Competencies Framework for the Acute Oncology Service (AOS) Clinical Nurse Specialist Role

Transcription

1 Competencies Framework for the Acute Oncology Service (AOS) Clinical Nurse Specialist Role For approvals and version control see Document Management Record on page 24 Doc Ref: AngCN-CCG-AO12 Approved and Published: March 2013 Page 1 of 90

2 Table of Contents 1 Introduction and Purpose Acute Oncology Service Clinical Nurse Specialist - Job Description... 4 PRINCIPAL DUTIES AND RESPONSIBILITIES: Principal Accountabilities Clinical Responsibilities AOS Implementation Responsibilities Managerial/Leadership Education and Development Clinical Governance General Duties of all employees The AOS CNS Person Specification An Outline of the Requirements of the role of:- Acute Oncology Service Clinical Nurse Specialist Evidence of Training Completion The AOS Nurse KSF Assessment Template Personal Development Plan Template...21 PERSONAL DEVELOPMENT PLAN (insert the next year period)...21 AND PERSONAL DEVELOPMENT REVIEW PROCESS (insert the previous year period)...21 PART ONE: REVIEW OF PROGRESS: OBJECTIVES...21 THE PAST YEAR (insert year)...21 PART TWO: WORK RELATED OBJECTIVES FOR THE YEAR AHEAD: (insert year)...22 PART THREE: PERSONAL DEVELOPMENT PLAN FOR THE YEAR AHEAD (insert year)...22 PART THREE: PERSONAL DEVELOPMENT PLAN 2012/ Document Management...23 Evidence of Agreement...24 Appendix A - Summary KSF Outline for the AOS CNS Role...25 Appendix B - Overview of the NHS KSFs for the AOS CNS Role...27 Appendix C Detail of the NHS KSFs for the AOS CNS Role...31 CORE DIMENSION 1: COMMUNICATION...31 CORE DIMENSION 2: PERSONAL AND PEOPLE DEVELOPMENT...37 CORE DIMENSION 3: HEALTH, SAFETY AND SECURITY...43 CORE DIMENSION 4: SERVICE IMPROVEMENT...48 CORE DIMENSION 5: QUALITY...52 CORE DIMENSION 6: EQUALITY AND DIVERSITY...56 DIMENSION HWB1: PROMOTION OF HEALTH AND WELLBEING AND PREVENTION OF ADVERSE EFFECTS ON HEALTH AND WELLBEING...61 DIMENSION HWB2: ASSESSMENT AND CARE PLANNING TO MEET HEALTH AND WELLBEING NEEDS...65 DIMENSION HWB4: ENABLEMENT TO ADDRESS HEALTH AND WELLBEING NEEDS...70 DIMENSION HWB5: PROVISION OF CARE TO MEET HEALTH AND WELLBEING NEEDS...75 DIMENSION HWB6: ASSESSMENT AND TREATMENT PLANNING...79 DIMENSION HWB7: INTERVENTIONS AND TREATMENTS...85 Approved and Published: March 2013 Page 2 of 90

3 1 Introduction and Purpose The purpose of this document is to outline the Competencies Framework for the Acute Oncology Service (AOS) Clinical Nurse Specialist (CNS) role within the Anglia Cancer Network. It is intended to provide a guideline for each Acute Trust within the Anglia Cancer Network for the recruitment and ongoing development of the AOS CNS role and contains details of all of the skills (both desirable and essential) required for this. Ultimately, it is intended as a guide of what should be aspired to within the role. It covers:- The pre-requisite skills for the AOS Clinical Nurse Specialist role The training and education required, once in post covering foundation and advanced skills levels The requirements of ongoing competency and assessment. It is intended that this document is retained on the personnel or training file of each AOS CNS across the Anglia Cancer Network as a permanent and personal record of training and ongoing development, as well as to provide accurate documented evidence of established and ongoing competency. This document should be used in conjunction with the AngCN AOS Induction Training Minimum Specification (AngCN-CCG-AO3 dated August 2011), located as follows on the AngCN website: This outlines the network-agreed minimum specification for the induction and awareness training of all those involved in the assessment and management of Acute Oncology patients across the Network. Approved and Published: March 2013 Page 3 of 90

4 2 Acute Oncology Service Clinical Nurse Specialist - Job Description Job Title: Acute Oncology Service Clinical Nurse Specialist Hours: Reports to: Accountable to: Department: AfC Banding: Band 7 (subject to AfC review) Essential qualifications: First level Nurse ENB 998 or equivalent Oncology Certificate 237/N59 or equivalent Evidence of continuing professional development Relevant Healthcare Degree 5 years clinical experience in speciality 2 years experience at a senior level Demonstrable change management ability proven organisational and communication skills JOB PURPOSE: This post focuses on the nursing skills and specialities required within the implementation and delivery of a hospital Acute Oncology Service (AOS). The post holder will: Play a key role in setting up the service and monitoring its impact using a number of key metrics Be a key member of the Trusts Acute Oncology Team (AOT) and play a key role in the delivery of the service throughout the Trust Provide early input of specialist care to oncology patients enabling: Safer and better quality of care to patients with complications of chemotherapy and radiotherapy (early recognition, better treatment, early discharge) Urgent review of patients with complications of cancer, rapid referral back to the specialist oncology and/or palliative care teams Appropriate investigation of patients who might benefit from treatment for unknown primary cancers (targeted investigations, rapid triage of patients into specialist oncology or palliative care) Taking a role within the appropriate investigation of patients who might benefit from treatment for MSCC Give advice and implement patient care in an area which requires specific clinical knowledge, skills and experience Work alongside other clinical colleagues in oncology, palliative care, ED, acute medicine, radiology and pathology to ensure quality of care to the patients is maximised. This will include the development of clinical guidelines and education programmes Approved and Published: March 2013 Page 4 of 90

5 PRINCIPAL DUTIES AND RESPONSIBILITIES: 1.0 Principal Accountabilities 1.1 Assess, plan, implement and evaluate AOS programmes (HWB2 L4). 1.2 Provide expert advice and clinical practice. (HWB5 Level 4). 1.3 Provide specialist AOS education and training to others (C2 L4). 1.4 Work collaboratively and co-operatively with clinical colleagues to develop services and quality of care delivered (C1 L4). 1.5 Lead the development of clinical services within the specialist field. (C4 L4). 2.0 Clinical Responsibilities 2.1 Perform comprehensive assessment of patient nursing needs, plan, implement and evaluate care delivery (HWB2 L4, HWB6 L2). 2.2 Perform advanced clinical skills in assessment and/or diagnosis and/or treatment (HWB7 L4). 2.3 Collect, collate, evaluate and report information, maintaining accurate patient records (HWB5 L4). 2.4 Involve patients and carers/relatives in the planning and delivery of care and development of services (C1 L3). 2.5 Monitor investigation results, initiating further assessment/review of treatment pathway as required (HWB6 L3). 2.6 Work collaboratively with other professionals and agencies to ensure patient needs are met, especially in relation to ongoing care needs and discharge arrangements. (D1 L3). 2.7 Establish and maintain effective communication with patients and carers/relatives, and professionals across health and social services (C1 L4). 2.8 Contribute to the health promotion agenda with the local health economy (HWB1 L1). 2.9 To undertake non-medical prescribing duties within the legal framework for nurse prescribing and adhere to the Trust s Policy for Non-medical Prescribing (HWB7 L4) In keeping with the NMC Code of Professional Conduct and Standards of Proficiency for Nurse and Midwife Prescribers, keep up to date with best prescribing practice in relation to the management of conditions within his/her specialist area (HWB7 L4) Undertake regular audits of his/her prescribing practice (IK 2 L2). 3.0 AOS Implementation Responsibilities 3.1 To produce and deliver an acute oncology service implementation plan, which meets national guidance and is in line with peer review requirements. 3.2 To highlight risks to implementation and develop remedial actions plans with the Lead Cancer Nurse and Lead Cancer Manager for inclusion in the Trusts Risk Register. 3.3 To be an active member of the Trust s acute oncology team and steering group. 3.4 With the Cancer Network, to produce and monitor performance against appropriate metrics to monitor implementation of the acute oncology service and its impact on emergency admissions and patient experience, including: Reduction in length of stay Reduction in number of A and E admissions Reduction in emergency admissions for oncology Increase in patient satisfaction More patients dying in their chosen place. 3.4 To implement Anglia Cancer Network-agreed acute oncology protocols and guidelines within the Trust. This will include the one hour antibiotic pathway and to establish an audit to monitor compliance. Approved and Published: March 2013 Page 5 of 90

6 3.5 To identify the optimal process to flag patients to the AOS team if admitted through the Trust s emergency departments. 3.6 To work with the PCT to develop a whole systems approach to communicating the acute oncology service to stakeholders, patients and the public. 3.7 Once the AOS team is in place, to work with commissioners and the Anglia Cancer Network to ensure patients have access to telephone advice 24/7 and professionals have access to on call oncology advice. 3.8 To work as part of the Trust s Acute Oncology Team to ensure a fully-compliant acute oncology service, as defined in the Peer Review quality standards. 3.9 Identify and highlight any gaps in service provision (within or outside of the quality standards) and work with the Trust s AOT to identify and implement solutions. 4.0 Managerial/Leadership 4.1 Provide specialist, expert clinical knowledge to clinical colleagues, patients and carers/relatives (C1 L3). 4.2 Undertake clinical supervision of nursing colleagues on an individual or group basis (C1 L4). 4.3 Evaluate service delivery against key performance targets, National Quality Measures, identify areas for improvement and initiate change (C4 L4). 4.4 Ensure the effective and efficient use of physical and financial resources; make recommendations regarding supplies and equipment (C5 L3). 4.5 Collect, collate and report activity data to key stakeholders, producing regular formal reports (IK2 L2). 5.0 Education and Development 5.1 Identify learning needs of the role and plan, implement and evaluate programmes of education to meet the identified need (C2 L4). 5.2 Participate in the education of pre- and post- registered nurses, medical staff, AHPs, patient and carers and participate in curriculum development where appropriate (C2 L4). 5.3 Address specific health targets e.g. CHI, NICE Guidance, NSF related to own area of practice through education (C2 L4). 5.4 Ensure own compliance and compliance of others with regard to mandatory training and PREP requirements (C2 L3). 6.0 Clinical Governance 6.1 Identify need for and participate and undertake the following in order to improve effectiveness of patient care: Research Clinical audit Benchmarking Equipment trials (C2 L3). 6.2 Disseminate research and audit findings through presentation to professional groups and publication (C2 L3). 6.3 Develop and implement policies, procedures and guidelines relevant to own area of work (C4 L4). 6.4 Promote patient and public involvement activities in the specialist area, leading to service improvement (C4 L4). 6.5 Promote people s equality, diversity and rights (C6 L3). Approved and Published: March 2013 Page 6 of 90

7 7.0 General Duties of all employees This is specific to, and to be determined by the appointing Trust, however areas can include: 7.1 Adherence to all Trust policies and procedures. 7.2 Active participation in the AOS Nurse annual performance review to identify personal development needs. 7.3 Attendance at Trust mandatory training sessions and any other training courses relevant to the post. 7.4 A statement of confidentiality. 7.5 Compliance with Health and Safety at work, and attendance at the relevant training sessions. 7.6 Respect and equality in the work environment. 7.7 Any no smoking policies. 7.8 Personal responsibility for the prevention and control of infection. 7.9 Adherence to the relevant Code of Practice of Professional body (NMC and guiding documents) The ongoing evolvement of AOS nurse duties as the service and roles within it develop within the Trust Flexibility within the duties of the role. Approved and Published: March 2013 Page 7 of 90

8 3 The AOS CNS Person Specification Job Title: Acute Oncology Clinical Nurse Specialist Band: 7 ATTRIBUTE ESSENTIAL DESIRABLE METHOD OF ASSESSING CRITERIA Education/ Qualifications RGN Allied Healthcare Degree Post-registration degree-level qualification in specialist area Teaching and assessing qualification Advanced communication skills. Experience 5 years clinical experience in speciality or cancer related area Participation in service development and implementation of change Experience of teaching and assessing in the clinical area Experience of developing and undertaking audit. Non Medical Prescribing Clinical Examination Module Clinical Diagnostics Module. Chemotherapy experience 2 years management experience in speciality or related area. All A/I/C All (A/I) Skills, ability and knowledge Ability to communicate difficult/sensitive information to patients in a variety of settings Able to perform advanced clinical skills Able to influence and overcome resistance through application of advanced communication skills Able to analyse data and provide written reports Intermediate IT skills in word processing and spreadsheets Able to manage work autonomously Knowledge of professional and NHS issues, and policy relating to specialist area Able to present information to professional groups Cannulation/venepuncture although training can be given. A/I A/I A/I A/I A/I/PR A/I A/I A/I Approved and Published: March 2013 Page 8 of 90

9 ATTRIBUTE ESSENTIAL DESIRABLE METHOD OF ASSESSING CRITERIA Able to perform assessment, planning, implementation and evaluation of nursing care Able to participate/undertake clinical audit and research. A/I A/I Personal attributes Assertive and confident Ability to develop effective interpersonal relationships with colleagues across health and social care setting Flexible and adaptive to the requirements of this patient-focused role. Other requirements (if applicable) Methods of Assessment: (A) Application Form (I) Interview (P) Presentation (T) Test / In-Tray Exercise / Role Play (PR) Personal References (C) Certificates of qualification Ability to travel Flexibility in the ability to do so Own transport/support driver. A/I A/I PR A/I Approved and Published: March 2013 Page 9 of 90

10 4 An Outline of the Requirements of the role of:- Acute Oncology Service Clinical Nurse Specialist Learning Outcome Assessment Criteria Evidence of Competence Examples Acute Oncology Induction Training The Acute Oncology Service (AOS) CNS will: The Network Configuration of the Acute Oncology Service Be familiar with the configuration of the Acute Oncology Service within the Anglia Cancer Network. Details of this are provided within the AOS Declaration available on the AngCN website as follows:- The Trust Configuration of the Acute Oncology Service Be familiar with the configuration of the AOS and how it operates within their Trust. Details of this are provided within the AOS Declaration The Acute Oncology Referral Guidelines Be familiar with the location and content of the AngCN Acute Oncology GP Referral Guidelines and understand how the local Trust Referral Guidelines dovetail into them. Be familiar with AOS contact points within each Trust. Be familiar with the Guidelines for the symptoms and signs of patients with MSCC. Approved and Published: March 2013 Page 10 of 90

11 The Protocols associated with the Acute Oncology Service The AngCN Network Acute Oncology Group Be familiar with the location and content of all AOS-related protocols within the Trust, comprising the following: Fast Track referral protocols A and E and Acute Medical Admissions Oncology Communication protocols AOS Assessment Service Communication protocols and Acute Oncology Treatment Protocols. Be aware of the NAOG, its role, core membership, contact points and frequency of meetings. The NAOG Terms of Reference are located as follows:- The AngCN Acute Oncology Nurses Group Be aware of the AngCN AOS Nurses Group, its role, core membership, contact points and frequency of meetings. Attend the meetings. Whilst it is not a Peer Review requirement for the AOS Nurses to meet, this group is viewed as an important mechanism in the development of AOS services across the Network and provides a useful support/discussion forum for the Network AOS Nurses. Trust Processes The Trust Acute Oncology Team The Acute Oncology Service (AOS) CNS will: Be aware of the Acute Oncology Team within the Trust, its role, membership, contact points and regularity of meetings. These are detailed in the Trust AOT Terms of Reference/Operational Policy. Approved and Published: March 2013 Page 11 of 90

12 Knowledge of the Principles of Acute Oncology Systems Knowledge of procedure for review of patients in the Emergency Departments, Clinical Decision Unit and other Wards Knowledge of process when asked by referring clinician to accept/review a patient for transfer to oncology or haematology ward Discuss acute oncology patient routes of entry as per Operational Policy Understand the 24/7 assessment process including follow u Demonstrate an awareness of the acute oncology experts and their specialist areas e.g. acute medicine, surgery, haematology and oncology and rotas e.g. registrar rota, consultant of the week rota for Oncology/Haematology, Consultant 24hr telephone service for advice Know how to access the Acute Oncology team experts 24 hours a day. Participate in handover meetings Document details in patient notes re review by AOS Manage patients for whom there are concerns and discuss with Consultant on call for Haematology and Oncology. Have an in-depth understanding of the different acute oncology and haematology patient groups Initiate review procedure for each patient group. Post-training assessment Effectively manage patients through different routes of entry to acute oncology Use acute oncology bleep system Identify list of acute oncology experts and rota for acute oncology and extended teams. Demonstrate procedure Lead handover meeting Appropriate documentation Appropriate referrals to consultant. Demonstrate procedure for all groups, e.g. the transfer of patients on active treatment to the wards Discuss with on call Consultant if patient not on active treatment Refer haematology patient to registrar before accepting patient Handover appropriate patients to ward doctors. Approved and Published: March 2013 Page 12 of 90

13 The Trust Acute Oncology Assessment Service Knowledge of fast track clinics processes Knowledge of the benefits of using a discharge package Be familiar with and adhere to the Trust s AOS Assessment Service, documented within the Operational Policy. Demonstrate a working knowledge of the location of the Assessment area and: Be able to access area for assessment Know hours of working Know procedure if there are no beds for admission Understand exclusion categories for patients from this area. Be aware of current clinic slots and how to book into these Direct discussion with the patients consultant should they need earlier follow up. Demonstrate an awareness of Trust discharge package. Demonstrate access or exclusion for different patient groups. Work with ward nurse to discharge patients as appropriate. The AngCN and Trust 24/7 Consultant Oncologist On-Call Service The Trust MSCC Coordinator Service The MSCC Senior Clinical Advisor Service A working knowledge of the On-Call Service and how this operates both in- and out-of-hours within the Trust. A working knowledge of the service and how this operates within the Trust. A working knowledge of: The service and how this operates within the Trust The role of the AOS Nurse within this service. Approved and Published: March 2013 Page 13 of 90

14 The identification and management of MUO and CUP patients? Where this is defined as part of the AOS Nurse role A working knowledge, as part of the role, of the appropriate investigation of patients who might benefit from treatment for unknown primary cancers (targeted investigations, rapid triage of patients into specialist oncology or palliative care). Acute Oncology Patient Pathways In depth knowledge of the Neutropenic Pathway Principles of Care for Oncologic Emergencies Care and manage patients with suspected spinal cord compression (SCC) [also oncologic emergency] The Acute Oncology Service (AOS) CNS will: Know how to access the pathway Explain the use of the PGD (Patient group Directive) if in place at the Trust Manage patients in the first 24hrs of pathway Understanding the importance of door to needle time and the target that 100% of suspected Neutropenic Sepsis patients are given initial antibiotics within 1 hour of presentation to the Trust Maintain a detailed audit of all neutropenic patients admitted in line with the NAOG-outlined requirements of the audit. Have knowledge of how to assess and manage patients with: SVCO Hypercalcaemia Tumour Lysis. Discuss responsibilities and know who to contact if a patient is admitted with suspected SCC Demonstrate an understanding of the main diagnostic test to be performed within 24 hours Discuss the Spinal/orthopaedic role in SCC. Clinical Assessment for Nurse Management of neutropenic patient Regular presentation of audit. Clinical Assessment for Nurse Management of patient on one of these three pathways. Clinical Assessment for Nurse Management of patient with suspected SCC. Approved and Published: March 2013 Page 14 of 90

15 Clinical Care and management of Central Venous Access Devices Comprehensive understanding of telephone assessment the Trust 24/7 Chemotherapy Patient Advice Service Clinical examination and assessment of patient The acute oncology nurse will: Be able to access, use and put dressing on CVADs (NB separate competencies available) Know who to contact if line infected and/or needs removing. Have a comprehensive working knowledge of the Advice Service, together with the use of the 24/7 Triage Log sheet and its role in: The consistent and safe telephone triage of all emergency cancer patients To this end, the requirement for all those within the Trust receiving calls into this Advice Service, to be competent in the use of (and use) the Triage Log sheet, Admission avoidance Be able to use and interpret triage assessment sheets Proactively manage/identify potential problems early with telephone follow up/support post treatment Give accurate advice to patients on active Chemotherapy/Radiotherapy and follows this up if unsure Understand protocol for patient review and referral to other disciplines: GP/Primary health care team or admit to hospital Carry out a daily review of overnight patient phone calls and follow up appropriately. Examine patient from head to toe Make a diagnosis from results of investigations. Clinical Assessment for Nurse Care of CVAD in acute oncology patient. All patients triaged and managed according to protocol. Follow the acute oncology pathway for patients and demonstrate appropriate care and management. Approved and Published: March 2013 Page 15 of 90

16 Communication Knowledge of who and how to inform of patient admission Understanding the oncology flagging system The Acute Oncology Service (AOS) CNS will: Demonstrate different methods of regularly informing appropriate clinicians e.g. , bleep, secretary. Know what group of patients are flagged Know who adds and deletes the patient from the system Know how to access and manage alerts to the flagging system. Documentation of communication method. Use of flagging system. Knowledge of Electronic Prescribing Systems and (Electronic) Patient Notes Demonstrate a knowledge of how to document on electronic systems Regular use of electronic systems. Systematically document any toxicities that a patient may experience Document any hospital admission that a patient may have. Enter findings in clinical notes in structured manner. Critique of documentation. Knowledge of importance of Correct Documentation Audit Enter acute oncology data including outcomes Analyse and present data regularly. System Training Be aware of any Trust level, Network level or national level system, on-line, IT training available to support in the development, and ongoing competency of the AOS Nurse role. Current examples are: e-learning package on tumour site cancer: NCIN.org.uk.profiles.gynae and urology NCIN.org.uk.home.aspk understanding cancer. Presentation of audit to Trust Group. Approved and Published: March 2013 Page 16 of 90

17 5 Evidence of Training Completion Induction Training in the use of the Acute Oncology Service - Evidence of Completion Member of Staff: Trust : I confirm that I have undertaken the Induction Training in the use of the Acute Oncology Services, comprising the following elements:- (Please initial appropriate boxes) Familiarisation with the Anglia Cancer Network Acute Oncology Service Configuration Familiarisation with the Trust Acute Oncology Service Configuration The location and content of the Anglia Cancer Network Acute Oncology Referral Guidelines The location and content of the Trust s Acute Oncology Referral Guidelines The location and content of the Trust protocols associated with the Acute Oncology Service The membership, roles and responsibilities of and Terms of Reference for the AngCN Network Acute Oncology Group (NAOG) The membership, roles and responsibilities of and Terms of Reference for the Trust Acute Oncology Team (AOT) The membership, roles and responsibilities of and Terms of Reference for the AngCN AOS Nurses Group Knowledge of the Principles of Acute Oncology Systems Knowledge of procedure for review of patients in the Emergency Departments, CDU and other wards Knowledge of the processes when asked by referring clinician to accept/review a patient for transfer to oncology or haematology ward The Trust Acute Oncology Assessment Service, its role within the Acute Pathway, the Trust contact points and location of the assessment area The Trust Fast Track Referral Processes The benefits of using a discharge package The Trust 24/7 Chemotherapy Patient Advice Service The Trust and AngCN 24/7 Consultant Oncologist On-Call Service The Trust MSCC Coordinator Service Approved and Published: March 2013 Page 17 of 90

18 The MSCC Senior Clinical Advisor Service The identification and management of MUO and CUP patients The Neutropenic Sepsis pathway Principles of care for Oncology and Haematology emergencies Care and management of patients with suspected MSCC Care and management of MUO/CUP patients Care and management of CVADs Telephone assessment and use of the 24/7 triage protocol Patient clinical examination and assessment Communication of a patient s presentation and/or admission The Oncology Flagging System e-prescribing and electronic patient notes Correct documentation Audit I understand that I am responsible for reading updated issues of all Anglia Cancer Network and Trust policies and procedures pertaining to the competencies undertaken I confirm I am aware of changes in practice implemented in the previous (1 year period). Signed: Date: Print name: Dept: Designation/Grade: The following should be determined by each Trust, locally: The method of completing and recording this Evidence of Completion whether manually or electronically, Document retention requirements for this Evidence of Completion, and Whether each trainee is required to keep a personal copy of this form. The method by which Staff Competency records, Training Registers and personnel files should be updated. Approved and Published: March 2013 Page 18 of 90

19 6 The AOS Nurse KSF Assessment Template Required Level of Competence Current level as agreed in discussion between the AOS Nurse Specialist and the Manager/person assessing Comments (this information to be transferred into the AOS Nurse Specialist s personal development plan) 1. Communication develop and maintain communication with people about difficult matters and/or in difficult situations 2. Personal and people development 3. Health, safety and security 4. Service improvement 5. Quality 6. Equality, diversity 7. HWB1 Promotion of health and well-being and prevention of the adverse effects on health and well-being HWB2 Assessment and care planning to meet peoples health and wellbeing needs HWB4 Enablement to address health and well-being needs HWB5 Provision of care to meet health and wellbeing needs Approved and Published: March 2013 Page 19 of 90

20 Required Level of Competence Current level as agreed in discussion between the AOS Nurse Specialist and the Manager/person assessing Comments (this information to be transferred into the AOS Nurse Specialist s personal development plan) 11. HWB6 Assessment and treatment planning HWB7 Interventions and treatments 13. IK2 Information collection and analysis First Gateway to achieve after 12 months i.e. KSF Foundation sub set. To achieve at Second Gateway full KSF Outline. Date of Assessment: Date of next planned Assessment: Approved and Published: March 2013 Page 20 of 90

21 7 Personal Development Plan Template PERSONAL DEVELOPMENT PLAN (insert the next year period) AND PERSONAL DEVELOPMENT REVIEW PROCESS (insert the previous year period) Name: Post Title: Performance Comments by appraiser Signature Nurse comments Signature Comments by Chairman Signature Date Date Date PART ONE: REVIEW OF PROGRESS: OBJECTIVES THE PAST YEAR (insert year) Objective Action to be taken Timescales (by when?) Outcome measure (How will you know it has been achieved?) Outturn/Result Add as appropriate Approved and Published: March 2013 Page 21 of 90

22 PART TWO: WORK RELATED OBJECTIVES FOR THE YEAR AHEAD: (insert year) Objectives Successes and criteria Date Outturn Add as appropriate PART THREE: PERSONAL DEVELOPMENT PLAN FOR THE YEAR AHEAD (insert year) What knowledge and skills will help you achieve your goals? How will you acquire these skills? (e.g. on-job training, coaching, reading, courses) How will you obtain this Education/ Development? Duration Estimate of Costs Training is required by (Date) Who will initiate this? Outturn Add as appropriate PART THREE: PERSONAL DEVELOPMENT PLAN 2012/13 Objectives Successes and criteria Date Outturn Add as appropriate Approved and Published: March 2013 Page 22 of 90

23 8 Document Management To be added when document finalised. Approved and Published: March 2013 Page 23 of 90

24 Evidence of Agreement Document management Document ratification and history Approved by: Date approved: 15 January 2013 Review period: Authors: Sally Legge (Chair of the AngCN Network Acute Oncology Group) Two years AngCN Acute Oncology Nurses Version number as approved and published: Monitoring the effectiveness of the Process 1 Date placed on electronic library: Document Owner: Unique identifier no.: March 2013 Anglia Cancer Network, Tel: ; AngCN-CCG-AO12_v1 a) Process for Monitoring compliance and Effectiveness - Review of compliance as determined by audit. Any non compliance to be presented by PQ Manager to the AngCN Business Meeting on an annual basis the minutes of this meeting are retained for a minimum of five years. b) Standards/Key Performance Indicators This process forms part of a quality system working to, but not accredited to, International Standard BS EN ISO 9001:2008. The effectiveness of the process will be monitored in accordance with the methods given in the quality manual, AngCN-QM. Equality and Diversity Statement This document complies with the Suffolk PCT Equality and Diversity statement an EqIA assessment is available on request to Anglia Cancer Network PQ Manager, Gibson Centre, Exning Road, Newmarket, CB8 7JG. Disclaimer It is your responsibility to check against the electronic library that this printed out copy is the most recent issue of this document. Approved and Published: March 2013 Page 24 of 90

25 Appendix A - Summary KSF Outline for the AOS CNS Role SUMMARY OF NHS KSF OUTLINE JOB TITLE Acute Oncology Service (AOS) Clinical Nurse Specialist POST OUTLINE CREATED BY:- STATUS OF OUTLINE? CORE PURPOSE OF THE JOB:- To provide urgent assessment and initial management of patients phoning or presenting into the Trust with acute symptoms and complications of cancer or of the treatment thereof. *Indicates the level as required in the Principal duties and responsibilities section. CORE/ SPECIFIC NUMBER DIMENSION SECOND GATEWAY (Full outline) FOUNDATION GATEWAY (Subset outline) LEVEL INDICATORS LEVEL INDICATORS Core C1 Levels 3 and 4 Communication 4 All 3 All Core C2 Levels 3 and 4 Personal and People Development - Develop oneself and others in areas of practice 4 All 3 All Core C3 Level 3 Health, Safety and Security 3 All 3 All Core C4 Level 4 Service Improvement 4 All 4 All Core C5 Level 3 Quality 3 All 3 All Core C6 Level 3 Equality and Diversity 3 All 3 All Specific HWB1 Level 1 Promotion of health and wellbeing and prevention of adverse effects on health and wellbeing 1 All 1 All Approved and Published: March 2013 Page 25 of 90

26 Specific HWB2 Level 4 Assessment and Care Planning to meet health and wellbeing needs Specific HWB4 Levels 3 and 4 Enablement to address health and wellbeing needs Specific HWB5 Level 4 Provision of care to meet health and wellbeing needs 4 All 4 All 4 All 3 All 4 All 4 All Specific HWB6 Levels 2 and 3 Assessment and treatment planning 3 All 2 All Specific HWB7 Level 4 Interventions and treatments 4 All 4 All Specific IK2 Level 2 Information collection and analysis 2 All 2 All Approved and Published: March 2013 Page 26 of 90

27 Appendix B - Overview of the NHS KSFs for the AOS CNS Role Dimensions Level Descriptors CORE Communication Communicate with a limited range of people on day-to-day matters 2. Personal and people Development 3. Health, safety and Security 4. Service Improvement Contribute to own personal development Assist in maintaining own and others health, safety and security Make changes in own practice and offer suggestions for improving services Communicate with a range of people on a range of matters Develop own skills and knowledge and provide information to others to help their development Monitor and maintain health, safety and security of self and others Monitor and maintain health, safety and security of self and others Contribute to the improvement of services Develop and maintain communication with people about difficult matters and/or in difficult situations Develop oneself and contribute to the development of others Promote, monitor and maintain best practice in health, safety and security Appraise, interpret and apply suggestions, recommendations and directives to improve services Develop and maintain communication with people on complex matters, issues and ideas and/or in complex situations Develop oneself and others in areas of practice Maintain and develop an environment and culture that improves health, safety and security Work in partnership with others to develop, take forward and evaluate direction, policies and strategies Work in partnership with others to develop, take forward and evaluate direction, policies and strategies Approved and Published: March 2013 Page 27 of 90

28 5. Quality Maintain the quality of own work 6. Equality and diversity Act in ways that support equality and value diversity Maintain quality in own work and encourage others to do so Support equality and value diversity Contribute to improving Quality Promote equality and value diversity Contribute to improving Quality Promote equality and value diversity Develop a culture that improves quality Develop a culture that promotes equality and values diversity Dimensions HEALTH AND WELLBEING HWB1 Promotion of health and wellbeing and prevention of adverse effects on health and wellbeing HWB2 Assessment and care planning to meet health and wellbeing needs Contribute to promoting health and wellbeing and preventing adverse effects on health and wellbeing Level Descriptors Contribute to promoting health and wellbeing and preventing adverse effects on health and wellbeing Assist in the assessment of people s health and wellbeing needs Plan, develop and implement approaches to promote health and wellbeing and prevent adverse effects on health and wellbeing Contribute to assessing health and wellbeing needs and planning how to meet those needs Plan, develop and implement programmes to promote health and wellbeing and prevent adverse effects on health and wellbeing Assess health and wellbeing needs and develop, monitor and review care plans to meet specific needs Promote health and wellbeing and prevent adverse effects on health and wellbeing through contributing to the development, implementation and evaluation of related policies Assess complex health and wellbeing needs and develop, monitor and review care plans to meet those needs Assess complex health and wellbeing needs and develop, monitor and review care plans to meet those needs Approved and Published: March 2013 Page 28 of 90

29 HWB4 Enablement to address health and wellbeing needs Help people meet daily health and wellbeing needs Enable people to meet ongoing health and wellbeing needs Enable people to address specific needs in relation to health and wellbeing Empower people to realise and maintain their potential in relation to health and wellbeing HWB5 Provision of care to meet health and wellbeing needs Undertake care activities to meet individuals health and wellbeing needs Undertake care activities to meet the health and wellbeing needs of individuals with a greater degree of dependency Plan, deliver and evaluate care to meet people s health and wellbeing needs Plan, deliver and evaluate care to address people s complex health and wellbeing needs Plan, deliver and evaluate care to address people s complex health and wellbeing needs Dimensions HEALTH AND WELLBEING HWB6 Assessment and treatment planning Undertake tasks related to the assessment of physiological and psychological functioning Level Descriptors Contribute to the assessment of physiological and psychological functioning Assess physiological and psychological functioning and develop, monitor and review related treatment plans Assess physiological and psychological functioning when there are complex and/or undifferentiated abnormalities, diseases and disorders and develop, monitor and review related treatment plans Approved and Published: March 2013 Page 29 of 90

30 HWB7 Interventions and treatments Assist in providing interventions and/or treatments Contribute to planning, delivering and monitoring interventions and/or treatments Plan, deliver and evaluate interventions and/or treatments Plan, deliver and evaluate interventions and/or treatments when there are complex issues and/or serious illness Plan, deliver and evaluate interventions and/or treatments when there are complex issues and/or serious illness Dimensions INFORMATION AND KNOWLEDGE IK2 Information collection and analysis Collect, collate and report routine and simple data and information Level Descriptors Gather, analyse and report a limited range of data and information Gather, analyse and report a limited range of data and information Gather, analyse, interpret and present extensive and/or complex data and information Plan, develop and evaluate methods and processes for gathering, analysing, interpreting and presenting data and information First Gateway to achieve after 12 months i.e. KSF Foundation sub set. To achieve at Second Gateway full KSF Outline. Approved and Published: March 2013 Page 30 of 90

31 Appendix C Detail of the NHS KSFs for the AOS CNS Role CORE DIMENSION 1: COMMUNICATION OVERVIEW Status Levels Description Core communication is a key aspect of all jobs in the NHS. This dimension underpins all the other dimensions in the KSF. 1. Communicate with a limited range of people on day-to-day matters 2. Communicate with a range of people on a range of matters 3. Develop and maintain communication with people about difficult matters and/or in difficult situations 4. Develop and maintain communication with people on complex matters, issues and ideas and/or in complex situations. This dimension relates to effective communication in whatever form it takes place. Effective communication is a two way process. It involves identifying what others are communicating (eg. through listening) as well as communicating oneself, and the development of effective relationships. Progression through the levels in this dimension is characterised by developments in: the subject matter of the communication the situation in which the communication takes place the purpose of the communication the numbers of people that are being communicated with, their diversity and the effect of these on the communication skills required. Examples of application These may be relevant to all levels in this dimension Communication might take a number of forms including: oral communication signing written communication electronic communication (eg , databases, electronic results and reports) the use of third parties (such as interpreters and translators) the use of communication aids (eg charts, pictures, symbols, electronic output devices, specially adapted computers) the use of total communication systems. Approved and Published: March 2013 Page 31 of 90

32 The people with whom the individual is communicating might be: users of services (such as patients and clients) carers groups (including families) the public and their representatives colleagues and co-workers managers workers from other agencies visitors the media. Barriers to communication may be: environmental (eg noise, lack of privacy) personal (eg the health and wellbeing of the people involved) social (eg conflict, violent and abusive situations, ability to read and write in a particular language or style). Legislation, policies and procedures may be international, national or local and may relate to: complaints and issue resolution confidentiality data protection (including the specific provisions relating to access to health records) disability diversity employment equality and good relations human rights (including those of children) information and related technology language. Links to other KSF Dimensions This dimension is supported by: Core 6 Equality and Diversity. Approved and Published: March 2013 Page 32 of 90

33 Core 1/Level 3: Develop and maintain communication with people about difficult matters and/or in difficult situations Indicators The worker: a) identifies the range of people likely to be involved in the communication, any potential communication differences and relevant contextual factors b) communicates with people in a form and manner that: is consistent with their level of understanding, culture, background and preferred ways of communicating is appropriate to the purpose of the communication and the context in which it is taking place encourages the effective participation of all involved c) recognises and reflects on barriers to effective communication and modifies communication in response d) provides feedback to other workers on their communication at appropriate times e) keeps accurate and complete records of activities and communications consistent with legislation, policies and procedures f) communicates in a manner that is consistent with relevant legislation, policies and procedures. Examples of application People with whom communicating See overview Communication differences might be in relation to: contexts and cultures of the different parties degree of confusion or clarity first/preferred language levels of familiarity with the subject of the communication/context in which the communication is taking place level of knowledge and skills sense of reality. Forms of communication See overview Purpose of communication might include: asserting a particular position or view breaking bad news encouraging and supporting people explaining issues in formal situations (such as courts) explaining outcomes of activities/interventions exploring difficult issues facilitating meetings helping people make difficult decisions making scripted presentations presenting and discussing ideas providing technical advice to non-technical specialists representing views seeking consent sharing decision making with others including users of services Approved and Published: March 2013 Page 33 of 90

34 sharing information supporting people in difficult circumstances. Barriers to communication See overview Modifies communication through, for example: deciding what information/advice to give/not give as the communication proceeds modifying the content and structure of communication modifying the environment modifying the methods of communicating using another language using different communication aids. Legislation, policies and procedures See overview Approved and Published: March 2013 Page 34 of 90

35 Core 1/Level 4: Develop and maintain communication with people on complex matters, issues and ideas and/or in complex situations Indicators The worker: a) identifies: the range of people involved in the communication potential communication differences relevant contextual factors broader situational factors, issues and risks b) communicates with people in a form and manner which: is consistent with their level of understanding, culture, background and preferred ways of communicating is appropriate to the purpose of the communication and its longer term importance is appropriate to the complexity of the context encourages effective communication between all involved enables a constructive outcome to be achieved c) anticipates barriers to communication and takes action to improve communication d) is proactive in seeking out different styles and methods of communicating to assist longer term needs and aims e) takes a proactive role in producing accurate and complete records of the communication consistent with legislation, policies and procedures f) communicates in a manner that is consistent with legislation, policies and procedures. Examples of application People with whom communicating See overview Communication differences might be in relation to: contexts and cultures of the different parties degree of confusion or clarity first/preferred language levels of familiarity with the subject of the communication/context in which the communication is taking place level of knowledge and skills sense of reality. Situational factors, issues and risks might include: changes affecting the people concerned which are outside their control history of poor communication and misunderstandings complexity of the issues and associated political issues and risks clashes in personal and/or organisational styles and approach that cause difficulties in ongoing communication. Forms of communication See overview Purpose of communication might include: advocating on behalf of others asserting a particular position or view and maintaining it in adversity breaking bad news and supporting those receiving it contributing to decision making balancing a number of different interests Approved and Published: March 2013 Page 35 of 90

36 delivering presentations without a script actively encouraging participation from the audience explaining complex issues in formal situations (such as courts, expert witnesses) explaining strategy and organisational decisions to everyone in an organisation facilitating processes motivating people negotiating outcomes involving a number of different parties presenting and explaining complex concepts, ideas and issues to others who are unfamiliar with them providing advice on complex issues or in difficult situations representing and articulating different viewpoints testing out others understanding resolving complex issues seeking consent sharing decision-making with others including users of services. Barriers to communication See overview Taking action to improve communication might include: assessing responses and acting in response changing the content and structure of communication changing the environment changing the methods of communicating deciding what information and advice to give and what to withhold using a range of skills to influence, inspire and champion people and issues using communication aids using another language. Legislation, policies and procedures See overview Approved and Published: March 2013 Page 36 of 90

37 CORE DIMENSION 2: PERSONAL AND PEOPLE DEVELOPMENT OVERVIEW Status Levels Description Core this is a key aspect of all jobs as everyone needs to develop themselves in order for services to continue to meet the needs of patients, clients and the public. 1. Contribute to own personal development 2. Develop own skills and knowledge and provide information to others to help their development 3. Develop oneself and contribute to the development of others 4. Develop oneself and others in areas of practice. This dimension is about developing oneself using a variety of means and contributing to the development of others during ongoing work activities. This might be through structured approaches (eg. the NHS KSF development review process, appraisal, mentoring, professional/ clinical supervision) and/or informal and ad hoc methods (such as enabling people to solve arising problems) Progression through the levels in this dimension is characterised by: taking greater responsibility for your own personal development this includes more reflectiveness self-evaluation, and addressing own development needs increasing involvement in supporting others and their development including a wider range of people with different backgrounds having a greater understanding of own and other s learning needs and preferences, styles of learning and how to facilitate learning and development. Example of application These may be relevant to all levels in this dimension Personal development includes taking part in: the development review process reviewing what you are doing well now and areas for development identifying own learning needs and interests and how to address these Approved and Published: March 2013 Page 37 of 90

38 on-job learning and development including: learning through doing, reflective practice, participating in specific areas of work, learning from others on the job, learning from developing others, professional supervision, undertaking qualifications in the workplace, networking off-job learning and development on one s own including: e-learning, private study, distance learning off-job learning and development with others including: induction, formal courses, scenario-based learning, role play, learning sets, undertaking qualifications in education settings evaluating the effectiveness of learning and its effect on own work. Others, who might support an individual s development or who the individual might help to develop, will include: patients and clients carers the wider public colleagues in immediate work team other colleagues workers from other agencies. Links to other KSF dimensions This dimension is supported by: Core 1 Communication This dimension is different from dimensions: G1 Learning and development which focuses on more formal approaches to learning and development G7 Capacity and capability which focuses on developing collective capacity and capability rather than the development of individuals. Approved and Published: March 2013 Page 38 of 90

39 Core 2/Level 3: Develop oneself and contribute to the development of others Indicators The worker: a) reflects on and evaluates how well s/he is applying knowledge and skills to meet current and emerging work demands and the requirements of the KSF outline for his/her post b) identifies own development needs and sets own personal development objectives in discussion with his/her reviewer c) takes responsibility for own personal development and maintains own personal development portfolio d) makes effective use of learning opportunities within and outside the workplace evaluating their effectiveness and feeding back relevant information e) enables others to develop and apply their knowledge and skills in practice f) contributes to the development of others in a manner that is consistent with legislation, policies and procedures g) contributes to developing the workplace as a learning environment. Examples of application Own development needs might include: critically appraising new and changing theoretical models, policies and the law developing new knowledge and skills in a new area developing new knowledge and skills in own work area developing strategies to manage emotional and physical impact of work keeping up-to-date with evidence-based practice keeping up-to-date with information technology maintaining work-life balance and personal wellbeing managing stress updating existing knowledge and skills in own work area. Personal development See overview Others See overview Enabling others to develop might include: acting as a coach to others acting as a mentor to others acting as a role model acting in the role of reviewer in the development review process demonstrating to others how to do something effectively discussing issues with others and suggesting solutions facilitating networks of practitioners to learn from each other (eg electronic forums, bulletin boards) providing feedback and encouragement to others providing feedback during assessment in the workplace (eg for NVQs/SVQs, student placements) Approved and Published: March 2013 Page 39 of 90

40 providing information and advice providing professional supervision sharing own knowledge, skills and experience supporting individuals who are focusing on specific learning to improve their work and practice supporting others on work placements, secondments and projects. Legislation, policies and procedures may be international, national or local and may relate to: confidentiality data protection (including the specific provisions relating to access to health records) disability diversity employment equality and good relations human rights (including those of children) information and related technology language learning and development. Approved and Published: March 2013 Page 40 of 90

41 Core 2/Level 4: Develop oneself and others in areas of practice Indicators The worker: a) evaluates the currency and sufficiency of own knowledge and practice against the KSF outline for the post and identifies own development needs and interests b) develops and agrees own personal development plan with feedback from others c) generates and uses appropriate learning opportunities and applies own learning to the future development of practice d) encourages others to make realistic self assessments of their application of knowledge and skills challenging complacency and actions which are not in the interest of the public and/or users of services e) enables others to develop and apply their knowledge and skills f) actively promotes the workplace as a learning environment encouraging everyone to learn from each other and from external good practice g) alerts managers to resource issues which affect learning, development and performance h) develops others in a manner that is consistent with legislation, policies and procedures. Examples of application Own development needs and interests might include: critically appraising new and changing theoretical models, policies and the law developing new knowledge and skills in a new area developing new knowledge and skills in own work area developing strategies to manage emotional and physical impact of work keeping up-to-date with evidence-based practice keeping up-to-date with information technology maintaining work-life balance and personal wellbeing managing stress updating existing knowledge and skills in own work area. Personal development See overview Others See overview Enabling others to develop might include: acting as a coach to others acting as a mentor to others acting as a role model acting in the role of reviewer in the development review process demonstrating to others how to do something effectively discussing issues with others and suggesting solutions facilitating networks of practitioners to learn from each other (eg electronic forums, bulletin boards) providing feedback and encouragement to others providing feedback during assessment in the workplace (eg for NVQs/SVQs, student placements) Approved and Published: March 2013 Page 41 of 90

42 providing information and advice providing pre-registration or post-registration placements providing professional supervision providing protected learning time sharing own knowledge, skills and experience supporting individuals who are focusing on specific learning to improve their work and practice supporting others on work placements, secondments and projects. Resource issues might include: pressure of service delivery affecting the development of individuals and groups in the short and longer term lack of funding for development raising governance issues broader workforce issues which cannot be managed by training and development of current team members (eg high turnover, inability to attract people of the necessary calibre). Legislation, policies and procedures may be international, national or local and may relate to: confidentiality data protection (including the specific provisions relating to access to health records) disability diversity employment equality and good relations human rights (including those of children) information and related technology language learning and development. Approved and Published: March 2013 Page 42 of 90

43 CORE DIMENSION 3: HEALTH, SAFETY AND SECURITY OVERVIEW Status Levels Description Core this is a key aspect of all jobs as it is vital that everyone takes responsibility for promoting the health, safety and security of patients and clients, the public, colleagues and themselves. 1. Assist in maintaining own and others health, safety and security 2. Monitor and maintain health, safety and security of self and others 3. Promote, monitor and maintain best practice in health, safety and security 4. Maintain and develop an environment and culture that improves health, safety and security. This dimension focuses on maintaining and promoting the health, safety and security of everyone in the organisation or anyone who comes into contact with it. It includes tasks that are undertaken as a routine part of one s work such as moving and handling. Those who come into contact with the organisation will be anyone who interacts with an employee of the organisation or who is affected by the actions of the organisation. Progression through the levels in this dimension is characterised by: an increasing number and range of people and work areas for which one is responsible greater proactivity and focus on good practice going from following set procedures to identifying the need for improvement increasing responsibilities for risk management and contingency management greater involvement in investigation and follow-up of breaches to health, safety and security. Example of application These may be relevant to all levels in this dimension The others for whom a worker has responsibility for their health, safety and security might be: users of services (including patients and clients) carers communities the wider public colleagues in immediate work team other colleagues Approved and Published: March 2013 Page 43 of 90

44 contractors visitors to the organisation workers from other agencies. Risks to health, safety and security might be related to: the environment (eg issues related to ventilation, lighting, heating, systems and equipment, pests, work-related stress) individuals (eg personal health and wellbeing) information and its use (eg sharing passwords, sharing information with other agencies) physical interactions (eg abuse, aggression, violence, theft) psychological interactions (eg bullying, harassment) social interactions (eg discrimination, oppression, lone working). Legislation, policies and procedures may be international, national or local and may relate to: accident/incident reporting building regulations and standards child protection clinical negligence data and information protection and security emergencies hazardous substances health and safety at work infection control ionising radiation moving and handling protection of vulnerable adults risk management security of premises and people working time workplace ergonomics (eg display screen equipment). Approved and Published: March 2013 Page 44 of 90

45 Links to other KSF Dimensions This dimension is supported by: Core 6 Equality and diversity This dimension is different from dimensions: HWB3 Protection of health and wellbeing which focuses on specific protective measures for health and wellbeing such as child protection, environmental protection EF3 Transport and logistics which focuses on the transportation and flow of people and materials with and between agencies and community locations rather than the routine movement of people and items as one small part of one s work. Approved and Published: March 2013 Page 45 of 90

46 Core 3/Level 3: Monitor and maintain health, safety and security of self and others Indicators a) The worker identifies: the risks involved in work activities and processes how to manage the risks how to help others manage risk b) undertakes work activities consistent with: legislation, policies and procedures the assessment and management of risk c) monitors work areas and practices and ensures they: are safe and free from hazards conform to health, safety and security legislation, policies, procedures and guidelines d) takes the necessary action in relation to risks e) identifies how health, safety and security can be improved f) and takes action to put this into effect. Examples of application Risks to health, safety and security: See overview Others: See overview Legislation, policies and procedures See overview Monitoring work areas and practices includes: confirming individuals maintain good health, safety and security practices ensuring individuals wear protective clothing and equipment monitoring aspects of the environment monitoring and reporting on compliance. Taking the necessary action in relation to risks might include: accident or incident reporting apprehending or expelling people consistent with organisational and statutory requirements challenging people who put themselves or others at risk contributing to maintaining and improving organisational policies and procedures evacuating buildings during emergencies initiating practice exercises for emergencies maintaining and improving the environment supporting others to manage risks more effectively. Approved and Published: March 2013 Page 46 of 90

47 Identifying how health, safety and security can be improved might include: acting as a role model identifying the need for expert advice and support identifying training needs negotiating resources for training and development in health, safety and security reporting and recording lack of resources to act effectively. Approved and Published: March 2013 Page 47 of 90

48 CORE DIMENSION 4: SERVICE IMPROVEMENT OVERVIEW Status Levels Description Core this is a key aspect of all jobs as everybody has a role in implementing policies and strategies and in improving services for users and the public. 1. Make changes in own practice and offer suggestions for improving services 2. Contribute to the improvement of services 3. Appraise, interpret and apply suggestions, recommendations and directives to improve services 4. Work in partnership with others to develop, take forward and evaluate direction, policies and strategies. This dimension is about improving services in the interests of the users of those services and the public as a whole. The services might be services for the public (patients, clients and carers) or services that support the smooth running of the organisation (such as finance, estates). The services might be single or multi-agency and uni or multi-professional. Improvements may be small scale, relating to specific aspects of a service or programme, or may be on a larger scale, affecting the whole of an organisation or service. They might arise from: formal evaluations (such as audit) more informal and ad hoc approaches (such as bright ideas ) applying developments from elsewhere national policy and targets changes in legislation at international or national level working closely with users and the public the need to modernise services. This dimension also covers the development of direction, policies and strategies to guide the work of the organisation or service, including agreeing vision, values and ethos. Leadership and partnership are key aspects here as it is through inspiring and working collectively with others that strategy and direction can be taken forward into service improvements. Approved and Published: March 2013 Page 48 of 90

49 Leadership includes such aspects as: understanding and rising to the challenges of service improvement critical tasks that need to be done, problems and issues to be faced understanding the context in which services are to be improved local politics, national policy imperatives, the local environment and the people in it understanding the characteristics of the people involved and building on their diversity. Progression through the levels in this dimension is characterised by: moving from implementing agreed changes to setting the context which guides and informs service improvements an increasing role in, and understanding of, direction, policies and strategies at a macro level increasing knowledge and skills in leading others, managing change and partnership working an increasing ability to identify direction in the longer term over a number of years rather than in the immediate to short term. Examples of application These may be relevant to all levels in this dimension Direction, policies and strategies might relate to any aspect of the NHS and the activities within it including: buildings, structures and grounds cleaning and catering development and innovation education, training and development equality and diversity financial services financial management health and social care services health and wellbeing health, safety and security human resources selection, recruitment, retention, deployment information and knowledge public relations and marketing other services that effect people s health and wellbeing (eg transport, education, housing) procurement and commissioning promotion of equality and diversity resource use Approved and Published: March 2013 Page 49 of 90

50 service effectiveness systems and equipment transport and logistics user involvement. Links to other KSF Dimensions This dimension is supported by: Core 1 Communication which is a key aspect of taking forward policy, strategy and direction G5 Services and project management which focuses on running services and projects in line with strategy and direction IK2 Information collection and analysis as research and interpretation of information is a key part of setting strategy and direction. This dimension is different from dimensions: Core 5 Quality which focuses on the quality of current practice whereas this dimension is about improving services G2 Development and innovation which focuses on appraising new and innovative methods, equipment, concepts and ideas and testing them in practice. This might be a fore-runner to service improvement G7 Capacity and capability which focuses on developing collective capacity this might be necessary to support service improvements. Terminology Direction the general way in which something should develop or progress. Policy set of principles or rules which govern the way an organisation/partnership deals with key issues. Strategy a carefully devised plan to achieve long-term goals and direction. Values the things that an organisation/partnership believes in and seeks to realise in its work. Objectives clearly defined and measurable results which need to be achieved. Approved and Published: March 2013 Page 50 of 90

51 Core 4/Level 4: Work in partnership with others to develop, take forward and evaluate direction, policies and strategies Indicators The worker: a) effectively engages the public, users of services and other interested parties in an open and effective discussion on values, direction, policies and strategies for the organisation/services b) works effectively with others to clearly define values, direction and policies including guidance on how to respond when these are under pressure or interests are in conflict c) works effectively with others to continually review values, direction and policies in the light of changing circumstances d) works effectively with others to formulate strategies and associated objectives that: are consistent with values, direction and policies are attainable given available resources and timescales contain sufficient detail for the operational planning of services, projects and programmes take account of constraints realistically balance competing interests and tensions whilst maintaining values and direction e) communicates values, direction, policies and strategies effectively to relevant people and enables them to: appraise and apply them to their area of responsibility feed in their views and suggestions for change f) works effectively with everyone affected by direction, policies and strategies to evaluate their impact and effectiveness and feed this information into ongoing improvements. Examples of application Direction, policies and strategies See overview Others might include: users of services the wider public colleagues and co-workers people in other parts of the organisation other agencies elected representatives. Approved and Published: March 2013 Page 51 of 90

52 CORE DIMENSION 5: QUALITY OVERVIEW Status Levels Description Core this dimension is a key aspect of all jobs as everyone is responsible for the quality of their own work. It underpins all the other dimensions in the NHS KSF. 1. Maintain the quality of own work 2. Maintain quality in own work and encourage others to do so 3. Contribute to improving quality 4. Develop a culture that improves quality. This dimension relates to maintaining high quality in all areas of work and practice, including the important aspect of effective team working. Quality can be supported using a range of different approaches including: codes of conduct and practice, evidence-based practice, guidelines, legislation, protocols, procedures, policies, standards and systems. This dimension supports the governance function in organisations clinical, corporate, financial, information, staff etc. Progression through the levels in this dimension is characterised by: increasing scope from own activities to the work of others and then broader areas greater proactivity in improving quality and addressing quality issues. Examples of application These may be relevant to all levels in this dimension Being an effective team member would include such aspects as: arriving and leaving promptly and working effectively during agreed hours developing the necessary knowledge and skills needed by and in the team enabling others to solve problems and address issues identifying issues at work and taking action to remedy them presenting a positive impression of the team and the service reacting constructively to changing circumstances. recognising, respecting and promoting the different roles that individuals have in the team recognising, respecting and promoting the diversity of the team seeking and reflecting on feedback from the team and adapting as necessary supporting other team members taking a shared approach to team work Approved and Published: March 2013 Page 52 of 90

53 understanding own role in the team and the wider organisation. Legislation, policies and procedures may be international, national or local and may relate to: accident/incident reporting anti-discriminatory practices building regulations and standards children clinical negligence corporate identity criminal justice data and information protection and security (including the specific provisions relating to access to medical records) emergencies employment equality and diversity harassment and bullying hazardous substances health, safety and security human rights infection control ionising radiation protection measures language mental health moving and handling protection of vulnerable adults public interest risk management. Approved and Published: March 2013 Page 53 of 90

54 Links to other KSF Dimensions This dimension is supported by: Core 1 Communication Core 6 Equality and Diversity. This dimension is different from dimensions: Core 4 Service Improvement which focuses on taking forward services whereas this focuses on the quality of current practice G6 People Management which focuses on managing the quality of other people s work. Terminology Team a group of people who work to achieve a purpose. Teams may work in close proximity to each other or team members might work largely on their own both types of team contribute to the wider effort of the NHS in improving health and wellbeing and addressing health needs. Approved and Published: March 2013 Page 54 of 90

55 Core 5/Level 3: Contribute to improving quality Indicators The worker: a) acts consistently with legislation, policies, procedures and other quality approaches and promotes the value of quality approaches to others b) understands own role in the organisation and its scope and identifies how this may develop over time c) works as an effective and responsible team member and enables others to do so d) prioritises own workload and organises and carries out own work in a manner that maintains and promotes quality e) evaluates the quality of own and others work and raises quality issues and related risks with the relevant people f) supports the introduction and maintenance of quality systems and processes in own work area g) takes the appropriate action when there are persistent quality problems. Examples of application Legislation, policies and procedures See overview Working as an effective and responsible team member See overview Quality issues and related risks might include: complaints data and information gaps health, safety and security inappropriate policies incidents ineffective systems lack of knowledge or evidence on which to base the work lack of shared decision making with users of services mistakes and errors poor communication poor individual or team practice resources risks team working workload. Approved and Published: March 2013 Page 55 of 90 Taking the appropriate action when there are persistent quality problems might include: alerting a trade union official alerting one s own manager alerting the manager of the person concerned issuing warnings investigating incidents whistle blowing.

56 CORE DIMENSION 6: EQUALITY AND DIVERSITY OVERVIEW Status Levels Description Core this is a key aspect of all jobs and of everything that everyone does. It underpins all dimensions in the NHS KSF. 1. Act in ways that support equality and value diversity 2. Support equality and value diversity 3. Promote equality and value diversity 4. Develop a culture that promotes equality and values diversity. It is the responsibility of every person to act in ways that support equality and diversity. Equality and diversity is related to the actions and responsibilities of everyone users of services including patients clients and carers; work colleagues; employees; people in other organisations; the public in general. Successful organisations are ones that reflect the richness of diversity that exists in society and will include people of different: abilities; ages; bodily appearances; classes; castes; creeds; cultures; genders; geographical localities; health, relationship, mental health, social and economic statuses; places of origin; political beliefs; race; religion; sexual orientation; and those with and without responsibilities for dependents. Where diversity and equality are not integral to an organisation, discrimination may occur. Progression through the levels in this dimension is characterised by: moving from own practice to the consideration of team and organisational cultures an increasing understanding of the nature and complexity of equality and diversity being more proactive and challenging in the promotion of equality and diversity increasing knowledge about the legislation, policies and procedures relating to equality and diversity from awareness, knowing where to obtain information, having a working knowledge of the legislation, policies and procedures and being able to interpret them to others, to an extended knowledge of the legislation, policies and procedures and monitoring their effectiveness in organisations. Approved and Published: March 2013 Page 56 of 90

57 Examples of application These may be relevant to all levels in this dimension Links to other KSF dimensions Terminology Legislation, policies and procedures may be international, national or local and may relate to: age complaints and issue resolution (including harassment and bullying) employment equality dependents people who have caring responsibilities and those who do not diversity age, gender, marital status, political opinion, racial group, religious belief, sexuality disability gender human rights (including those of children) language marital status mental health mental incapacity political opinion racial group religious belief sexual orientation. This dimension is supported by: Core 1 Communication Core 2 Personal and people development Core 3 Health, safety and security Core 4 Service improvement Core 5 Quality G1 Learning and development G7 Capacity and capability. Equal opportunities emphasises the structures, systems and measures of groups within society and within organisations. Equal opportunities is about addressing representation and balance. Approved and Published: March 2013 Page 57 of 90

58 Equality -is about creating a fairer society where everyone can participate and has the opportunity to fulfil their potential. It is backed by legislation designed to address unfair discrimination based on membership of a particular group. Diversity is about the recognition and valuing of difference in the broadest sense. It is about creating a working culture and practices that recognise, respect, value and harness difference for the benefit of the organisation and individuals. Discrimination the practice of treating individuals less fairly than other people or groups. Approved and Published: March 2013 Page 58 of 90

59 Core 6/Level 3: Promote equality and value diversity Indicators The worker: a) interprets equality, diversity and rights in accordance with legislation, policies, procedures and relevant standards b) evaluates the extent to which legislation is applied in the culture and environment of own sphere of activity c) identifies patterns of discrimination and takes action to overcome discrimination and promote diversity and equality of opportunity d) enables others to promote equality and diversity and a nondiscriminatory culture e) supports people who need assistance in exercising their rights. Examples of application Legislation, policies and procedures See overview Evaluating the extent to which legislation is applied in the culture and environment of own sphere of activity might relate to: communication with different people health, safety and security including risk management systems, standards and guidelines designed to promote quality the allocation of resources the availability of services the development of services. Patterns of discrimination might relate to: the learning and development offered to different people the recruitment, selection and promotion of staff. Enabling others to promote equality and diversity and a nondiscriminatory culture might include: acting as a role model being aware of the wellbeing of all members of the work team and supporting them appropriately enabling others to reflect on their behaviour identifying training and development needs. Supporting people who need assistance might relate to: advocacy enabling people to make the best use of their abilities intervening when someone else is discriminating against someone on a one-off basis or routinely Approved and Published: March 2013 Page 59 of 90

60 making arrangements for support (eg as part of the development review process) representing people s views. Approved and Published: March 2013 Page 60 of 90

61 DIMENSION HWB1: PROMOTION OF HEALTH AND WELLBEING AND PREVENTION OF ADVERSE EFFECTS ON HEALTH AND WELLBEING OVERVIEW Status Levels Description Specific it will relate to some jobs but not all 1. Contribute to promoting health and wellbeing and preventing adverse effects on health and wellbeing 2. Plan, develop and implement approaches to promote health and wellbeing and prevent adverse effects on health and wellbeing 3. Plan, develop, implement and evaluate programmes to promote health and wellbeing and prevent adverse effects on health and wellbeing 4. Promote health and wellbeing and prevent adverse effects on health and wellbeing through contributing to the development, implementation and evaluation of related policies. This dimension focuses on promoting people s health and wellbeing and preventing adverse effects on health and wellbeing. The promotion of health and wellbeing includes giving information to people on how to promote their own and others health and wellbeing and different forms of education (eg using a variety of teaching methods, techniques and approaches). The prevention of adverse effects might be through: improving people s resistance to disease and other factors that affect health and wellbeing; limiting people s exposure to risk; reducing the stressors that affect people s health and wellbeing. Activities might take place at individual, family, group, community or population level. They may be undertaken with users of services, the public as a whole and within organisations with staff and workers from other agencies. Partnership is a fundamental aspect of this dimension as it is only through working closely with members of the public and users of services (patients, clients and carers) that health and wellbeing can be promoted effectively. Approved and Published: March 2013 Page 61 of 90

62 The policies, programmes, approaches and activities within this dimension might be focused on one or more of the different aspects of health and wellbeing, ie. emotional, mental, physical, social, and spiritual. Progression through the levels in this dimension is characterised by: moving from a focus on individuals and groups to an approach that focuses on improving the health of populations and the general public increasing knowledge and skills in relation to the complex nature of health and wellbeing, the stressors which affect it and its relationship to religion, belief and culture advancing from working within set programmes to designing such programmes and wider approaches. Examples of application These may be relevant to all levels in this dimension Policies, programmes, approaches and activities that are designed to promote health and wellbeing or prevent adverse effects on health and wellbeing might relate to: awareness raising broader aspects of the environment that affect people s lives and their health and wellbeing (eg housing, transport, education, employment) enabling people to adopt healthy lifestyles enabling people to learn how to look after their own health and wellbeing/become expert in managing conditions that affect their health and wellbeing enabling people to maintain their mobility enabling people to maintain and develop their self-management skills involving people in decision making about their health and wellbeing improving people s resistance limiting people s exposure to risks to health and wellbeing providing information and advice on health and wellbeing and stressors to health and wellbeing reducing risks in lifestyles reducing the stressors that effect people s health and wellbeing screening. Approved and Published: March 2013 Page 62 of 90

63 Links to other KSF Dimensions This dimension is supported by: Core 1 Communication which focuses on effective communication in a wide range of different ways and in different circumstances Core 2 Personal and people development which contains ad hoc approaches to developing people s knowledge and skills Core 6 Equality and diversity which focuses on promoting equality and valuing diversity IK2 Information collection and analysis which focuses on collecting and structuring information that might support the promotion of health and wellbeing and the prevention of adverse effects G1 Learning and development which contains structured approaches to the promotion of health that might be used, for example, in health education approaches. This dimension is different from dimension: HWB3 Protection of health and wellbeing which focuses on protecting people when there are risks and using statutory processes to do so if this is necessary G7 Capacity and capability which focuses on capacity building across groups of people such as community development, organisational development and workforce development. Terminology Health: a state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity. Health is a resource for everyday life, not the object of living. It is a positive concept emphasising social and personal resources as well as physical capabilities. A comprehensive understanding of health implies that all systems and structures which govern social and economic conditions and the physical environment should take account of the implications of their activities in relation to their impact on individual and collective health and well-being. (World Health Organisation). Stressors to health and wellbeing are features of the environment that may induce harm or damaging responses in a living system or organism. They may be: biological, chemical, physical, social, psychosocial. Target group: the individuals, families, groups, communities or populations who are the focus of a specific approach, programme or policy for promoting health and wellbeing or preventing adverse effects to health and wellbeing. Approved and Published: March 2013 Page 63 of 90

64 HWB1/Level 1: Contribute to promoting health and wellbeing and preventing adverse effects on health and wellbeing Indicators The worker: a) identifies factors which have a positive and negative affect on health and wellbeing and how it can be promoted and adverse effects prevented b) enables people to view health and wellbeing as a positive aspect of their lives c) enables people to be involved in activities and make their own decisions about them consistent with people s views and beliefs d) undertakes planned activities with people with their agreement consistent with legislation, policies and procedures e) records and reports back fully on the activities undertaken and alerts others in the team to any issues that arise during the activities. Examples of application Activities to promote health and wellbeing and prevent adverse effects on health and wellbeing See overview Legislation, policies and procedures may be international, national or local and may relate to: consent health improvement public health shared decision making. Any issues would include: adverse changes in/to the people as a result of the activities the activities not working out as planned. Approved and Published: March 2013 Page 64 of 90

65 DIMENSION HWB2: ASSESSMENT AND CARE PLANNING TO MEET HEALTH AND WELLBEING NEEDS OVERVIEW Status Levels Description Specific it will relate to some jobs but not all. 1. Assist in the assessment of people s health and wellbeing needs 2. Contribute to assessing health and wellbeing needs and planning how to meet those needs 3. Assess health and wellbeing needs and develop, monitor and review care plans to meet specific needs 4. Assess complex health and wellbeing needs and develop, monitor and review care plans to meet those needs. This dimension relates to assessing the health and wellbeing needs of people individuals and groups (including families). This assessment focuses on the whole person in the context of their community, family, lifestyle and environment. It may take place in any setting. In undertaking this work staff will need to be aware of their legal obligations and responsibilities, the rights of the different people involved, and the diversity of the people they are working with. Progression through the levels in this dimension is characterised by: increasing complexity of health and wellbeing needs and an understanding of how these can be addressed increasing demands for interagency and interprofessional working increasing involvement in the planning, monitoring and review of programmes of care (as contrasted with making a contribution to the assessment). Examples of application These may be relevant to all levels in this dimension Health and wellbeing needs may be: emotional mental physical social spiritual. Approved and Published: March 2013 Page 65 of 90

66 Legislation, policies and procedures may be international, national or local and may relate to: carers children criminal justice disability domestic violence duty of care education human rights mental health mental incapacity medicines vulnerable adults. Links to other KSF dimensions This dimension is supported by: Core 1 Communication which focuses on effective communication with people during assessment of their health and wellbeing needs. Core 6 Equality and diversity which focuses on promoting equality and valuing diversity and supporting people s rights. G2 Development and innovation which focuses on testing and developing new and innovative forms of assessment. This dimension is different from dimensions: HWB4 Enablement to address health and wellbeing which focuses on the enablement that might take place as part of the programmes developed in this dimension. HWB5 Provision of care to meet health and wellbeing needs which focuses on the various care interventions that might take place as part of the programmes developed in this dimension. HWB6 Assessment and treatment planning which focuses on assessing and diagnosing physiological and psychological functioning. Approved and Published: March 2013 Page 66 of 90

67 Terminology Health: a state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity. Health is a resource for everyday life, not the object of living. It is a positive concept emphasising social and personal resources as well as physical capabilities. A comprehensive understanding of health implies that all systems and structures which govern social and economic conditions and the physical environment should take account of the implications of their activities in relation to their impact on individual and collective health and well-being. (World Health Organisation). Care plans: overall plans for the protection, enablement and care that people require to meet their health and wellbeing needs. Approved and Published: March 2013 Page 67 of 90

68 HWB2/Level 4: Assess complex health and wellbeing needs and develop, monitor and review care plans to meet those needs Indicators The worker: a) explains clearly to people: own role, responsibilities and accountability the information that is needed from the assessment of health and wellbeing needs and who might have access to it the benefits and risks of the assessment process and alternative approaches the outcomes of assessment options within care plans and associated benefits and risks b) respects people s dignity, wishes and beliefs; involves them in shared decision-making; and obtains their consent c) plans and uses assessment methods that are appropriate for complex needs, and uses processes of reasoning that are appropriate for the complex needs of the people concerned s/he has the knowledge, skills and experience to use effectively are based on available evidence obtain sufficient information for decision-making including gaining assessment information from other practitioners d) follows processes of reasoning which: balance additional information against the overall picture of the individual s needs to confirm or deny developing hypotheses are capable of justification given the available information at the time are likely to result in the optimum outcome e) interprets all of the information available and makes a justifiable assessment of: people s health and wellbeing their related complex needs and prognosis Examples of application Health and wellbeing needs See overview Assessment methods that are appropriate for complex needs include the use of: checklists discussions and conversations frameworks observations questioning specific tests specific activities specially designed methods to assess the particular needs of the people concerned. Legislation, policies and procedures See overview Risks to health and wellbeing might arise from: abuse incidents/accidents neglect rapid deterioration of condition or situation self-harm the complexity and range of contributory factors the environment. Approved and Published: March 2013 Page 68 of 90

69 risks to their health and wellbeing in the short and longer term transferring and applying her/his skills and knowledge to address the complexity of people s needs f) develops and records care plans that are appropriate to the people concerned and: are consistent with the outcomes of assessing their complex health and wellbeing needs identify the risks that need to be managed have clear goals involve other practitioners and agencies to meet people s complex health and wellbeing needs and risks are consistent with the resources available note people s wishes and needs that it was not possible to meet g) coordinates the delivery of care plans, feeding in relevant information to support wider service planning h) monitors the implementation of care plans and makes changes to better meet people s complex health and wellbeing needs. Approved and Published: March 2013 Page 69 of 90

70 DIMENSION HWB4: ENABLEMENT TO ADDRESS HEALTH AND WELLBEING NEEDS OVERVIEW Status Levels Description Specific it will relate to some jobs but not all 1. Help people meet daily health and wellbeing needs 2. Enable people to meet ongoing health and wellbeing needs 3. Enable people to address specific needs in relation to health and wellbeing 4. Empower people to realise and maintain their potential in relation to health and wellbeing. This dimension is about enabling and empowering people of any age individuals, families and groups, to address their own health and wellbeing needs. This would include such areas as: enabling people to acknowledge and address issues in their lives helping people to develop their knowledge and skills helping people manage their health conditions providing advice and information supporting carers in their caring roles supporting people to live independently supporting people during life events. Progression through the levels in this dimension is characterised by: increasingly complex forms of enablement (eg from helping to supporting to facilitating and developing knowledge and skills) increasing complexity of the needs being addressed (eg being able to live independently as compared with undertaking specific daily living activities) increasing knowledge and skills in how to enable people effectively. Examples of application These may be relevant to all levels in this dimension Health and wellbeing needs may be: emotional mental physical social Approved and Published: March 2013 Page 70 of 90

71 spiritual. Risks to health and wellbeing might arise from: abuse incidents/accidents neglect rapid deterioration of condition or situation self-harm the complexity and range of contributory factors the environment. Legislation, policies and procedures may be international, national or local and may relate to: carers children and young people criminal justice disability duty of care education employment human rights mental health mental incapacity vulnerable adults. Links to other KSF Dimensions This dimension is supported by: Core 1 Communication which focuses on effective communication a key aspect of enablement Core 3 Health, safety and security maintaining and promoting people s health, safety and security during work with them Core 6 Equality and diversity which focuses on promoting equality and valuing diversity during work with people and enabling them to do the same HWB2 Assessment and care planning to meet health and wellbeing needs which would set the overall care plan in which this work is undertaken G2 Development and innovation which focuses on testing and developing new and innovative forms of enablement. Approved and Published: March 2013 Page 71 of 90

72 This dimension is different from dimension: HWB5 Provision of care to meet health and wellbeing needs which focuses on working with individuals who are dependent on others for meeting some or all of their health and wellbeing needs in the short or long term HWB7 Interventions and treatments which focuses on intervening and treating individuals physiological and/or psychological needs in the context of the whole person. Terminology Health: a state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity. Health is a resource for everyday life, not the object of living. It is a positive concept emphasising social and personal resources as well as physical capabilities. A comprehensive understanding of health implies that all systems and structures which govern social and economic conditions and the physical environment should take account of the implications of their activities in relation to their impact on individual and collective health and well-being. (World Health Organisation). Team a group of people who work to achieve a purpose. Teams may work in close proximity to each other or team members might work largely on their own both types of team contribute to the wider effort of the NHS in improving health and wellbeing and addressing health needs. Approved and Published: March 2013 Page 72 of 90

73 HWB4/Level 3: Enable people to address specific needs in relation to health and wellbeing Indicators The worker: a) respects people s dignity, wishes and beliefs; involves them b) in shared decision making; and obtains their consent c) identifies with the people concerned: goals for the specific activities to be undertaken within the context of their overall care plan and their health and wellbeing needs the forms the activities should take the involvement of other people and/or agencies relevant evidence-based guidelines d) enables people to address their specific needs consistent e) with legislation, policies and procedures acting as a f) resource as and when they need it g) takes the appropriate action to address any issues or risks h) reviews the effectiveness of specific activities as they i) proceed and makes any necessary modifications j) provides feedback to the person responsible for the overall k) care plan on its effectiveness and the health and wellbeing and needs of people l) makes accurate records of the activities undertaken and m) any risks. Examples of application Health and wellbeing needs See overview Enabling people to address specific needs might include: accessing specific forms of information and support for people adapting to disability or illness addressing specific areas of emotional need addressing specific areas of intellectual need addressing specific areas of psychological need addressing specific areas of social need advocacy developing daily living skills developing skills and knowledge in relation to self care developing specific mobility skills enabling people to access information and advice enabling people to decide what to do after receiving the outcomes of an assessment of their health and wellbeing encouraging citizenship managing people s behaviour and that of others spiritual support supporting people during specific therapeutic activities supporting people to take their medicines effectively using leisure activities for health and wellbeing using play for specific purposes. Legislation, policies and procedures See overview Risks to health and wellbeing See overview Approved and Published: March 2013 Page 73 of 90

74 HWB4/Level 4: Empower people to realise and maintain their potential in relation to health and wellbeing Indicators The worker: a) respects people s dignity, wishes and beliefs; involves them in shared decision making; and obtains their consent b) identifies with the people concerned: goals for the specific activities to be undertaken within the context of their overall care plan and their complex health and wellbeing needs the form different activities should take the involvement of other people and/or agencies relevant evidence-based guidelines risks c) enables people to realise and maintain their potential in a manner that is consistent with: evidence-based practice legislation, policies and procedures the management of risk applying own skills, knowledge and experience and using considered judgment to support people s different needs d) takes the appropriate action to address any issues or risks e) evaluates the effectiveness of work with people and makes any necessary modifications f) provides effective feedback to inform the overall care plan g) makes complete records of the work undertaken, people s health and wellbeing, needs and related risks. Examples of application Health and wellbeing needs See overview Risks to health and wellbeing See overview Enable people to realise and maintain their potential might include: counselling developing people s mobility empowering individuals to adjust to and manage large scale changes in their lives empowering people to develop intellectually empowering people to develop their parenting skills empowering people to manage their own behaviour where there are complex issues empowering people with complex needs to develop their daily living skills empowering people with complex needs to develop their social skills enabling individuals to become expert in managing their condition/illness/treatment giving people support to move on and away from others providing psychological support providing spiritual support when there are specific and complex needs. Legislation, policies and procedures See overview Approved and Published: March 2013 Page 74 of 90

75 DIMENSION HWB5: PROVISION OF CARE TO MEET HEALTH AND WELLBEING NEEDS OVERVIEW Status Levels Description Specific it will relate to some jobs but not all 1. Undertake care activities to meet individuals health and wellbeing needs 2. Undertake care activities to meet the health and wellbeing needs of individuals with a greater degree of dependency 3. Plan, deliver and evaluate care to meet people s health and wellbeing needs 4. Plan, deliver and evaluate care to address people s complex health and wellbeing needs. This dimension relates specifically to working with individuals who are dependent on others for meeting some or all of their health and wellbeing needs, and with their carers whose own needs might affect what happens to those individuals. This dependence might be short-term, long term, or intermittent to meet carers needs dependent on the support structures available. The areas of care that would address this dependence include such aspects as: personal care administration and monitoring of medications application of dressings caring for individuals after death ensuring individual s comfort and need for rest monitoring individual s safety and wellbeing palliative and terminal care providing social stimulation and interaction respite care supporting individuals with their nutritional needs supporting people during specific life transitions supporting women during pregnancy, labour, childbirth and the postnatal period the management of pain the provision of equipment, aids and products. Approved and Published: March 2013 Page 75 of 90

76 Progression through the levels in this dimension is characterised by: increasing complexity of needs and associated risks increasingly complex forms of care to address those needs and the associated knowledge and skills increased accountability for whole plans of care rather than aspects within them. Examples of application These may be relevant to all levels in this dimension Health and wellbeing needs may be: emotional health and wellbeing needs mental health and wellbeing needs physical health and wellbeing needs social health and wellbeing needs spiritual health and wellbeing needs. Risks to health and wellbeing might arise from: abuse incidents/accidents neglect rapid deterioration of condition or situation self-harm the complexity and range of contributory factors the environment. Approved and Published: March 2013 Page 76 of 90 Legislation, policies and procedures may be international, national or local and may relate to: blood transfusion carers children consent criminal justice disability domestic violence duty of care education human rights medicines mental health mental incapacity

77 vulnerable adults. Links to other KSF Dimensions This dimension is supported by: Core 1 Communication Core 6 Equality and diversity HWB2 Assessment and care planning to meet health and wellbeing needs which would set the overall care plan in which this work is undertaken G2 Development and innovation which focuses on testing and developing new and innovative forms of enablement G3 Procurement and commissioning which focuses on commissioning services within which care is delivered. This dimension is different from dimensions: HWB1 Promotion of health and wellbeing and prevention of adverse affects on health and wellbeing which focuses on the promotion of health and wellbeing rather than caring for people who are dependent in some way HWB4 Enablement to address their own health and wellbeing needs which focuses on helping people to develop their own knowledge and skills in relation to health and wellbeing and related needs HWB7 Interventions and treatments which focuses on intervening and treating individuals physiological and/or psychological needs in the context of the whole person. Terminology Health: a state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity. Health is a resource for everyday life, not the object of living. It is a positive concept emphasising social and personal resources as well as physical capabilities. A comprehensive understanding of health implies that all systems and structures which govern social and economic conditions and the physical environment should take account of the implications of their activities in relation to their impact on individual and collective health and well-being. (World Health Organisation). Team a group of people who work to achieve a purpose. Teams may work in close proximity to each other or team members might work largely on their own both types of team contribute to the wider effort of the NHS in improving health and wellbeing and addressing health needs. Approved and Published: March 2013 Page 77 of 90

78 HWB5/Level 4: Plan, deliver and evaluate care to address people s complex health and wellbeing needs Indicators The worker: a) respects people s dignity, wishes and beliefs; involves them in shared decision making; and obtains their consent b) identifies with the people concerned: goals for the specific activities to be undertaken within the context of their overall care plan and their complex health and wellbeing needs the nature of the different aspects of care needed to meet their complex needs the involvement of other people and/or agencies relevant evidence-based practice and/or clinical guidelines how to manage possible risks c) undertakes care in a manner that is consistent with: evidence-based practice and/or clinical guidelines multidisciplinary team working his/her own knowledge, skills and experience legislation, policies and procedures applying own skills, knowledge and experience and using considered judgment to meet people s different care needs d) takes the appropriate action to address any issues or risks e) evaluates the effectiveness of care and makes any necessary modifications f) provides effective feedback to inform the overall care plan g) makes complete records of the work undertaken, people s health and wellbeing, needs and related risks. Examples of application Health and wellbeing needs See overview Care needed to meet people s complex needs might relate to: emotional health and wellbeing psychological health and wellbeing psychosocial health and wellbeing physical health and wellbeing social health and wellbeing spiritual health and wellbeing. Legislation, policies and procedures See overview Risks to health and wellbeing See overview Approved and Published: March 2013 Page 78 of 90

79 DIMENSION HWB6: ASSESSMENT AND TREATMENT PLANNING OVERVIEW Status Levels Description Specific it will relate to some jobs but not all. 1. Undertake tasks related to the assessment of physiological and/or psychological functioning 2. Contribute to the assessment of physiological and/or psychological functioning 3. Assess physiological and/or psychological functioning and develop, monitor and review related treatment plans 4. Assess physiological and/or psychological functioning when there are complex and/or undifferentiated abnormalities, diseases and disorders and develop, monitor and review related treatment plans. This dimension is about assessing physiological (eg autonomic nervous system, cardiovascular, gastrointestinal, musculo-skeletal, respiratory) and/or psychological functioning and any treatment planning associated with this, within the context of that person as an individual. It includes clinical history taking and examination, and a range of tests and investigations, including various forms of imaging and measurement of body structures, and tests of physiological and psychological functioning. It also includes diagnosis and treatment planning. It involves interactions using a variety of communication methods with individuals and carers (either face to face or at a distance, eg by telephone) and may require the use of equipment and technology, including computer assisted tools. Progression through the levels in this dimension is characterised by: the move from tasks or specific activities to more complex procedures with higher levels of associated risk the move from undertaking delegated tasks to planning assessment, informing diagnoses and the planning of treatment, making diagnoses planning treatment increasing levels of clinical, technical and interpretive skills and knowledge greater complexity in presenting cases and/or the ability to make diagnoses of undifferentiated abnormalities, diseases and disorders. Approved and Published: March 2013 Page 79 of 90

80 Example of application These may be relevant to all levels in this dimension Links to other KSF Dimensions Legislation, policies and procedures may be international, national or local and may relate to: carers children consent criminal justice disability equality and diversity health and safety information ionising radiation medicines mental health mental incapacity technology and equipment the practice and regulation of particular professions vulnerable adults. This dimension is supported by: Core 1 Communication: which covers all forms of communication with individuals, colleagues and others Core 3 Health, safety and security: which focuses on dealing with risks and hazards in the workplace Core 6 Equality and diversity: which focuses on promoting equality and valuing the diversity of everyone HWB4 Enablement to address health and wellbeing needs: which focuses on helping people to manage their health and wellbeing needs themselves HWB7 Interventions and treatments which focuses on intervening and treating individuals as part of an overall treatment plan G2 Development and innovation which focuses on testing and developing new and innovative forms of assessment and related diagnosis G3 Procurement and commissioning which focuses on commissioning services within which assessment, diagnosis and treatment is delivered. Approved and Published: March 2013 Page 80 of 90

81 This dimension is different from dimensions: HWB2 Assessment and care planning: which focuses on the assessment of the person s needs in the context of their lives, rather than the diagnosis of diseases and disorders causing health deficits and needs HWB8 Biomedical investigation and intervention: which focuses on the testing and analysis of samples and specimens to inform diagnosis and treatment. Terminology Treatment plans the overall plan of the treatments and/or interventions that individuals will need including any interconnections. Approved and Published: March 2013 Page 81 of 90

82 HWB6/Level 2: Contribute to the assessment of physiological and/or psychological functioning Indicators The worker: a) discusses the assessment to be undertaken with the work team and understands his/her own role in the overall assessment and the activities to be undertaken b) respects individuals dignity, wishes and beliefs; involves them in shared decision making; and obtains their consent for the assessment to be undertaken c) identifies appropriate methods, techniques and equipment for different activities and individuals and prepares appropriately taking into account any risks d) undertakes and records assessment activities as agreed with the care team, following established protocols/procedures and consistent with legislation, policies and procedures e) monitors individuals during assessment activities and takes the appropriate action in relation to any significant changes or possible risks f) reports assessment findings in the appropriate format to the people who need them g) offers to the team his/her own insights into the health and wellbeing needs and wishes of the people concerned and makes suggestions on the treatment that might be needed. Examples of application Activities might include: measuring and monitoring body functioning other specific delegated assessment tasks preparing and passing equipment, instruments and materials to the person responsible for the assessment/diagnostic procedure producing or obtaining images or assisting with this dependent on complexity screening assessments. Preparation might include preparing: equipment materials self the environment the individuals with whom the assessment is being undertaken. Risks might arise from: abuse incidents/accidents neglect rapid deterioration of condition or situation self-harm the complexity and range of contributory factors the environment. Legislation, policies and procedures See overview Approved and Published: March 2013 Page 82 of 90

83 HWB6/Level 3: Assess physiological and/or psychological functioning and develop, monitor and review related treatment plans Indicators The worker: a) evaluates relevant information to plan the range and sequence of assessment required and determines: the specific activities to be undertaken the risks to be managed the urgency with which assessments are needed b) selects appropriate assessment approaches, methods, techniques and equipment, in line with: individual needs and characteristics evidence of effectiveness the resources available c) respects people s dignity, wishes and beliefs; involves them in shared decision making; and obtains their consent d) prepares for, carries out and monitors assessments in line with evidence based practice, and legislation, policies and procedures and/or established protocols/ established theories and models e) monitors individuals during assessments and takes the appropriate action in relation to any significant changes or possible risks f) evaluates assessment findings/results and takes appropriate action when there are issues g) considers and interprets all of the information available using systematic processes of reasoning to reach a justifiable assessment and explains the outcomes to those concerned h) determines and records diagnosis and treatment plans according to agreed protocols/pathways/models that are: consistent with the outcomes of the assessment consistent with the individual s wishes and views include communications with other professions and agencies involve other practitioners and agencies when this is necessary to meet people s health and wellbeing needs and risks Examples of application Risks might arise from: abuse incidents/accidents neglect rapid deterioration of condition or situation self-harm the complexity and range of contributory factors the environment. Assessment approaches, methods, techniques may include: taking case history examinations obtaining images tests and measurements and may be carried out with others by self by others on request. Legislation, policies and procedures See overview Approved and Published: March 2013 Page 83 of 90

84 are consistent with the resources available note people s wishes and needs that it was not possible to meet i) monitors and reviews the implementation of treatment plans and makes changes within agreed protocols/pathways/models for clinical effectiveness and to meet people s needs and views j) identifies individuals whose needs fall outside protocols/ pathways/ models and makes referrals to the appropriate practitioners with the necessary degree of urgency. Approved and Published: March 2013 Page 84 of 90

85 DIMENSION HWB7: INTERVENTIONS AND TREATMENTS OVERVIEW Status Levels Description Specific it will relate to some jobs but not all 5. Assist in providing interventions and/or treatments 6. Contribute to planning, delivering and monitoring interventions and/or treatments 7. Plan, deliver and evaluate interventions and/or treatments 8. Plan, deliver and evaluate interventions and/or treatments when there are complex issues and/or serious illness. This dimension is about intervening and treating individuals physiological and/or psychological needs in the context of the whole person. The interventions and treatments that are undertaken are within an overall treatment plan the development and monitoring of the overall treatment plan is covered in dimension HWB6. Interventions and treatments may take a variety of forms including ongoing monitoring of the individual s condition to identify a need for possible intervention at a later date. Examples of application These may be relevant to all levels in this dimension Approved and Published: March 2013 Page 85 of 90 Progression through the levels in this dimension is characterised by: the move from routine tasks or specific activities to more complex procedures with higher levels of associated risk increasing levels of clinical and technical skills and knowledge greater complexity in /seriousness of the conditions being treated. Interventions and treatments may relate to physiological and/or psychological functioning and might include: advice, explanation and reassurance application of energy (eg radiation) application of materials and substances exercise extraction/removal manual treatments medicines modification ongoing monitoring

86 palliation psychotherapeutic approaches rehabilitative approaches replacement restoration supporting and supplementing body functioning surgery therapeutics (not included above). Legislation, policies and procedures may be international, national or local and may relate to: carers children consent counselling and therapeutic regulation criminal justice disability equality and diversity health and safety information ionising radiation medicines mental health mental incapacity the practice and regulation of particular professions vulnerable adults. Links to other KSF Dimensions This dimension is supported by: Core 1 Communication: which covers all forms of communication with individuals, colleagues and others Core 3 Health, safety and security: which focuses on dealing with risks and hazards in the workplace Core 6 Equality and diversity HWB6 Assessment and treatment planning: which focuses on assessing and diagnosing problems, conditions and illnesses relating to physiological and psychological functioning G2 Development and innovation which focuses on testing and developing new and innovative forms of treatment and interventions Approved and Published: March 2013 Page 86 of 90

87 G3 Procurement and commissioning which focuses on commissioning services within which treatment is delivered. This dimension is different from dimensions: HWB4 Enablement to address health and wellbeing needs which focuses on helping people to address their own and others needs HWB5 Provision of care to meet health and wellbeing needs which focuses on caring for people who are dependent in the short or longer term on others to meet their health and wellbeing needs. Terminology Treatment plans the overall plan of the treatments and/or interventions that individuals need to address their diseases and/or disorders including any interconnections. The interventions and treatments undertaken within this dimension are within an overall treatment plan see dimension HWB6. Approved and Published: March 2013 Page 87 of 90

88 HWB7/Level 4: Plan, deliver and evaluate interventions and/or treatments when there are complex issues and/or serious illness Indicators The worker: a) respects individuals dignity, wishes and beliefs; involves them in shared decision making; and obtains their consent b) identifies with the people concerned: goals for the specific interventions/treatments to be undertaken within the context of the overall treatment plan and the individual s physiological and/or psychological functioning the nature of the different interventions/treatments given the complexity of the issues and/or the seriousness of the illness relevant care pathways the involvement of other people and/or agencies relevant evidence-based practice and/or clinical guidelines/theories and models any specific precautions or contraindications to the proposed interventions/treatment and takes the appropriate action how to manage potential risks c) undertakes interventions/treatments in a manner that is consistent with: evidence-based practice and/or clinical guidelines/ theories and models multidisciplinary team working his/her own knowledge, skills and experience legislation, policies and procedures applying own skills, knowledge and experience and using considered judgment to meet individual s complex needs d) takes the appropriate action to address any issues or risks e) evaluates the effectiveness of the interventions/treatments and makes any necessary modifications f) provides effective feedback to inform the overall treatment plan. Examples of application Interventions and/or treatments may relate to physical and/or psychological functioning See overview Legislation, policies and procedures See overview Risks might be from: abuse incidents/accidents neglect rapid deterioration of condition or situation self-harm the complexity and range of contributory factors the environment. Approved and Published: March 2013 Page 88 of 90

89 g) makes complete records of the interventions/treatments undertaken, people s health and wellbeing, needs and related risks h) responds to, records and reports any adverse events or incidents relating to the intervention/treatment with an appropriate degree of urgency Approved and Published: March 2013 Page 89 of 90

90 IK2/Level 2: Gather, analyse and report a limited range of data and information Indicators The worker: a) identifies and agrees: the question/issue to be addressed by the data/ information the nature and quantity of data/information to be collected the quality criteria which the data/information should meet b) effectively uses appropriate methods and sources for obtaining and recording the data/information c) confirms that the data/information meets the agreed quality criteria and takes appropriate action if it does not d) collates and analyses the data/information using methods appropriate to: the initial questions which the data/information is intended to answer the nature of the data/information e) reports the data and information at the agreed time using presentation, layout, tone, language, content and images appropriate to: its purpose the people for whom it is intended agreed formats and protocols f) complies with relevant legislation, policies and procedures throughout. Examples of application Data and information might be: See overview Data and information may be held in systems which are: See overview Data and information might relate to: See overview Data and information may be raw intermediate processed. Legislation, policies and procedures See overview Images include: charts diagrams maps pictures spreadsheets. Approved and Published: March 2013 Page 90 of 90