Staff focus topics
- Competences
- Role development and redesign.
Competences
Competences are the behaviours or skills employees must have, or need to develop or acquire, to achieve a specified level of performance. Competences are often grouped together in competency frameworks - these are a means of linking individual performance to organisational performance and can be used to ensure consistency in standards of competence across health care.
Most frameworks, such as the NHS Knowledge and Skills Framework (KSF) describe competences in concise measurable statements (Department of Health 2004). The NHS KSF is a key resource for competence based activities within the NHS as it “sets out to describe and recognize the types of knowledge and skills that a post-holder needs to be effective in his/her NHS job” (Green et al 2010, p.1294). Skills for Health competences link to the NHS KSF dimensions.
The RCN core career and competence framework for nurses working at bands 5 to 8 maps to the KSF core dimensions. The competences include indicators of the required level of knowledge and skills and suggestions of how nurses would apply the identified level in their day to day practice (Royal College of Nursing 2009). The framework provides the basis for the development of other competence frameworks for specialist areas of practice. These competence frameworks can be accessed from the RCN publications list.
Competency frameworks are being used as a means of developing staff. They can provide a basis for self-assessment be incorporated into the appraisal process for reviewing performance and to identify training and professional development needs. They play a part in career development and recruitment, selection and grading and pay structures. Increasingly they are used as a workforce development tool to develop new roles or look at ways in which roles can be redesigned. An RCN publication provides guidance on developing NHS KSF outlines for nursing posts and selecting appropriate KSF dimensions for different roles (Royal College of Nursing 2005).
Findings from a pilot project testing Skills for Health competences “suggested the benefits of using competences and competence tools included increased clarity and a structured, consistent and standardized approach to workforce development" (Green at al 2010, p.1297).
References
These resources were last accessed on 5 August 2011. Some of them are in PDF format - see how to access PDF files.
Department of Health (2004) NHS Knowledge and Skills Framework. London: DH.
Green T et al (2010) Using competences and competence tools in workforce development. British Journal of Nursing 19(2) pp.1293-1298. The full text can be accessed using your RCN membership nursing via the RCN e-journals.
Royal College of Nursing (2005) NHS Knowledge and Skills Framework outlines for nursing posts: RCN guidance for nurses and managers in creating KSF outlines in the NHS (PDF 138KB). London: RCN.
Royal College of Nursing (2009) Integrated core career and competence framework for registered nurses (PDF 1.50MB). London: RCN.
Role development and redesign
A competency-based workforce offers more flexibility and transferability of skills for role redesign and development and helps towards creating "a matrix of opportunities that encompasses traditional pathways as well as new, innovative and flexible career routes" (Welsh Assembly Government 2008, p.13).
A key factor in current initiatives is the need to respond to the profound changes taking place in structures and methods of health care delivery. The Modernising Nursing Careers initiative has set a direction for all UK countries in developing "flexible, diverse and rewarding careers for all nurses" (Department of Health 2006, p.3). Added to this are the challenges raised by an economic recession (Royal College of Nursing 2009). A common theme across the four UK countries is the requirement for new and innovative ways of delivering care to increase productivity while continuing and improving upon high quality person-centred care. This calls for clarity on workforce requirements and new and changing roles.
Key policy drivers for role development
The focus on delivery of care in community settings, near people's homes and at home continues to have a considerable impact on role redesign and development. This includes supporting people with long-term conditions and providing increasingly complex care in community settings.
Responses to this have seen a major review of community nursing in Scotland (Scottish Government 2006) and the establishment of the Modernising Nursing in the Community (MNiC) initiative (Scottish Government 2011a). In Northern Ireland a consultation document presents a future strategic vision for district nursing. The review highlights the factors which are impacting on the development and complexity of the district nursing role which is seen as key to the provision of nursing in the home and co-ordination of care with other specialist nurses and practitioners (Department of Health Social Services and Public Safety 2011). In England the Transferring Community Services programme developed under the previous Government stimulated innovative approaches to delivering services (Department of Health 2011a).
In a position statement the RCN provides an overview of the context and sets out core statements to guide the development of community nursing across the UK (Royal College of Nursing 2010).
The greater emphasis on public health and preventive health care is influencing how roles are viewed and developed. The Prime Minister’s Future Commission on Nursing describes the need for nurses to be “ever alert for health promotion opportunities – making wellness everyone’s business” (Prime Minister's Commission on the Future of Nursing and Midwifery 2010, p. 33). This is echoed in the new public health policy in England (Department of Health 2011b).
In Northern Ireland three overlapping ‘zones’ are to be used to shape nursing and midwifery professional development and careers one of which is identified as ‘health and wellbeing care’ (Department of Health, Social Services and Public Safety 2010a).
Interlinked with this is the increasing attention to supporting early years and the recognition of the importance of investing in good support and preventive health care in early childhood. In Scotland and England highly trained family nurses have been involved in a programme supporting first-time mothers in parenting and engaging in good preventive health practice (Scottish Government 2011b).
In England the health visiting workforce is to be expanded “to energise and transform services, to re-establish the profession as a vital part of family and community health and to use their skills to work with others to improve health outcomes and life chances” (Department of Health 2011c, p.8). Northern Ireland proposes a model of service provision to children and young people via zero to 19 teams and examines the roles of health visitors and school nurses in leading and delivering this (Department of Health Social Services and Public Safety 2010b).
The RCN’s UK position on the development of the health visiting workforce makes a series of statements underlining what is required for successful reform of early years services (Royal College of Nursing 2011).
The requirement for role development in the wider nursing team, for example health care assistant and assistant practitioner roles, is also an important factor. The aim in Scotland has been to achieve a consensus on role definitions and parameters for health care support workers (HCSWs) (NHS Education for Scotland 2010). The RCN has published a discussion paper looking at key policy issues regarding the emergence of the role of the assistant practitioner in health care and has undertaken a scoping project looking at the development of APs and mapping the UK wide support workforce (Royal College of Nursing 2011b; Royal College of Nursing Policy Unit 2009).
References
These resources were last accessed on 5 August 2011. Some of them are in PDF format - see how to access PDF files.
Department of Health (2006) Modernising nursing careers - setting the direction. London: The Department.
Department of Health (2011a) Transforming community services. Department of Health website.
Department of Health (2011b) Healthy lives, healthy people: update and the way forward. London: DH.
Department of Health (2011c) Health visitor implementation plan 2011-15: a call to action February 2011. London: DH.
Department of Health, Social Services and Public Safety (2010a) A Northern Ireland strategy for nursing and midwifery 2010-2015 (draft strategy). Belfast: DHSSPS.
Department of Health, Social Services and Public Safety (2010b) Healthy futures 2010-2015: the contribution of health visitors and school nurses in Northern Ireland (PDF 1.71MB). Belfast: DHSSPS.
Department of Health, Social Services and Public Safety (2011) A district nursing for today and tomorrow: a review of district nursing in Northern Ireland (draft strategy) . Belfast: DHSSPS.
NHS Education for Scotland (2010) A guide to healthcare support worker education and role development. Edinburgh: NHS Education for Scotland.
Prime Minister's Commission on the Future of Nursing and Midwifery in England (2010) Front line care: report by the Prime Minister’s Commission on the Future of Nursing and Midwifery in England 2010. London: The Commission.
Royal College of Nursing (2009) Nursing and the economic downturn - a roundtable discussion (PDF 573.3KB). London: RCN.
Royal College of Nursing (2010) Pillars of the community: the RCN’s UK position on the development of the registered nursing workforce in the community ((PDF 310KB). London: RCN.
Royal College of Nursing (2011) RCN’s UK position statement on health visiting in the early years (PDF 324KB). London: RCN.
Royal College of Nursing (2011b) Assistant practitioner scoping project (PDF 198.41KB). London: RCN.
Royal College of Nursing Policy Unit (2009) The Assistant Practitioner role: a policy discussion paper (PDF 3.51MB). London: RCN.
Scottish Government (2006) Review of Nursing in the Community. Scottish Government website.
Scottish Government (2011a) Modernising Nursing in the Community. Scottish Government website.
Scottish Government (2011b) The evaluation of the Family Nurse Partnership Programme in Scotland: Phase 1 report. Edinburgh: Scottish Government.
Welsh Assembly Government (2008) Designed to realise our potential: a 'Beliefs and Action' statement for nurses, midwives and specialist community public health nurses in Wales for 2008 and beyond. Cardiff: Welsh Assembly Government.