How the Principles relate

PNP circles diagram

Here is an explanation of how the Principles of Nursing Practice relate to other publications about the quality of nursing care:

Principles of Nursing Practice have been developed by the Royal College of Nursing, in partnership with the Department of Health, The Nursing and Midwifery Council and user organisations.

The overarching Principles describe what the public can expect from nursing practice in any setting. They apply to healthcare assistants, students and registered nurses.

Organisations such as Guidelines and Audit Implementation Network (GAIN) in Northern Ireland, Scottish Intercollegiate Guidelines Network (SIGN) in Scotland and the National Institute for Health and Clinical Excellence (NICE) in England and Wales publish evidence based clinical guidelines and service specific standards. These publications inform how care is delivered at a service level.

Finally services are regulated by inspectorates in each of the four countries of the U.K. All four inspectorates have published standards for care that are required of health services. The inspectorates use these standards when reviewing the care given by health services.

Each of these publications promotes the quality of nursing and the quality of services in general.

PNP matrix diagram


Here is another way of showing how these publications compliment each other and work together. The points at the ends of these lines are like the points of a compass. We can show how the publications sit in this frame.

The Principles of Nursing Practice

The eight Principles describe what the public can expect from nursing practice in any setting. They have been produced jointly between nurses and patient groups.

They are intended for nursing teams for the purposes of quality improvement, continuing professional development, and for sharing with patients and carers. They enable regulators, providers and patients to know what quality nursing looks like.

The Nursing and Midwifery Council (NMC) Code

The NMC Code defines standards of conduct, performance and ethics. The NMC is the regulator for UK nurses and midwives. The NMC Code is used by the NMC to review education, conduct and performance.


Next comes guidance such as clinical guidelines and standards around a specific patient pathway or clinical area for the multidisciplinary team. They are developed by clinicians and researchers using the evidence base and working with stakeholder groups.

They are used by nurses and the multidisciplinary team in their own work settings and by regulators, employers and education providers.

The standards used by inspectorates

Finally there are the standards used by inspectorates in each of the four countries of the UK. They have been developed by inspectorates based on people’s experience of care and the quality of the treatment and support they receive. They are used by regulators to assess the quality of care delivered by services.

Completing the picture

The NMC Code of Conduct and the standards for inspection are there to safeguard the public and regulate health care services and nursing care.

The standards and guidance are there to provide healthcare staff with the best available evidence. The evidence helps decision making and the design of services.

The Principles of Nursing Practice describe what quality nursing care looks like. The Principles are for every member of the nursing team and for sharing with patients, carers and the public. They support quality improvement in any setting wherever nursing care is given.


Nursing and Midwifery Council (2008) The Code: Standards of conduct, performance and ethics for nurses and midwives. NMC website.

Further information about the national regulatory bodies and clinical guideline development agencies is available via the online RCN Clinical Governance resource - See Regulatory and review bodies and National guideline development.