Introduction
Focus of framework
Clinical Nurse Specialists (CNS) are registered nurses who practice at an advanced level within their specialty area. They are a crucial part of the multi-disciplinary cardiology team, providing expertise in a number of areas within cardiology, including, but not exclusive to diagnosis, treatment and rehabilitation of patients living with cardiac disease in Scotland.
The Scottish Government’s Chief Nursing Officer Directorate published Transforming Nursing Roles paper 8 (TNR Paper 8) in August 2021. This outlined that there is clear demarcation of roles for CNS across Scotland and job titles are often not aligned with clear education pathways and provisions.
To address this, this framework will promote a national approach for advanced nursing within cardiology, providing structure for the knowledge and skills required for career pathway in advanced cardiology practice. The framework is aligned with TNR Paper 8 and recognises that additional sub-specialist competency requirements will be decided at the local level depending on service needs.
Aim and outcomes
The Framework for Specialist Nursing in Cardiology is designed to outline the knowledge and skills essential for delivering high-quality cardiology nursing service. The framework is intended to be used by healthcare practitioners, managers, and educators to understand and develop knowledge and skills across the clinical pillar of practice at levels 6 and 7. For further information please refer to the Career Framework for Health model.
The outcome and impact of using the framework:
- Describing the knowledge and skills required within the service:
- The framework can be used by individuals developing their current and future practice; organisations reviewing or developing their services for their local populations; and educators ensuring knowledge and skills meet the needs of the service.
- Providing career pathways:
- The framework allows individuals and their managers to identify the necessary knowledge and skills, helping them to assess their own competence and prepare for career advancement within the services.
- Recruitment and succession planning:
- Organisations developing cardiology services can use the framework to define the knowledge and skills required for practitioners working in these services across Scotland. Consideration of service models in other areas that may be transferable to their own service. Recruiting the right people who aspire to develop their careers within the service can aid succession planning.
Background and strategic alignment
The Scottish Government’s Chief Nursing Officer Directorate published Transforming Nursing Roles paper 8 (TNR paper 8) in August 2021. The paper provides strategic oversight, direction and governance to CNSs across Scotland, with a particular focus on ensuring consistent career pathways for these professionals. It states that there is currently a lack of clear demarcation of roles for CNS across Scotland and job titles are often not aligned with clear education pathways and provisions.
The overarching aim is for CNS roles to be reported under umbrella specialities and sub-coded to identify specific roles for individuals. Achievement of such alignment would allow accurate reporting of workforce data across professional groups and build further national consistency.
The Heart Disease Action Plan (2021), within Priority 3: Workforce, supported understanding on how the principles of the TNR Paper 8 could be implemented within cardiology. A Short Life Working Group (SLWG) was established. This group undertook work to map the current Cardiology CNS workforce, agreed umbrella Cardiology CNS titles and associated sub-specialty titles to support reporting and sub-coding of Cardiology CNS roles and agreed the core Cardiology CNS competencies at levels 6 and 7, contained within this framework.
This framework has been co-produced by NHS Education for Scotland (NES) in collaboration with the Scottish Government’s Heart Disease policy team and members of the SLWG. There was clinical representation from all 14 health boards in Scotland and the group comprised of service managers, clinician, educators, Scottish Government and NES.
This approach has enabled the framework to reflect the design and delivery models of current and emerging services.
As part of the framework development process the framework was consulted on and approved by the Scottish Government’s Heart Disease Task Force, the Chief Medical Officer’s Specialty Advisor for Cardiology, the Heart Failure Hub Scotland, Scottish Heart Failure Nurse Forum and Scottish Cardiac Society.