The Framework – Level 5 – Practitioner

Level 5 Practitioner

Role and responsibility

Qualifications and experience

Core Competency 1: Specialist Knowledge

Core Competency 2: History Taking, Clinical Assessment and Investigation

Core Competency 3: Analysing Data in the Diagnosis Process

Core Competency 4: Treatment and Care

Core Competency 5: Co-ordination of Care

Core Competency 6: Expert Specialist Resource

Core Competency 7: Facilitation of Learning

Core Competency 8: Leadership

Core Competency 9: Evidence, Research and Development

The Framework has a section for each level of practice on level 5, level 6 and level 7. The role and responsibility of staff at each level is described along with relevant qualifications and experience. The knowledge, skills, and behaviours (KSBs) are then described for the clinical pillar of practice.

For core KSBs for each pillar of practice, please refer to the NMAHP Development Framework

Level 5 Practitioner
Role and responsibility
People at level 5 will have a comprehensive factual and theoretical knowledge within a field of work and an awareness of the boundaries of that knowledge. They are able to use knowledge to solve problems creatively, make judgements which require analysis and interpretation, and actively contribute to service and self development. They may have responsibility for supervision of staff or training. Indicative Reference Title: Practitioner The level outline is informed by the Clinical Nurse Specialist (Paper 8)
Qualifications and experience expected for practitioners at this level of career framework
Registered as a Nurse or Midwife with the Nursing and Midwifery Council or registered with the Health and Care Professions Council Successfully completed degree level pre-registration programme as a minimum Working at Degree level Scottish Credit and Qualifications Framework (SCQF) level 8-10

Core Competency 1: Specialist Knowledge
Develops basic knowledge on the aetiology and current leading theories on the causation of the condition
Develops basic knowledge on the classification and staging of the condition
Develops basic knowledge of anatomy/physiology and pathophysiology related to the condition
Is aware of the general risk factors associated with the condition
Awareness of typical and atypical symptoms of the condition
Is aware of the need for holistic assessment including history taking, physical examination in conjunction with relevant scales and investigations
Develops knowledge and understanding on the potential pharmacological and non-pharmacological management options
Develops knowledge of the pharmacokinetic and pharmacodynamic properties of the drugs specific to condition
Develops awareness of appropriate treatment alternatives for specific patient groups
Can work under supervision with the aim of being autonomous
Is aware of limitations. Recognises when to seek advice from line manager in relation to patient care
Recognises when to raise concerns and/or serious incidents in accordance with local reporting procedures
Keeps good records and documentation
Acts to incorporate non-judgemental values-based care into practice
Recognises and responds to health inequalities, respects diversity, and protects pwNC against discrimination in practice

Core Competency 2: History Taking, Clinical Assessment and Investigation
Obtains consent from individuals before initiating assessment
Understands the need for a person-centred approach.
Identifies the physiological, psychological, social, cultural, developmental, sexual and spiritual needs of the person
Promotes and delivers person-centred care during assessments as part of the MDT
Develops skills to take an accurate history, taking into account age, gender and cultural background
Understands and identifies factors (such as demographic details) that might highlight a need for adapted assessment
Awareness of scales and assessment tools relevant to specific neurological condition
Develops skills required for physical examination relevant to neurological condition
Awareness of local guidelines and training relevant to investigations specific to neurological condition
Willingness to undertake training relevant to specific investigations
Awareness of defined roles of the specialist nurse and other members of the MDT in the assessment process

Core Competency 3: Analysing Data in the Diagnosis Process
Awareness of the need for thorough assessment of history, physical examination and investigations which may be used to assist the diagnostic procedure
Awareness of existing diagnostic criteria and consider how that applies to pwNC
Develops awareness of red flags which may lead to differential diagnoses/atypical forms of neurological condition
Awareness of the ‘common’ symptoms and presentations of the condition and demographic contexts during the diagnostic stage

Core Competency 4: Treatment and Care
Develops knowledge of relevant guidance, policies and legislation that govern legal and ethical aspects of service provision, in relation to specific neurological condition
Awareness of how to access relevant standards and guidelines that inform care
Uses and contributes to the development, implementation, and review of local policies, guidelines and protocols
Develops a knowledge base in the pharmacological and non-pharmacological treatment/management for the pwNC
Awareness of the needs of developing an individual care plan, ensuring that the care plan follows the principles of person-centred care
Aware of the importance of including family and carers, where consent is obtained, in the formulation of treatment plan
Develops knowledge of relevant information, with the aim of passing this onto pwNC, to help empower in the self-management of their condition
Encourages pwNC to engage in healthy behaviours. Takes into account how demographic contexts and biopsychosocial factors may influence this edcation
Understands the importance and need for the ‘expert patient’
Develops own expertise of the specific neurological condition with the aim of assisting pwNC to make healthy choices
Develops a therapeutic relationship with the pwNC to ensure sufficient psychosocial support is given
Recognise the need for advocacy for the pwNC/carer when required
Recognises the need for regular review
Develops knowledge of factors which may affect frequency of contact

Core Competency 5: Co-ordination of Care
Understands, promotes and delivers care based on the principles of evidence-based medicine.
Understands the importance of MDT working, has awareness of relevant local pathways, and establishes relationships with the MDT.
Is aware of the nurse specialist role within MDT
Can explain to pwNC/carer different roles within MDT and wider support networks and benefits of referrals

Core Competency 6: Expert Specialist Resource
Evidence reflection on own and others experiences in the workplace
Makes use of networking and engages with experienced professionals to improve their own competence
Identifies and participates in educational programmes and recognised CPD programmes that relate to the management of the disease/condition to support own development
Can identify their own individual learning needs and personal development planning
Develops advanced communication skills and understands the need to apply these to individual communication styles
Develops the therapeutic relationship with the pwNC
Translates evidence and recent research and disseminates additional evidence-based resources to the pwNC and their family members and/or carers
Demonstrates facilitation of teaching skills and behaviours including supervision and teaching
Evidences use of a wide range of skills to motivate, stimulate and encourage others to facilitate the learning process

Core Competency 7: Facilitation of Learning
Engages in the development of patient education programmes and resources
Assists in the development of a positive learning environment
Engages in learning theories to improve practice and engage with learning in the local environment
Demonstrates knowledge and use of a range of information to review/evaluate and enhance the learning environment
May think about the need to develop therapeutic education programmes for the pwNC and for the HCPs

Core Competency 8: Leadership
Uses national leadership frameworks to assess and develop self-leadership
Engages in a supportive culture and makes use of constructive feedback
Understands how leadership can be used to improve people’s wellbeing and experiences of healthcare
Apply and continue to develop, leadership skills and behaviours appropriate to specific role
Demonstrates leadership qualities and behaviours including skills in motivating, influencing and negotiation
Is able to communicate complex information to the nursing and multi-disciplinary team
Identifies and analyses problems and recommends solutions
Demonstrates the ability to work well within a team and in collaboration with others
Understands the need for recognised workload assessment
Contributes to effective management of resources including workforce resources within own area of practice

Core Competency 9: Evidence, Research and Development
Uses a range of research approaches to assess how evidence is being used, by self and others, to inform and develop practice
Share with others good practice from audits, and quality improvement activity
May identify the need for, and engage with, audits within local services
Ability to critically identify, define, and analyse complex professional problems and issues
Critically analyses and evaluates information and has the ability to search and appraise evidence
Applies and continue to develop specialist knowledge of research appropriate to role
Has an understanding of research governance including GCP, ethics, data protection and confidentiality
Is able to explain the principles of clinical trials and the contribution of the specialist nurse