District Nursing and General Practice Nursing Service

1 Health Careers Health Education England District Nursing and General Practice Nursing Service Education and Career Framework October 2015. Get started Executive District Nursing General Practice Foreword Appendices Summary Service Nursing Service Developed in partnership with: Service users Care Quality Commission General Practice and District Nursing Service practitioners CCG Chief Nurses NHS England National Association of Primary Care Public Health England Association of District Nurse Educators Queen's Nursing Institute Higher Education Institutes Royal College of General Practitioners Nursing Group: General Local Medical Committees Practice Foundation Directors of Nursing Service providers Council of Deans of Health Royal College of Nursing RCGP General Practice Foundation Nursing Group General Practice and District Nursing Service Education and Career Framework 2.

2 Executive District Nursing General Practice Foreword Appendices Summary Service Nursing Service Contents 04 Foreword 27 District Nursing Service education and career framework District Nursing Service stepped career and education illustration District Nursing Service key responsibilities/role 08 Executive summary Core values, skills and competence Rationale Level descriptors Introduction Key characteristics of District and General Practice 89 General Practice Nursing Service education and Nursing Service career framework General Practice Nursing Service stepped career and education illustration 153 Appendicies General Practice Service key responsibilities/role Core values, skills and competence Level descriptors General Practice and District Nursing Service Education and Career Framework 3.

3 Foreword Executive District Nursing General Practice Appendices Summary Service Nursing Service Foreword The Health Education England (HEE) Transforming Nursing for Community and Right numbers, with the right skills, values and behaviours, at the Primary Care (TNCPC) workforce programme commenced in 2014 to enable right time and place.. both the delivery of the HEE Mandate and the HEE responsibilities of the NHS. England (NHSE) led TNCPC Programme Board that was established by Jane In terms of District Nursing , although the Health and Social Care Information Cummings, Chief Nursing Officer (CNO) for England in 2013. The focus agreed Centre (HSCIC) reported in 2013 that there appeared to have been an overall between the key strategic partners NHSE, HEE, Public Health England (PHE) increase in community staff numbers, including Health Care Assistants (HCAs), and the Department of Health (DH) was District and General Practice Nursing and greater numbers of nurses in specific areas such as asthma, diabetes and services.

4 Chronic Obstructive Pulmonary Disease (COPD), there was a drop of over 40%. in specialist qualified District Nurse (DN) numbers between 2002 and 2012. TNCPC Vision (HSCIC, 2013). The QNI Report on District Nurse Education in England Wales & Northern Ireland 2012/2013' (QNI 2013) highlighted the lack of profile of Strengthening innovation, supporting the workforce and improving District Nursing as a career option as being one of the causes of the drop, commissioning Practice for District , community and primary care partly due to nurses having little exposure to community Nursing Practice in Nursing that enables care to be delivered closer to home and their training and the need for updating of the Nursing and Midwifery Council improve the outcomes for people with long term conditions whilst (NMC) standards for DN specialist education.

5 The QNI has now published simultaneously improving the experience of patients, carers and staff. voluntary standards to enhance the NMC standards 1. Alongside this is the fact that 60% of the DN workforce is aged 45 years or over, which prompts the Policy drivers need to recruit and retain. Several key government policy drivers introduced during the life of this work reaffirm the original vision Transforming Primary Care: Safe, proactive, 1 QNI/QNIS Voluntary Standards for District Nurse Education and Practice . (2015) personalised care for those who need it most' (DH, April 2014) and more latterly the Five Year Forward View' (NHSE, 2014). The new care models described therein and particularly the resultant development of these models support the whole purpose of HEE in terms of improving the quality of health and healthcare by ensuring that the workforce has the: General Practice and District Nursing Service Education and Career Framework 4.

6 Foreword Executive District Nursing General Practice Appendices Summary Service Nursing Service Care in local communities; A new vision and model for District Nursing ' (DH, 2013) describes the roles of DNs in population and caseload management delivering preventative support, care for patients who are unwell, recovering and rehabilitating at home, have Long Term Conditions (LTC), require end of life care and support and care for independence. It also identifies action needed to work with Higher Education Institutions and other education and training providers to ensure the curriculum will equip DNs with the skills and knowledge to enable them to deliver the new Service offer. It identifies the need to promote professional development and support joint training between DNs and other members of the community Nursing team Health Care Assistants (HCAs) and Community Staff Nurses, and the need to secure sufficient training commissions to deliver the Service offer.

7 General Practice and District Nursing Service Education and Career Framework 5. Foreword Executive District Nursing General Practice Appendices Summary Service Nursing Service The development of the education and career framework for District Nursing During the development of the DN and GPN education and career framework and General Practice Nursing is the first attempt to develop a national solution the independent review of the education and training of nurses and care to enable a consistent approach to ensuring the whole District and General assistants, Shape of Caring', commissioned by HEE in partnership with the Practice Nursing team are equipped to deliver health outcomes now and in NMC in May 2014 and led by Lord Willis of Knaresborough was published the future.

8 It has also been recognised that while some provider organisations in early March 2015. There has been a period of stakeholder engagement in England value the need for a level 6 professional to lead the community across the country which began in September 2015 to provide advice on Nursing team, they are not all choosing to insist that person is a qualified DN, which recommendations of the report to take forward. A Reform Board so a degree of flexibility in catering for that is also implicit. under the chairmanship of Sir Stephen Moss will be established which will use the outcomes of the engagement phase to provide oversight of the In contrast to the DN role, while General Practice Nurses (GPNs) sometimes recommendations being taken forward. work alone in GP practices or in teams that may include HCAs and other specialist nurses, their work is usually delivered in General Practice premises.

9 Their role is mainly to contribute to the delivery of the GP contract across 2 Pearce C, Hall S, Phillips C (2010) When policy meets the personal: General Practice nurses in Australia. Journal of the spectrum of provision and the life course of the Practice population. This Health Services Research and Policy. 15, 2, 26-34. requires a specific skill set necessary to manage uncertainty and risk when supporting people who may have undifferentiated diagnoses. GPNs and their teams also need to have the ability to work within integrated teams to deliver care based on guidelines and protocols Quality Outcomes Framework (QOF) to enhance the quality of health outcomes, in particular in prevention and supporting those with LTC who need support to self-manage. In 2014, the HSCIC GPN Workforce and Development Census showed there was an increase of in GPNs since 2012.

10 Although the numbers have risen slightly, the functions GPNs undertake have also substantially changed to embrace expertise in LTC, preventative services, sexual health and advanced clinical skills, with positive outcomes for patients 2. General Practice and District Nursing Service Education and Career Framework 6. Foreword Executive District Nursing General Practice Appendices Summary Service Nursing Service It gives us great pleasure to present this HEE District Nursing and General Professor Lisa Bayliss-Pratt, Practice Nursing Service Education and Career Framework (hereafter known as the Framework ). The Framework, while differentiating the two roles Director of Nursing /National Deputy Director of Education within both of these Nursing disciplines, supports standardisation and also and Quality, Health Education England, sets out their comparators and expectations for each level in both skills and educational requirements which will assist with workforce planning Co-Chair Health Education England Transforming Nursing and educational commissioning.