Career & Development Framework for Public Health Nursing Health Visiting and School Nursing

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1 & Development for Public Health Nursing Health Visiting and School Nursing

2 & Development for Public Health Nursing Health Visiting and School Nursing Contents Introduction Practitioner Senior Advanced Practitioner Consultant Practitioner Appendices Appendix 1 Appendix 2 Appendix 3 Appendix 4 Appendix 5 Model Articulation of with Scottish Credit Qualification & Development : Mapping to Skills for Health - Health Protection Competencies Suggested matching of the four identified in this document against the Core and Specific Dimensions of the NHS Knowledge and Skills Members of the Development Group

3 Introduction Rationale Public health nursing and its contribution to children and young peoples services is one of the three initial work streams reporting to the Modernising Nursing in the Community Programme Board. The decision to focus on public health nursing was informed by growing evidence about the extent to which both vulnerabilities and potentials in adult life are shaped by experiences pre-birth and in our early years (Early Years 2008a). The early years are a key opportunity to shape Scotland of the future which is smarter, healthier, safer, stronger, wealthier and fairer and greener. Getting it Right for Every Child is our overarching approach to improving outcomes for all children and young people. The approach is a vehicle for change in culture, systems and practice which have been outlined within key social policies (The Early Years 2008a, Equally Well 2008b, Achieving our Potential 2008c). Early intervention and prevention, reducing poverty, social inclusion and identifying and reducing health inequalities are key challenges facing us. Public health nurses play a pivotal role in contributing to this agenda and to improving outcomes for children and young people.

4 The development of this for Public Health Nursing provides a tool which enables staff to take ownership of their career development in line with current ambitions for the NHS workforce and allows NHS Boards to build on best value. The describes the leadership of all aspects of care within a bio psychosocial model which will include complex emotional and physical conditions, within a health and community context. As such, this requires advanced level communication skills and clinical competence underpinned by a sound education and research base delivered through strong and visible leadership. This development will assist organisations, senior nurses and service leads in identifying the practice and competence required to provide a high quality of care in line with the Quality Strategy and allow for the benchmarking of existing roles. Workforce planners and developers can use the framework in decisions around capacity building within the public health nursing workforce. It can also be used by individuals within public health nursing teams to focus educational and career development needs. This framework has been developed as part of the Scottish Government Modernising Nursing in the Community programme. It was facilitated by the original work of NHS Education for Scotland and Health Improvement Scotland on the career framework for Nurses working in Sexual Health and subsequently, the for Nursing in Occupational Health. It responds to policy initiatives such as Delivering Care, Enabling Health and Better Health, Better Care which puts nurses at the forefront of service design and delivery, ensuring safe, effective and person centred care.

5 Structure This and Development is comprised of templates which map progress through s 5-8 of the for Health (Appendix 1). The intention is to include all levels (1-9) and as they are developed they will be added to this framework. Examples are provided of the sphere of responsibility/ role associated with a particular level, key knowledge and skills, appropriate educational and development preparation including levels of qualification as identified in the Scottish Credit and Qualifications (Appendix 2) and suggested mapping to the NHS Knowledge and Skills (Appendix 3). The is organised around four central pillars of practice described in the Advanced Practice toolkit - Leadership; Facilitation of Learning: Evidence, Research and Development, and Clinical Practice. The material presented in the first three pillars is generic to any professional group. It is the Clinical Practice pillar which defines the specific nature of Public Health Nursing. The emphasis on each pillar, at a particular level of the, will vary according to role e.g. for clinical managers the Leadership may predominate. There is no direct matching of content across individual columns. Practitioners develop in confidence and competence as they progress within, and across, each level of the career framework moving from newly qualified novice practice, towards experienced, expert practice. The gateway review processes that take place as part of the NHS Knowledge and Skills support and influence this developmental process (Scottish Executive 2004). The consolidation of existing knowledge and skills, and the acquisition of new ones, are reflected in the incremental nature of the s. It is important to note that the levels in this do not directly read across to the Agenda for Change (AfC) pay bands levels as the for Health has no direct link to pay.

6 5 Practitioner

7 & Development 5 Overview Broad Sphere of Minimum Professional/ Education Requirements Examples of Core Educational Themes SCQF LEVEL 5 Practitioner 1. Clinical Practice 2. Facilitation of Learning Deliver care as part of a multiprofessional/ multiagency team Registered on the Part 1 of the Nursing and Midwifery Council (NMC) register Public Health (Assessing health needs, Epidemiology, Policy Drivers, Service Provision) Leadership 4. Evidence, Research and Development Undertake personal and professional development Contribute to the supervision of undergraduate/ preregistration nurses and support workers within team Educated to a minimum of Pre- Registration Diploma Appropriate and relevant formal and work based educational preparation relevant to public health nursing Mentorship preparation Working towards NMC Community Practitioner Prescribing Child development and stages of transitional care across the life span Community Profiling Team Working Health Promotion Management Communication Teaching, Learning and Facilitation Children, Young People and Family Health Complex Needs Vulnerable groups e.g. Child Protection

8 & Development 5 LEVEL 5 Practitioner 1. Clinical Practice 1.1 Demonstrate developing competence, and clinical skills in public health nursing and management appropriate to children, young people and families Practitioner must work a under direct / indirect supervision of a 6 Nurse or above as part of a Public Health Nursing Team using specialist knowledge and skills to provide and enhance clinical care to a defined children and families population in relation to:- Search for health needs Stimulating awareness of health needs Facilitating health enhancing activities Influencing policies affecting health Work within a clinical governance framework Assume accountability and responsibility for delivery of agreed specific aspects of care for children, young people and families in line with the NMC Code (2008) A broad knowledge and understanding of children and families health underpinned by comprehensive theoretical knowledge and relevant clinical experience and competence required to work at 5 (Appendix 3) Knowledge of range and needs of vulnerable and hard to reach groups Knowledge of local child protection policies and procedures Child development and interventions Risk assessment Empowerment and influencing skills Provision of additional support to enable children and young people to reach their full potential Community assets, strength based approaches and resilience Flying Start NHS web-based resource programme Effective Practitioner website resource - Clinical Practice Learning Activities Child protection competencies Getting it right for every child (GIRFEC) Child health surveillance Family assessment skills Health informatics Introduction/ orientation to e-ksf

9 LEVEL 5 Practitioner 1. Clinical Practice 1.1 Demonstrate developing competence, and clinical skills in public health nursing and management appropriate to children, young people and families Ensure delivery of safe and effective and person centred care informed by evidence based practice Skills in:- Enabling Partnership working Interagency working Evaluation of effectiveness of current practice Feedback to inform future policies Lobbying and evaluation skills Developing knowledge and understanding of clinical governance framework within own organisation Work with patient group directives and/or Standing orders Work with national standards pertinent to child and young person requirements

10 LEVEL 5 Practitioner 1. Clinical Practice 1.2 Promote and influence others to incorporate non-judgemental, values-based care into practice Respect the dignity, wishes and beliefs of children, young people and families involving them in shared decision making and obtaining their informed consent High level of awareness of own values and beliefs Comply with the NMC Code (2008) in demonstrating a personal and professional commitment to equality and diversity Ethical decision making Equality and Diversity Legislation Adhere to the UN convention of rights of the child (The UN General Assembly 1989) 1.3 Work within sphere of practice to exercise judgement about actions while accepting professional and organisational accountability and responsibility Utilise critical thinking to explore and contribute to analysis of evidence, cases and situations in public health practice. Draw on a range of sources in making judgements guided by senior colleagues within defined policies, procedures and protocols Practitioners must work within a defined clinical supervision model Aware of own level of competence and confidence Knowledge of legislation, policies, procedures, protocols, professional regulation and codes of practice Access and participation in clinical supervision framework

11 LEVEL 5 Practitioner 2. Facilitation of Learning 2.1 Learning, Teaching and Assessment Be responsible and accountable for keeping own knowledge and skills up to date through continuing professional development and participating in clinical support strategies e.g. mentoring, coaching, clinical supervision Facilitate students and others to develop their competence, using a range of professional and personal development skills Provide educational support and facilitation to clients, patients and families to support selfmanagement and decision making Conduct a fair, objective and timely assessment of learners Ability to:- maintain own personal and professional development, learning from experience through supervision, feedback, reflection and evaluation motivate, stimulate, encourage and facilitate the learning process use reflective practice techniques develop skills in:- clinical/practice assessment teaching/ facilitation Flying Start NHS programme Effective practitioner resources-learning, teaching and supervision activities Workplace Assessor Preparation e.g. SQA Assessor qualification Mentorship preparation Development of motivational, assessment and reflective skills Information technology skills 2.2 Creation of the learning environment Use established models of supervision and mentorship Contribute to creation of an effective learning environment ensuring learning opportunities for students Participate in educational audit Ability to:- use core facilitation and teaching skills develop educational materials understand improvement approaches such as learning audit and appreciative enquiry use models of supervision/ mentor-ship

12 LEVEL 5 Practitioner 3. Leadership 3.1 Team Work and Development Act as a positive role model Work independently as well as in teams to coordinate, delegate and supervise care for a designated group of individuals Manage risk and remain accountable for the care given to these individuals Work effectively across professional and agency boundaries, actively involving and respecting others contribution Ability to:- demonstrate clinical leadership behaviours and skills give and receive feedback in a open, honest and constructive manner apply equality and diversity legislation which underpins practice Flying Start NHS Teamwork Effective Practitioner resources - Leadership and management learning activities Handling complaints Equality, diversity, values based care Recognise diversity, individual differences and perspectives

13 LEVEL 5 Practitioner 3. Leadership 3.2 Professional and Organisational Leadership Identify priorities, manage time and resources effectively to ensure that quality of care is maintained or enhanced In conjunction with senior NMAHPs, monitor and evaluate standards of care adhering to defined guidelines, policies standards and protocols to ensure the delivery of safe, effective and person centred care (Scottish Government 2010) Responsible for aspects of clinical effectiveness and management of resources Recognise own accountability to act where performance and practice of self and others should be improved Engage in any required change management Participate in monitoring the effectiveness and impact of change Seek opportunities to improve the service for example, by generating ideas for innovation and solution Ability to:- respond autonomously and confidently to planned and uncertain situations, managing themselves and others confidently practice in line with local, national and professional strategies, policies, protocols and standards e.g. Health and Safety, Equality legislation, SIGN Guidelines, Professional policies and codes demonstrate professional accountability in relation to performance of self and others Develop skills in: negotiation influencing organisation problem solving sustaining arguments to solve problems Consolidate critical thinking skills analytical skills evaluation skills interpersonal skills Early Clinical Fellowships Developing leadership skills Leadership and management learning activities Communication and developing management skills (accredited or work based) Clinical audit Flying Start NHS Safe practice and Policy Effective Practitioner resources Work shadowing of more senior colleagues

14 LEVEL 5 Practitioner 3. Leadership 3.2 Professional and Organisational Leadership Adherence to importance of confidentiality and appropriate disclosure Awareness of how organisational goals are reflected in personal and team objectives Recognise early signs of poor performance and take appropriate measures Ability to:- understand improvement approaches to support service enhancement understand implications for practice of key legal and ethical issues Build professional networks promoting exchange of knowledge, skills and resources in relation to work and health

15 LEVEL 5 Practitioner 4. Evidence, Research and Development 4.1 Evidence into practice Access databases on research and evidence related to area of practice Appraise research and evidence and use to underpin own practice Assess own practice and interventions against person centred outcomes Contribute to review of impact of NMAHP interventions on the wider individual/ patient experience Consolidate understanding and application of different research approaches Identify ideas for research activity Observe and record data as directed for clinical trials, audits, surveillance Ability to:- display literature/ database searching and information literacy skills demonstrate confidence in using information technology skills and systems access and apply research critically appraise Ability to demonstrate knowledge of:- clinical audit and local NHS information and research governance policies local systematic processes that contribute to quality improvement e.g. releasing time to care user defined and person centred outcomes e.g. Talking Points and other personal outcome approaches Flying Start NHS Research for Practice Effective practitioner resources-evidence based practice learning activities Appropriate and relevant work based learning /accredited courses in Research and research based practice Knowledge network, for example Joanna Briggs Institute and Cochrane review Research methods Quality improvement methodology research governance ethics, data protection, confidentiality data analysis and interpretation

16 6 Senior

17 & Development 6 Overview Broad Sphere of Minimum Professional/ Education Requirements Examples of Core Educational Themes SCQF LEVEL 6 Senior 1. Clinical Practice 2. Facilitation of Learning 3. Leadership 4. Evidence, Research and Development Responsible for maintenance of high levels of evidence based public health nursing Skilled effective practitioner in the field of public health nursing Manage/supervise work of others Act as a mentor and preceptor Registered on Part 3 of the Nursing and Midwifery Council register(nmc) Educated to a minimum of degree level NMC Specialist Community Public Health Nursing Qualification NMC Community Prescribing Research and Evidence Based Practice Reflective Practice Leadership and Management Curriculum content which supports the achievement of the NMC Standards of Proficiency for Public Health Nursing (2004) 9 11 Working towards Nurse Independent Prescribing

18 & Development 6 LEVEL 6 Senior 1. Specialist Clinical Practice 1.1 Demonstrate specialist competence, innovation and clinical leadership in public health nursing and management appropriate to children, young people and families Practitioner must work as part of a public health nursing team using specialist knowledge and skills to provide and enhance clinical care to a defined children and families population in relation to:- Search for health needs Stimulating awareness of health needs Facilitating health enhancing activities Influencing policies affecting health Work within a clinical governance framework providing appropriate clinical supervision Ensure delivery of safe and effective and person centred care to children, young people and families within a caseload using evidence informed practice Working as the Named Person (0-5) Detailed knowledge and understanding of children and family health underpinned by theoretical knowledge and relevant clinical experience and competence required to work at 6 (Appendix 3 ) Detailed level of knowledge of range and needs of vulnerable and hard to reach groups Child development and interventions Undertake a risk assessment related to a defined health need Identifying vulnerable client groups (vulnerable children s pathway) and range and needs of vulnerable and hard to reach groups Community profiling Assessing families and allocation of Health Plan Indicators Empowerment and influencing skills Effective Practitioner website resource - Clinical Practice Learning Activities Appropriate and relevant work based learning / accredited courses Advanced clinical assessment Maintain and enhance KSF profile Clinical supervision

19 LEVEL 6 Senior 1. Specialist Clinical Practice 1.1 Demonstrate specialist competence, innovation and clinical leadership in public health nursing and management appropriate to children, young people and families May as appropriate adopt the Lead Professional role Community assets, strength based approaches and resilience Skills in:- Enabling Partnership working Interagency working Uses evaluation of effectiveness of current practice and feedback to inform future policies Skills in lobbying and evaluation Work with patient group directions and/or Standing orders Act as a Prescriber Case load analysis Family Health assessment 1.2 Promote and influence others to incorporate non-judgemental, values-based care into practice Promote and influence the dignity, wishes and beliefs of children, young people and families involving them in shared decision making and obtaining their informed consent Practice in a way that supports equality and diversity High level of awareness of own values and beliefs Comply with national guidance, local policy and the NMC Code in demonstrating a personal and professional commitment to equality and diversity (NMC 2008) Ethical decision making Dignity and respect Equality and Diversity Legislation

20 LEVEL 6 Senior 1. Specialist Clinical Practice 1.3 Freedom to exercise judgement about actions, while accepting professional and organisational accountability and responsibility Utilise critical thinking to explore and analyse evidence, cases and situations in clinical practice Draw on a range of sources in making judgements Freedom to act but is guided by precedent and clearly defined policies, procedures and protocols Manage case load /team and resources to provide a quality service which is person-centred, safe and effective (Scottish Government 2010) Contribute to legislation, policies, procedures, protocols, professional regulation and codes of practice Utilise evidence informed decision making frameworks, standards and clinical audit Full understanding of informed consent and the implications of the Data Protection Act and Access to Medical Reports Act Knowledge and understanding of clinical governance framework and delivery structures within own organisation Critical appraisal of legislation, policies, procedures, protocols, professional regulation and codes of practice

21 LEVEL 6 Senior 2. Facilitation of Learning 2.1 Learning, Teaching and Assessment Identify and support the achievement of learning needs of individuals/team in response to service need and personal development planning Ability to:- Consolidate core skills to support workplace learning reflect on practice and support reflection in others Test for the best resources Effective practitioner resources-learning, teaching and supervision activities Evaluate the effectiveness of educational interventions Consolidate own assessment skills and support others in making assessment judgments Participate in teaching and student selection in HEIs and/or other education organisations understand and apply standards and guidelines that underpin a quality learning environment demonstrate skills in undertaking and responding to evaluation of learning use appropriate interviewing techniques Mentorship/Practice Teacher preparation Programme of preparation for clinical supervision Information technology skills 2.2 Creation of the learning environment Use established models of supervision and mentorship Contribute to creation of an effective learning environment ensuring learning opportunities for students Participate in educational audit Ability to:- use core facilitation and teaching skills develop educational materials understand improvement approaches such as learning audit and appreciative enquiry use models of supervision/ mentor-ship

22 LEVEL 6 Senior 3. Leadership 3.1 Team Work and Development Act as a positive role model Work independently as well as in teams to coordinate, delegate and supervise care for a designated group of individuals Manage risk and remain accountable for the care given to these individuals Work effectively across professional and agency boundaries, actively involving and respecting others contribution Recognise diversity, individual differences and perspectives Manage professional development of individuals and groups Ability to:- demonstrate clinical leadership behaviours and skills give and receive feedback in a open, honest and constructive manner apply equality and diversity legislation which underpins practice implement suggestions for own improvement and that of others demonstrate knowledge, understanding and utilisation of KSF and its application Communication skills Negotiation skills Effective Practitioner Education and Development for Senior charge nurses/midwives and team leaders in all areas of practice ( NES 2011) Information Governance Begin to develop skills in recognized workload assessment tools and skill mix

23 LEVEL 6 Senior 3. Leadership 3.2 Professional and Organisational Leadership Act as a change agent Provide leadership for quality improvement and service development to enhance people s wellbeing and experiences of healthcare Encourage staff to contribute ideas and solutions for quality improvement and innovation Actively contribute to a variety of professional networks e.g. managed knowledge networks(mkn), professional learning Ability to:- organise and implement change support others improve and enhance practice display creativity and innovation in exploring and implementing possible solutions to problems and evaluate their effectiveness lead, persuade and influence others effectively Test for the best resources Leadership and management learning activities Communication and developing management skills (accredited or work based) Effective Practitioner resources Work shadowing of more senior colleagues Negotiate and influence locally in terms of professional practice and in relation to health care Recognise early signs of poor performance and take appropriate measures to address concerns

24 LEVEL 6 Senior 4. Evidence, Research and Development 4.1 Evidence into practice Use research related approaches to assess how evidence is being used to inform the quality of care of individuals by self and others Observe and record data using appropriate methods, tools and technology for complex audits or clinical trials or projects (Employability Skills L6) Contribute to, or participate in research related activity Identify and disseminate information on NHS Board/ University programmes of research/forums/special interest groups/networks relevant to area of practice Ability to:- adhere to research governance for self and others support others to access data and develop literacy skills participate in research audit/ evaluation and Quality Improvement processes understand research governance processes Effective practitioner resources-evidence based practice learning activities Research skills Advanced report writing skills Funding applications Contribute to the development of local guidelines and policy and where appropriate at regional and national level

25 LEVEL 6 Senior 4. Evidence, Research and Development 4.1 Evidence into practice Identify and utilise skills and knowledge of staff to support or undertake research related activity such as audit, evaluation, and wider research for benefit of the organisation. Share research activity findings through local bulletins, team meetings forum/professional journals

26 7 Advanced Practitioner

27 & Development 7 Overview Broad Sphere of Minimum Professional/ Education Requirements Examples of Core Educational Themes SCQF LEVEL 7 Advanced Practitioner 1. Clinical Practice 2. Facilitation of Learning 3. Leadership 4. Evidence, Research and Development Professional Leader Manage/supervise work of others Provide training, support and supervision to staff Ensure the delivery of evidence informed care Inform and participate in practice development Hold clinical governance responsibility for service management Registered on the third part of Nursing & Midwifery Council register NMC Specialist Community Public Health Nursing Qualification Working towards Masters Award Nurse Independent Prescribing Research methods Evidence Based Practice Reflective Practice Leadership and Management Public Health (Epidemiology, Policy Drivers, Service Provision) Legal & ethical issues including Health and Safety Law, Employment Law and Equal Opportunities 11 Influence policy and implement national and local guidance Responsible for a specific area of advanced specialist practice e.g. child protection, infant nutrition

28 & Development 7 LEVEL 7 Advanced practitioner 1. Clinical Practice 1.1 Demonstrate advanced competence, innovation and clinical leadership in public health nursing Practitioner must work as part of a public health nursing integrated team, and may work autonomously, using highly specialised knowledge and skills to provide and enhance clinical care to a defined children and family s population in relation to the:- Search for health needs Stimulating awareness of health needs Facilitating health enhancing activities Influencing policies affecting health Highly developed specialist knowledge of public health nursing underpinned by theoretical knowledge and relevant clinical experience and competence required to work at 7 (Appendix 3) Highly specialised level of knowledge of range and needs of vulnerable and hard to reach groups Child development and interventions Undertake a risk assessment related to a defined health need Identifying vulnerable client groups (vulnerable children s pathway) and range and needs of vulnerable and hard to reach groups Advanced Practice Toolkit web based resource Ethical decision making Reflective practice Getting it Right for Every Child (GIRFEC) Community profiling Assessing families and allocation of Health Plan Indicators

29 LEVEL 7 Advanced practitioner 1. Clinical Practice 1.1 Demonstrate advanced competence, innovation and clinical leadership in public health nursing Contribute to operational aspects of service delivery Responsible for delivery of Quality ambitions for the local community or team caseload Empowerment and influencing skills Media skills Enabling and Partnership working skills Interagency working Advanced public health knowledge related to children and young people e.g. infant nutrition, parenting and child development Identification of policies impacting on public health nursing Lead and contribute to public health nursing and policy development Demonstrates leadership in lobbying and evaluation Detailed knowledge of clinical governance procedures

30 LEVEL 7 Advanced practitioner 1. Clinical Practice 1.2 Promote and influence others to incorporate non-judgemental, values-based care into practice Negotiate care with clients as an equal partner. Puts the values, views and understanding of individual service users at centre of care (Advanced Practice Toolkit) GIR principles High level of awareness of own values and beliefs Works in a positive way with difference and diversity (Advanced Practice Toolkit) 1.3 Practice autonomously have freedom to exercise judgement about actions while accepting professional and organisational accountability and responsibility Utilise critical thinking to explore and analyse evidence enabling a high level of judgement and decision making Freedom to act but is guided by precedent and clearly defined policies, procedures and protocols Practice in line with The Code (NMC 2008) Knowledge of legislation, policies and procedures relating to equality and diversity Critical thinking and reflective practice Ethical decision making Manage case load and/team and resources to provide a quality service which is person-centred, safe and effective (Scottish Government 2010)

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