual staff member’s induction and orientation
competencies for achievement within 4 weeks of commencing in Trust in
order to determine induction and development plans.
5.34 Negotiate and agree annual development plans with individual staff
members.
5.35 Manage a process to check each staff member’s
developments/achievements annually against the standards and
expectations for practice as set out in this document.
5.36 Maintain accurate and accessible records of staff member’s competency
achievement.
5.37 Support the development of staff who are failing to progress their
competency achievement in accordance with their individual development
plan.
5.38 Identify where new competencies are required and initiate/action
development of these.
5.39 Release staff to attend appropriate and agreed training sessions to support
competency achievement.
5.310 Provide assurance annually to the Matron/Department Head that their
staff, both registered and unregistered practitioners, meet the standards
and expectations for practice as set out in this document.
Matrons/ Department Head will:
5.41. Provide assurance annually to the Head of Nursing/Head of Midwifery that
their staff, both registered and unregistered practitioners, meet the
standards and expectations for practice as set out in this document.
5.42 Identify training requirements across their practice area, and ensure these
are addressed in annual training plans.
5.43 Promote the value of the framework to all key staff groups.
Head of Nursing/ Equivalent Post Holder will:
5.51 Monitor competency achievement across clinical service centre and ensure
competency-training needs are being met through training plans.
5.52 Provide assurance annually to the clinical service centre Team that their
staff, both registered and unregistered practitioners, meet the standards
and expectations for practice as set out in this document.
Practice Educators will:
5.61 Facilitate and support competency achievement with staff in their
respective clinical areas.
5.62 Develop competencies as required and ensure they are based on the best
available evidence.
5.63 Promote the value of the framework to all key staff groups.
Named Competency Lead will:
5.71 Review their competency (ies) two yearly and ensure current evidence is
incorporated appropriately.
5.72 Consult on proposed changes to competencies.
5.73 Ensure that the most current version of their competency (ies) is available
on the Trust’s intranet (Nursing and Midwifery Education pages).
5.74 Work with the Head of Education for Nursing and Midwifery to implement
appropriate education resources to support competency achievement.
5.75 Present revisions to competencies to the appropriate committee in a
timely manner.
Head of Education for Nursing and Midwifery will:
Development and Management of Procedural Documents: Version 4 Issue Date: 18/10/2012
(Review date October 2015 (unless requirements change)
5.81 Oversee the implementation and ongoing management of the Generic
Competency Framework.
5.82 On behalf of the Trust, ensure that all registered and unregistered
practitioners are clear about minimum competency requirements.
5.83 Promote the value of the framework to all key staff groups.
5.84 Ensure all staff adhere to the correct process for developing and
approving new competencies.
5.85 Ensure new competencies and any amendments are presented to the
appropriate committee for ratification in a timely manner.
5.86 Monitor education resources to support competency achievement.
6. PROCESS
6.1 Registered and non registered practitioners who attend the introductory Setting Direction
Programme will receive a personal copy of a Learning Record and the generic competencies
via taught sessions as appropriate.
6.2 Registered and unregistered practitioners will have access to information about the Generic
Competency Framework during their induction period, and will agree priorities with their line
manager within 4 weeks of commencing employment with the Trust.
6.3 New staff will review their progress with their line manager every 3 months during the first
year of their employment with the Trust and at least annually thereafter via the performance
review process. Appraisal and Performance Review Policy (APDR)
6.4 All registered and unregistered practitioners will discuss their self/peer assessment against
the minimum competency requirements of the framework with their line manager and agree an
annual development programme for achieving new competencies and/or increasing levels of
achievement.
6.5 Registered and unregistered practitioners will only practice a specific skill when they have
been deemed competent to do so.
6.6 All registered practitioners who have already been deemed competent in a particular skill to
at least level 3 will offer peer review and assessment in that skill as appropriate.
6.7 All registered nurses and midwives supporting and assessing learners in practice are
required to meet the educational aspect of the Nursing and Midwifery Council (NMC) Standards
for Mentorship through a NMC recognised preparation for mentorship course (NMC 2006) and
in accordance with hospital policy.
6.8 Managers will facilitate registered and unregistered practitioners to attend annual updates,
and individual practitioners are expected to access annual updates relating to competency
achievement as required.
6.9 Registered, unregistered practitioners and their managers will maintain robust and easily
accessible records of competency achievement via their learning records.
6.10. Staff who are involved in the development of a new competency will follow the agreed
process (Appendix A), and use the validated proforma. (Appendix B).
Development and Management of Procedural Documents: Version 4 Issue Date: 18/10/2012
(Review date October 2015 (unless requirements change)
7. TRAINING REQUIREMENTS
Registered and unregistered practitioners are expected to undertake learning and development
opportunities to support the development of their competence as required within their clinical
area. Development plans will be discussed and agreed with Line Managers within the APDR
process and education sessions and learning opportunities accessed as agreed in accordance
with the Learning and Development Policy.
8. REFERENCES AND ASSOCIATED DOCUMENTATION
DOH (2004). Knowledge and Skills Framework. London. HMSO
DOH (2006) The regulation of the non-medical healthcare professions. HMSO
Heath Care Professions Council (HCPC). (2008). Standards of Conduct, Performance
and Ethics. Retrieved from HCPC website:
http://www.hpcuk.org/assets/documents/10003B6EStandardsofconduct,performancean
dethics.pdf
Mc Mullan et al (2003). Portfolios and assessment of competence: a review of the
literature. Journal of Advanced Nursing. 41. 3. 283-294.
NMC (2007). Advice for delegation to non-regulated healthcare staff. www.nmc.org.uk
NMC Code of Professional Conduct (2008)
http://www.nmc-uk.org/nmc/main/publications/codeOfProfessionalConduct.pdf
PHT Trust Policy Appraisal and Personal Development Review (2012)
Appraisal and Personal Development Review Policy ( 2012)
PHT Trust Policy Adverse Incident and Near Miss policy (2011)
Adverse Event and Near Miss Policy ( 2011)
RCN, CSP, RCSLT and BDA (2006). Supervision, accountability and delegation of
activities to support workers.
RCN (2006). The regulation of Health Care Support Workers Policy Briefing 11/2007.
9. EQUALITY IMPACT STATEMENT
Portsmouth Hospitals NHS Trust is committed to ensuring that, as far as is reasonably
practicable, the way we provide services to the public and the way we treat our staff reflects
their individual needs and does not discriminate against individuals or groups on any grounds.
This policy has been assessed accordingly.
Development and Management of Procedural Documents: Version 4 Issue Date: 18/10/2012
(Review date October 2015 (unless requirements change)
10. MONITORING COMPLIANCE WITH PROCEDURAL DOCUMENTS
This document will be monitored to ensure it is effective and to assurance compliance.
Minimum requirement
to be monitored
Lead
Tool
Frequency of
Report of
Compliance
Reporting arrangements
Lead(s) for acting on
Recommendations
Policy audit report to:

Policy audit report to:

Policy audit report to:

The effectiveness in practice of all procedural documents should be routinely monitored (audited) to ensure the document objectives are being
achieved. The process for how the monitoring will be performed should be included in the procedural document, using the template above.
The details of the monitoring to be considered include:






The aspects of the procedural document to be monitored: identify standards or key performance indicators (KPIs);
The lead for ensuring the audit is undertaken
The tool to be used for monitoring e.g. spot checks, observation audit, data collection;
Frequency of the monitoring e.g. quarterly, annually;
The reporting arrangements i.e. the committee or group who will be responsible for receiving the results and taking action as required. In
most circumstances this will be the committee which ratified the document. The template for the policy audit report can be found on the Trust
Intranet Trust Intranet -> Policies -> Policy Documentation
The lead(s) for acting on any recommendations necessary
Development and Management of Procedural Documents: Version 4 Issue Date: 18/10/2012
(Review date October 2015 (unless requirements change)
APPENDIX A: GUIDELINES FOR WRITING A NURSING/MIDWIFERY COMPETENCY
Wards and departments are required to produce speciality specific competencies to ensure safety
and consistency of practice for nurses and midwives. This document is intended to provide
guidance to ensure a standardised process in constructing these competencies.
Guidelines
1. Before writing a competency complete the proposal form (AC1) for developing a new
competency. Send to the Head of Education for Nursing and Midwifery to ensure that the
competency does not exist already. The reply will be via email within 7 days.
2. New competencies are to be produced in accordance with the agreed Trust proforma (form
AC2). Please see appendix B
3. Competency levels 1 - 4 are based on the Agenda for Change, Knowledge and Skills
Framework (DoH 2004). These are intended to map skills from a minimum level of safety
to expert but are not grade specific. Wards/departments will require staff to achieve
different levels of skills to meet patient need so you need to indicate which level is expected
to be achieved by which staff groups in your competency. Please refer to appendix B for an
example of this.
4. Educational resources are to be stated within the competency document to support and
guide staff development through the competency levels. These may include formal study
days/modules, recommended reading, e-learning etc.
5. The competency is to be based on evidence, which is essential to ensure safe and effective
practice. References are to be documented in the reference section on the back of the
competency document.
6. The originator/specialty is responsible for the review of the competency, which is required
annually to ensure currency of practice. The author’s name, department, date of completion
and review date are to be stated on the competency document.
7. Ensure multi-professional consultation on the competency document including
departmental
8. Managers if financial commitment is required to support staff’s competency development.
9. Submit draft of competency via email to the Head of Education for guidance/support in
completing the competency as per the Trust format. This will be returned to you within 14
days.
10. The competency requires ratification prior to use. Return the completed document to the
Head of Education who will submit it to the Nursing and Midwifery Learning and
Development Committee (NMLDC). This forum will ratify the competency and inform you of
the outcome.
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Proposal Form for Developing a Nursing/Midwifery Competence (AC1)
Name
Position
Contact
no/email
Department &
Division
Title of
proposed
competence
Rationale for
Competence
e.g. new practice/updated clinical evidence
Overview of
evidence to
support
competency
development
Staff roles
covered by
competency
e.g. HCSWs, RNs, RMs, RODPs etc
Signature
Date
Competency Requirement Agreed
1.
Y / N
Rationale if No
Head of Education Nursing/Midwifery: signature
Date
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(Review date XXX (unless requirements change)
APPENDIX B – COMPETENCY PROFROMA (AC2)
Competency Statement:
st
Competency Indicators 1
Level
Achieved
Assessor
Signature
Competency Indicators
2nd Level
Achieved
Assessor
Signature
Competency Indicators
3rd level
Achieved
Assessor
Signature
Competency Indicators
4th level
Achieved
Assessor
signature
Education resources to support your development
Author:
Department:
Review Date:
Record of Achievement.
To verify competence please ensure that you have the appropriate level signed as a record of your achievement in the boxes below either by
the educator/ trainer if attendance on study session and or the workplace assessor when performed in practice.
Level 1
Level 2
Level 3
Level 4
Date:
Signature of Educator/ Trainer
Date:
Signature of Educator/ Trainer
Date:
Signature of Educator/ Trainer
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Date:
Signature of Educator/ Trainer
Date
Date
Date
Date
Signature of Workplace
Assessor
Signature of Workplace
Assessor
Signature of Workplace
Assessor
Signature of Workplace
Assessor
References to Support Competency
Development and Management of Procedural Documents: Version XX Issue Date: XXXX
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Appendix C: GENERIC COMPETENCY FRAMEWORK COMPETENCY ACHIEVEMENT
REQUIREMENTS FOR REGISTERED PRACTTIONERS
1. The competencies stated in this section are the minimum expected to be achieved by
registered practitioners and have been included to reflect current clinical priorities. The list
is not exhaustive and will be reviewed in line with the policy review date.
2. The competencies are expected to be completed to at least level 2 within the first year of
employment in time for the foundation gateway.
3. All registered staff are expected to achieve and maintain a minimum of level 2 competence.
4. Additional competencies and levels to be achieved will be identified by clinical specialties
based on patient and service requirements.
5. The individual practitioners are expected to keep a record of their achievements which they
will utilise in their APDR.
Staff Groups
All
Registered
Nurses,
Midwives
and
Operating
Department
Practitioners
Ward/Dept
based front
line
staff
involved in
direct patient
care
as
appropriate
to
clinical
requirements












Competencies
Basic Life Support or specialty
equivalent. (maternal, neonatal,
child health)
Adult/child Anaphylaxis
Patient centred dignity in care
Documentation
Assess physical wellbeing of the
adult
Administration of blood products**
Administration of medication
Prevention of Falls
Moving and Handling
Nutrition
Prevention of Pressure Ulcers
Taking, recording and assessment
of vital signs in adults
Comments
**Only for staff involved
in
handling
blood
products
Please Note: The competencies do not include hand hygiene as all staff are expected to
comply with the policy and practice, the 7 step technique, which is assessed in regular
compliance
audits.
Development and Management of Procedural Documents: Version XX Issue Date: XXXX
(Review date XXX (unless requirements change)
Appendix D: GENERIC COMPETENCY FRAMEWORK COMPETENCY ACHIEVEMENT
REQUIREMENTS FOR NON REGISTERED PRACTTIONERS
1. The competencies stated in this section are the minimum expected to be achieved by the
unregistered practitioners and have been included to reflect current clinical priorities. The list
is not exhaustive and will be reviewed in line with the policy review.
2. The competencies are expected to be completed to at least level 1 to meet the requirements
of the Minimum Skill Set for Unregistered Practitioners.
3. All unregistered staff are expected to achieve and maintain a minimum of level 1 competence.
4. Additional competencies and levels to be achieved will be identified by clinical specialities
based on patient and service requirements.
5. The individual practitioners are expected to keep a record of their achievements which they
will utilise in their APDR.
Staff Groups
All
non
Registered
Practitioners
excluding
Maternity
Support
Workers
(see section
below)
Ward/Dept.
based front
line
staff
involved in
direct patient
care
as
appropriate
to
clinical
requirements
Maternity
Support
Workers
Competencies
Basic Life Support or specialty
equivalent. (maternal, neonatal,
child health)
 Adult/child Anaphylaxis
 Patient centred dignity in care
 Documentation
Comments










Personal Care
Elimination
Assess physical wellbeing of the
adult
Prevention of Falls
Moving and Handling
Nutrition
Prevention of Pressure Ulcers
Taking, recording and assessment
of vital signs in adults
To achieve all competencies as
identified in the Maternity Support
Worker Competency Framework
which is specific to Maternity
Services.
Please Note: The competencies do not include hand hygiene as all staff are expected to
comply with the policy and practice, the 7 step technique, which is assessed in regular
compliance audit.
Development and Management of Procedural Documents: Version XX Issue Date: XXXX
(Review date XXX (unless requirements change)
Appendix E Minimum Skill Set for Health Care Support Workers and Nursery Nurses
Portsmouth Hospitals Minimum
Skill Set for Health Care Support
Workers and Nursery Nurses
Portsmouth Hospitals has set a minimum level of expectation for the role of the Health Care
Support Worker and Nursery Nurse. Each unregistered member of nursing staff must ensure
that they are competent to deliver the care and seek education to support them to meet their
role.
Minimum Skill Set Expectations
Core Skills
Components
1. Patient Safety
Basic Life Support
Routine monitoring of vital Signs (temperature,
pulse, respiration rate blood pressure, oxygen
saturations, level of consciousness via AVPU
and to include blood glucose)
Recognition of an ill patient
Moving and handling
Falls prevention
Health and safety
Personal and environmental infection prevention
and control to include ward equipment and
priority cleaning
Safeguarding the vulnerable adult and child
Reporting risks to include completing adverse
incident forms
Supporting relatives and carers in the care the
patient e.g. listening to patients/carers raising
issues, to help raise concerns and to help
resolve concerns to avoid progression to a
formal complaint
2. Communication
Feedback on care provision
Record keeping to include recording basic
patient information and demographic detail as
well as care provision.
Appropriate communication with patients and
relatives and in challenging situations e.g. deaf,
confused, upset, aggrieved.
Using basic Trust information technology e.g.
patient access system (PAS) electronic
rostering and email
Maintaining confidentiality & data protection
Access to patient records
Obtain patients consent in accordance with
policy
Employ appropriate telephone skills
3. Being an Effective
Being accountable for your actions
Team Member
Understanding and responding appropriately to
delegation
Ensuring equality & diversity
Professional behaviours e.g. treating patients
and team members with respect. Upholding the
Trust values
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4. Respect for Others
5. Personal Hygiene
6. Continence
7. Nutrition
8. Pressure Area Care
9. Planned Simple
Discharge
10. End of Life Care
Resource management and reducing waste
Supporting learners
Delivering customer service in accordance with
the Trust values
Maintaining privacy and dignity in accordance
with the Trust’s dignity charter
Assisting to wash in for example bed, bath and
or shower
Providing oral hygiene
Care of hair, nails and feet
Providing eye care
Assist patients to the toilet and managing
incontinence
Using bedpans, commodes
Catheter care
Specimen taking
Emptying urinary devices
Assist with eating and drinking
Promote independence
Monitor and record weight, height and Body
Mass Index (BMI)
Recording food and fluid input/output
Recognition of vulnerable pressure areas
Provide skin care
Moving and turning
Maintenance and ordering of equipment
Tablet To take Home (TTO) collection
Ordering transport
Completing discharge checklist and giving
discharge leaflets to patients
Communicating with families/ carers
Managing patient property
Care skills and knowledge of Liverpool Care
Pathway and last offices
Assisting in last offices
Supporting bereaved relatives
Please discuss this with you Ward Sister/Charge Nurse to recognise the skills you have
and to action plan how you maintain and develop to meet the skill set. This will be
monitored as part of your annual appraisal.
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Appendix F: Guidance on Conduct for Nursing and Midwifery Support Workers
Guidance on Conduct
for Nursing and Midwifery Support Workers
This guide is designed to help you set the standard for how you work on a day to day
basis. It is based on the key principle of protecting the public and mirrors what is
required from professionals who are formally regulated.
You have a significant impact on the quality of service delivered within the Trust and
the following guidance identifies the standards of behaviour and attitudes that are
required from all Nursing and Midwifery Support Staff* working within Portsmouth
Hospitals NHS Trust.
The clinical responsibilities and activities of all staff who support the delivery of nursing and
midwifery services are defined within individual job descriptions and the knowledge and skills
framework outlines. Role boundaries are also agreed in accordance within Portsmouth Hospital
NHS Trust policies and guidelines within relevant legal frameworks.
Delegation
This is the transfer of authority to a competent individual to enable a specific task to be performed in
a specified situation without direct supervision. Delegation of care must always take place in the best
interests of the patient and be based on individual patient need.



The registered practitioner delegating an aspect of care is held accountable for the
appropriateness of that delegation.
If you accept a task you become accountable for the performance of that task.
The registered practitioner is accountable for ensuring that the outcome of delegated tasks meet
the required standards.
Accountability
This is the principle that individuals, organisations and the community are responsible for
their actions and that you should be able to explain your actions to others if required.


You are accountable for your actions when work is delegated to you.
You are also accountable for any actions you do not take when you might have been
reasonably expected to anticipate that distress or harm may arise.
Responsibility
 You are responsible to your manager for your standard of performance.
 Delegated tasks must fall within your job description and your level of competence.
Competence
Competent practice requires appropriate skill, knowledge, understanding and attitude to perform a
task safely and effectively without direct supervision.
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* This guidance applies to all staff who work under the delegated authority of the Registered
Nurse or Midwife. This includes Health Care Support Workers, Maternity Support Workers,
Out-Patient Support Workers , Nursery Nurses, Dialysis Assistants etc.
This list is not intended to be exhaustive
Expected Conduct
for Nursing and Midwifery Support Workers
The following guidance is based on the Royal College of
Nursing Principles of Nursing Practice (2010)
What this means to you is:
1. Respect, protect and promote the dignity and privacy of patients and provide compassionate
and sensitive care in a way that respects all people equally.
2. Always act under the direction and supervision of a registered practitioner.
3. Ensure that you carry out all activities safely, effectively and to the best of your abilities, in
accordance with the policies and protocols of the Trust and relevant legal obligations.
4. Be aware of potential risks to patients and act immediately to ensure their safety and be
conscientious in reporting any concerns or complaints.
5. Ensure that the patient is central to the delivery of care. Work in partnership with patients,
families and carers to support their rights to make informed choices, be independent and selfmanage their treatment and care.
6. Handle patient information sensitively and treat all information about patients as confidential.
7. Work constructively with all members of your own team and other health care colleagues:
respect their skills and contribution to ensure that care delivered is of a high standard and
promotes the best possible outcomes.
8. Do not take on an activity unless you have the relevant knowledge and skills to do so and
have been assessed as competent to carry it out safely and effectively.
9. If you do not feel ready to take on an activity, report this to a registered practitioner and ask
them to help you develop or update to ensure that you have up-to-date knowledge and skills.
10. Maintain your Learning Record. This will provide evidence of Essential Skills training and of
relevant other learning and will enable you to demonstrate nursing competencies achieved in
practice.
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References
Please also refer to associated documents
Heath Care Professions Council (HCPC). (2008). Standards of Conduct, Performance and
Ethics. Retrieved from HCPC website:
http://www.hpcuk.org/assets/documents/10003B6EStandardsofconduct,performanceandethics.
pdf
Nursing Midwifery Council (2008) Code of Professional Conduct. London: Nursing and
Midwifery Council. Retrieved from NMC website: www.nmc.org.uk
Royal College of Nursing (2007) Policy Briefing 11/2007 The Regulation of Health Care
Support Workers. London
Royal College of Nursing (2008) Health Care Assistants and Assistant Practitioners Delegation
and Accountability. Nursing Standard Essential Guide. Middlesex
Royal College of Nursing (2010) Principles of Nursing Practice. RCN Bulletin. Nov 2010. p5
.
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