RCN competencies for occupational health nursing

Competencies:an integrated career and competency

framework for occupational health nursing

RCN CompetenciesRCN Competencies

Acknowledgements This integrated career and competency framework foroccupational health nursing has been developed in partnershipwith the RCN Society of Occupational Health Nursing and theRCN Occupational Health Managers Forum. Wide consultationwith RCN members and the involvement of key stakeholdersworking in occupational health settings has helped to inform thisframework and we thank those who contributed towards itdevelopment.

We would also like to thank all those who participated in theearly Values Clarification exercises; all who contributed to theThemes Workshop and helped refine the focus of the framework;and everyone who responded to our call for comments on theearlier drafts, their input was invaluable.

A full list of acknowledgements can be found in Appendix 3.

Carol BannisterRCN Occupational Health Adviser

Jan MawRCN Occupational Health Adviser

Competencies: an integrated career and competencyframework for occupational health nursing has been updatedto take account of the final version of the NHS Knowledgeand Skills Framework and the development review processpublished by the Department of Health (2004). It replacesthe July 2004 version that was available on the RCN website.

Published by the Royal College of Nursing, 20 Cavendish Square, London, W1G 0RN

© 2005 Royal College of Nursing. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmittedin any form or by any means electronic, mechanical, photocopying, recording or otherwise, without prior permission of the Publishers or alicence permitting restricted copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1T 4LP. This publicationmay not be lent, resold, hired out or otherwise disposed of by ways of trade in any form of binding or cover other than that in which it ispublished, without the prior consent of the Publishers.

R O Y A L C O L L E G E O F N U R S I N G

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Competencies: an integrated career and competency frameworkfor occupational health nursing

Foreword 2

Introduction 2

1. How to use the framework 4

2. Tables 5

● Table 1: OHN competencies mapped against the KSF six core dimensions 5

● Table 2: OHN competencies mapped against seven KSF-specific dimensions 6

● Table 3: OHN competencies mapped against examples of KSF level descriptors 7

3. The competency framework for occupational health nursing 8

1. Self-assessment 8

2. Core transferable skills 9

3. Core leadership and management skills 10

4. Core quality assurance and research skills 11

5. Legal and ethical issues 12

6. Risk assessment 13

7. Heath promotion, protection and surveillance 14

8. Sickness, absence, and rehabilitation 15

9. Psychological and psychosocial interventions 16

10. Ergonomics 17

11. Occupational hygiene 18

12. Maintaining safety and accident control 19

4. References 20

5. Glossary 21

6. Appendices 22

Appendix 1: Mapping standards for of RCN OHN competencies against NMC standards for specialist community public health nursing 22

Appendix 2: The 11 key functions of occupational health services 25

Appendix 3: Full acknowledgements 26

Approved by the RCN Accreditation Unit until December 2005

Contents

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R C N C O M P E T E N C I E S – O C C U P A T I O N A L H E A L T H

IntroductionForeword

The introduction of Agenda for Change (AfC) and the NHSKnowledge and Skills Framework (KSF) has impacted on thecareer and pay progression of occupational health nursesworking in the NHS and in the private and independentsectors.As a result of many requests for advice about this, theRCN asked the Society of Occupational Health Nursing(SOHN) and the Occupational Health Managers Forum tohelp them develop specific guidance on the competenciesand skills required throughout occupational health nursingcareer progression.

This framework has taken the competencies identifiedthrough consultation with occupational health, nursesthemselves and allied professions to occupational health,and mapped them against the six core NHS KSFcompetencies and seven of the specific NHS KSFcompetencies. It has also mapped them against the tenpublic health proficiencies required by the Nursing andMidwifery Council (NMC) for entry into Part 3 of theProfessional Register (see Appendix 1).

Providing signposts to a scope of practice at key points incareer development and progression, the framework is aguide to occupational health nurses and their employers fordecisions on practice competency; personal and professionaldevelopment; and career and pay progression.

We are delighted with the publication of these competencies,which will provide OHN practitioners and curriculumleaders with a benchmark which will assist them to plandevelopments for practice, which in turn will continue tosupport and enhance the health of the working population.

Sharon HoranChair, RCN Society of Occupational Health Nursing

Christina ButterworthChair, RCN Occupational Health Managers Forum

Competence can be defined as:“The state of havingthe knowledge, judgement, skills, energy, experienceand motivation required to respond adequately to thedemands of one’s professional responsibilities”(Roach, 1992).

This integrated career and competency framework foroccupational health is an important step forward foroccupational health nursing. It addresses a number ofpolitical and professional issues, and initiatives including:

✦ Agenda for Change (DH, 1999a)

✦ need for leadership in specialist nursing

✦ need for the development of standards

✦ NHS Plan (DH, 2000) and its equivalent in Scotland,Wales and Northern Ireland

✦ increased focus on work-based and lifelong learningplus supervision

✦ changing focus towards professional rather thanacademic accreditation.

Agenda for Change

SummaryAgenda for Change (AfC) was implemented fromDecember 2004, with pay, terms and conditions backdatedto October 2004. The reform package for pay, careerstructure and terms and conditions of work for all NHSnurses and health care assistants applies to all NHSorganisations, and sets a UK framework for pay, terms andconditions of employment.

AfC means that all staff will have clear and consistentdevelopment objectives; can develop in such a way thatthey can apply the knowledge and skills appropriate totheir level of responsibility; and are helped to identify anddevelop knowledge and skills that will support their careerprogression.

Under the new system, jobs are evaluated using a jobevaluation scheme. This gives each job a weighting, whichthen determines where each job slots into the new paybands. To aid transition to the new system common 'jobprofiles' have been finalised across the countries. Where ajob fits a profile it is possible to place it straight onto an


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appropriate new pay band. For those jobs that do notautomatically fit a profile, trained job evaluators drawnfrom management and staff side are carrying out theevaluation. Each pay band has a number of points. Staffbelow the maximum point can expect to progress to thenext point each year.

There are, however, two points on each pay band calledgateways, at which staff 's knowledge and skills will beassessed using the NHS Knowledge and Skills Framework(KSF). Pay progression at these gateways is linked to thedemonstration of applied knowledge and skills to supportcontinuing professional development.

For more comprehensive information on Agenda forChange please refer to www.rcn.org.uk/agendaforchange/

Competency levels and the knowledge andskills framework

The RCN competency framework mirrors the careerframeworks designed around the core functions of theconsultant nurse and the career benchmarks of AfC andthe NHS Knowledge and Skills Framework (NHS KSF) andthe development and review process (DH, 2004).

The AfC generic competencies expected of all health careprofessionals are captured by the NHS KSF. OHNs andothers are required to achieve all six core competencies,and some of the 24 specific competencies.

The six core competencies are:

1. communication

2. personal and people development

3. health, safety and security

4. service improvement

5. quality

6. equality and diversity.

The 24 specific competencies are grouped into thefollowing themes:

✦ health and wellbeing (HW)

✦ estates and facilities (EF)

✦ information and knowledge (IK)

✦ general (G).

Every competency, or dimension, is subdivided into fourlevels, each of which is given a level descriptor. Level 1represents basic knowledge and skills, through to level 4which represents the highest level of knowledge and skills.

“Every NHS KSF post outline must include an appropriatelevel from each of the six core dimensions, to which will beadded a number of specific dimensions. There is no limitto the number of specific dimensions which can beincluded, but it would be unusual for a post to need morethan seven. The specific dimensions should reflect criticalaspects of the post.”

NHS Knowledge and Skills Framework (NHS KSF) and thedevelopment and review process (DH, 2004).

Chapter 2 shows two tables that map OHN competenciesto the six core dimensions and the seven specificcompetencies. The third table mapped the competenciesagainst examples of KSF level descriptors.

Remember, the scope of the KSF is extremely broad.Essentially, it is a development tool that provides the basisfor pay progression within bands. It is designed to be usedduring the ongoing review, planning, development andevaluation cycle for NHS staff, linked to organisational andindividual development needs. Post outlines based on theNHS KSF should be developed in partnership, and should“reflect the requirements of the post, not the abilities orpreferences of the person who is employed in that post”(DH, 2004).

How to use theframework

Nurses working in the field of occupational health practicein a wide variety of settings, from being a lone practitionerto being part of an extended team.Your scope of practice isdependent on the historical expectations of:employers/employees; outcome of hazard/risk assessment;and legislative requirements. Therefore, while the broadestspectrum of practice has been included in the descriptorsand levels of practice, some elements may not be coveredin the actual role of the practitioner. However, thedescriptors and levels do provide an indication of theexpected ability to be able to function at that level if thesituation arises.

As you move from the level of competence, to experiencedand on to expert practice levels, you build on the previousset of skills and knowledge. Hence, as an expert nurse youwould be able to function across the entire range ofdescriptors for practice, where this is called for in an OHsetting.

The OHN competency framework should be used inconjunction with the following RCN publications:

✦ Agenda for Change – a guide to the new pay, terms andconditions in the NHS (RCN, 2004)

✦ Agenda for Change and nurses employed outside of theNHS (RCN, 2005)

How you produce evidence todemonstrate competence You are responsible for developing your own portfolios ofevidence for each competency in order to demonstrate thatyou have achieved it at the identified/desired level. Forms ofevidence that you can use include case histories, self-appraisal via a reflective diary, 360-degree feedback,verification of practice and structured observation ofpractice.

So, when you gather evidence it is important to consider thefollowing:

✦ ensure you understand what the competency statement isasking of you

✦ review any existing work that could be used

✦ identify whether the existing evidence is appropriate. For

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1example, if you attended a study day to prepare toperform a particular intervention, but you have notpractised the skill in a clinical setting, your certificate ofattendance is not evidence of competence.You will have toconsider making arrangements for supervised practice.However, if you have undergone training and haveevidence of supervised practice and use new knowledgeand skills on a regular basis the evidence should beenough

✦ consider what else you may need to do in developingevidence such as feedback on your practice? Also, if youhave further developmental needs, are they recorded in apersonal development plan?

✦ think about using evidence that covers severalcompetencies. One case study may demonstrate that youhave used a variety of knowledge and skills in caring for aperson.

Using the framework flexiblyWhile the framework provides comprehensive guidance oncompetencies for OHN practice, it should be used flexiblyand in conjunction with the RCN publications mentionedabove. This will help you to determine the scope of actualposts, individual development needs, and pay banding. Itshould also take account of developing roles as you expandin line with changing occupational health care needs andknowledge.


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TablesTable 1: OHN competencies mapped against theKSF six core dimensions

OHN competenceKSF core

dimensionKSF level 1 KSF level 2 KSF level 3 KSF level 4

Core transferableskills

Ethical and legalissues

1 Communication Communicate witha limited range ofpeople on day-to-day matters

Communicate witha range of peopleon a range ofmatters

Develop andmaintaincommunicationwith people aboutdifficult mattersand/or in difficultsituations

Develop andmaintaincommunicationwith people oncomplex matters,issues andsituations


Core leadershipand managementskills

2 Personal andpeopledevelopment

Contribute to ownpersonaldevelopment

Develop own skillsand knowledgeand provideinformation toothers to help theirdevelopment

Develop oneselfand contribute tothe developmentof others

Develop oneselfand others in areasof practice

Risk assessment

Occupationalhygiene


3 Health, safetyand security

Assist inmaintaining ownand others health,safety and security

Monitor andmaintain health,safety and securityof self and others

Promote, monitorand maintain bestpractice in health,safety and security

Maintain anddevelop anenvironment andculture thatimproves health,safety and security



4 Serviceimprovement

Make changes inown practice andoffer suggestionsfor improvingservices

Contribute to theimprovement ofservices

Appraise, interpretand applysuggestions,recommendationsand directives toimprove services

Work inpartnership withothers to develop,take forward andevaluate direction,policies andstrategies



5 Quality Maintain thequality of ownwork

Maintain quality inown work andencourage othersto do so

Contribute toimproving quality

Develop a culturethat improvesquality



6 Equality anddiversity

Act in ways thatsupport equalityand diversity

Support equalityand value diversity

Promote equalityand value diversity

Develop a culturethat promotesequality andvalues diversity

RCN level descriptors Competent ExpertExperienced

(taken from NHS KSF page 45)

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Table 2: OHN competencies mapped againstseven KSF-specific dimensions

OHN competenceKSF core

dimensionKSF level 1 KSF level 2 KSF level 3 KSF level 4

Health promotion,health protectionand surveillance

HWB 1

Promotion ofhealth andwellbeing, andprevention ofadverse affects onhealth andwellbeing

Contribute topromoting healthand wellbeing,preventing adverseeffects on healthand wellbeing

Plan, develop andimplementapproaches topromote healthand wellbeing, andprevent adverseeffects on healthand wellbeing

Plan, develop andimplementprogrammes topromote healthand wellbeing andprevent adverseeffects on healthand wellbeing

Promote healthand wellbeing andprevent adverseeffects on healthand wellbeing bycontributing to thedevelopment,implementationand evaluation ofrelated policies


HWB 2

Assessment andcare planning tomeet health andwellbeing needs

Assist in theassessment ofpeople’s healthand wellbeingneeds

Contribute toassessing healthand wellbeingneeds andplanning how tomeet those needs

Assess health andwellbeing needsand develop,monitor andreview care plansto meet specificneeds

Assess complexhealth andwellbeing needsand develop,monitor andreview care plansto meet thoseneeds

Risk assessment

Ergonomics

Occupationalhygiene

Psychosocialinterventions

Maintaining safety

Health protectionand surveillance

HWB 3

Protection ofhealth andwellbeing

Recognise andreport situationswhere there mightbe a need forprotection

Contribute toprotecting peopleat risk

Implement aspectsof a protectionplan and review itseffectiveness

Develop and leadon theimplementation ofan overallprotection plan

Equality, sicknessabsence, retentionand rehabilitation


HWB 4

Enablement toaddress healthand wellbeing

Help people meetdaily health andwellbeing needs

Enable people tomeet ongoinghealth andwellbeing needs

Enable people toaddress specificneeds in relationto health andwellbeing

Empower peopleto realise andmaintain theirpotential inrelation to healthand wellbeing

Risk assessment

Ergonomics

Health promotion,protection andsurveillance

Maintaining safety

Occupationalhygiene

IK 2

Informationcollection andanalysis

Collect, collate andreport routine andsimple data andinformation

Gather, analyseand report alimited range ofdata andinformation

Gather, analyse,interpret andpresent extensiveand/or complexdata andinformation

Plan, develop andevaluate methodsand processes forgathering,analysing,interpreting andpresenting dataand information

Leadership &management

G 5

Services andprojectmanagement

Assist with theorganisation ofservices and/orprojects

Organise specificaspects of servicesand/or projects

Prioritise andmanage theongoing work ofservices and/orprojects

Plan, co-ordinateand monitor thedelivery of servicesand/or projects

Leadership andmanagement

G 8

Public relationsand marketing

Assist with publicrelations andmarketingactivities

Undertake publicrelations andmarketingactivities

Market andpromote aservice/project

Plan, develop,monitor and reviewpublic relations,and marketing for aservice/organisation

RCN level descriptors Competent ExpertExperienced

(taken from NHS KSF pages 46 to 48)

Key

HW

Bhe

alth

and

wel

lbei

ng d

imen

sion

IK

info

rmat

ion

and

know

ledg

e di

men

sion

Gge

nera

l dim

ensi

on

• Develops own and others skills andknowledge

• Develops strategies and policies

• Enables

• Leads

• Implements

• Evaluates

• Innovates

• Develops strategies

• Researches

• Disseminates

• Influences


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Table 3: OHN competencies mapped againstexamples of KSF level descriptors

• 1st level registered nurse

• 2 years post-basic experience

• Post-basic education and trainingequivalent to university diploma

• Works under guidance ofestablished protocols and proceduresat operational level

• Maintains safe and competentpractice

• 2 years experience in OH setting

• Post-basic education and trainingequivalent to university degree

• Holds or working toward arecordable/registered OHNqualification with the NMC

• Develops and establishes protocolsand procedures at operational level

• Develops and leads on safe andcompetent practice

• 5 years experience in OH setting

• Post-basic education and trainingequivalent to university higher degree

• Holds a recordable/registered OHNqualification with the NMC

• Develops, leads and establishesprotocols and procedures atoperational and strategic levels

• Innovates, develops and leads onsafe and competent practice

• Leads and develops consultantoccupational nursing and consultancy

Competent OHN Experienced OHN Expert OHN

KSF dimension 1 and 2 descriptors KSF dimension 3 and 4 descriptors KSF dimension 5 descriptors

• Maintains

• Contributes

• Assists

• Ensures

• Routine

• Monitors

• Prepares

• Produces

• Influences

• Participatesat individual andgroup level

• Establishes

• Maintains

• Develops

• Monitors

• Contributes

• Supports

• Ensures

• Assists

• Maintains

• Leads onspecific aspect

• Raisesawareness

• Modifies

• Analyses andinterprets

• Designs

• Undertakesand reports

• Participatesat individual,group,community andagency level

• Leads others

• Plans andallocates

• Establishes

• Maintains

• Develops

• Contributes

• Promotes

• Assesses

• Modifies

• Monitors

• Evaluates

• Plans,delivers andevaluates

• Improves

• Protects

• Co-ordinates

• Processes andmanages data

• Designs,produces andmodifies

• Plans,analyses,interprets, andassesses reports

• Develops andsustainspartnerships

• Leads teams

• Allocates

• Obtains

• Establishes

• Maintains

• Develops

• Designs

• Improves

• Enables

• Assesses

• Plans

• Delivers

• Evaluates

• Improves

• Analyses

• Synthesises

• Innovates

• Developsknowledge

• Effective

• Developsfiscal andphysicalresourcemanagement

• Developsstrategies

• Sustains

• Complexity

• Partnershipsat individual,group,community andagency levels

• Leads multi-agency teams

Under the supervision I am able to:

• plan and carry out initialassessments for a range of clientsusing an evidence-based and client-centred approach to practice

• monitor clients in workingenvironments. Prescribe care for arange of clients in working environment

• implement a plan of care for a rangeof clients using an evidence-basedapproach and client-centred to practicein collaboration with others

• set and monitor clients’ goals usingan evidence-based and client-centredapproach to practice in collaborationwith clients and other members of theteam

• evaluate a plan of care for a range ofclients using an evidence-based andclient-centred approach to practice

• make decisions about priorities ofcare for a range of clients in theworking environment in collaborationwith clients and other team members

• initiate interventions for clients inthe working environment.

With the minimum guidance andsupervision I am able to:

• decide on priorities in the caresetting for a range of clients

• organise a team of others to deliverthe care of a range of clients in aworking environment

• initiate the care of a range of clientgroups in different occupationalsettings

• monitor the care of a range of clientsin the working environment

• facilitate others to set client goalsusing evidence-based and clientcentred-approach to practice incollaboration with clients and othermembers of the team

• challenge care practices andprocesses and decide on care priorities

• interpret care practices andprocesses in the care setting

• evaluate care practices andprocesses in a range of workplaceenvironments

• take responsibility for leading ateam over time and facilitating othersto lead on a day-to-day basis.

Working autonomously I am able to:

• take responsibility withoutsupervision in any care setting formonitoring interventions for the care ofclients in the working environment

• take responsibility for deciding onthe priorities for care of clients in theworking environment

• take responsibility in any caresetting for prescribing the care ofclients in the working environment

• take responsibility for initiatinginterventions for the care of clients inthe working environment

• independently organise nursing carein the working environment

• actively lead on developments innursing practice and their day-to-dayimplementation

• manage and lead an occupationalhealth nursing team and (in the case ofa nurse-led service) manage and leadthe occupational health service

• manage occupational health nursingresources and (in the case of a nurse-led service) manage resources for theoccupational health service.

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1. Self-assessment

Competent Experienced Expert

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The competency framework foroccupational health nursing


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• Uses transferable nursing skills ofresearch, audit, quality assurance, ITand data collection.

• Works under guidance ofestablished protocols and proceduresat operational level. Maintains safe andcompetent practice, and able to applythe principles of the Code ofProfessional Conduct (NMC, 2004b) tooccupational health settings.

• Through practice, developsunderstanding of the OHN role inworkplace and a range of settings bothin and outside the NHS.

• Adheres to occupational healthstandards and polices, and recogniseslimitations of own competence andscope of professional practice inrespect of occupational health nursingpractice.

• Requires support of moreexperienced practitioners for non-routine decisions, and in more complexoccupational health issues defers toexperienced or expert nurse, and/oroccupational heath physician, and/orline manager, and/or human resourcesfor support.

• Communicates effectively withoccupational health team and clients.

• Able to undertake a range of routineoccupational health screening tasks,and collects, records and stores dataaccurately.

• Maintains and develops competentpractice in occupational health nursingwith regular personal and professionaldevelopment activity.

• Able to collect, record and interpretoccupational health data using anevidence base accurately.

• Has developed communication skillswith specific groups and individuals ina justified, sensitive and mediatingway, and communicates effectively withthe occupational health team; clients;and across operational boundaries.

• Able to work autonomously, andwhere appropriate, seeks support andguidance from expert nurse, and/oroccupational heath physician, and/orline manager, and/or human resourcesfor support in more complexoccupational health issues.

• Able to participate in the trainingand supervision of junior practitioners,and engages in continuing professionaldevelopment and clinical supervision tomaintain and develop evidence-basedskills and knowledge in occupationalhealth nursing.

• Able to work interdependently in amultidisciplinary team andautonomously within a framework ofclinical governance and clinicalsupervision.

• Analyses and evaluates data, and isable to integrate data and give strategicplanning advice at organisational level.

• Demonstrates excellentpresentation and analytical skills, andmanages conflict with mediating skills.

• Leads on coaching, mentoring andclinical supervision of competent andexperienced nurses, and engages incontinuing professional developmentand clinical supervision to maintain anddevelop evidence-based skills andknowledge.

• Where appropriate, and dependenton an individual’s scope of professionalpractice, will have undertakencontinued professional developmentthat leads to admission to the registerof recognised occupational health andsafety professional bodies in, forexample, ergonomics, hygiene, andoccupational psychology.

2. Core transferable skills


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• Able to manage themselves andtheir workload, and prioritises theirown actions in the workingenvironment.

• Participates in new initiatives anddevelopments in practice andcontributes to their evaluation.

• Relates to other members of themultidisciplinary team, and participatesas a team member through the wholechain of care.

• Gains insight into occupationalhealth agenda through an awareness ofthe local and national political agendasthat impact on their area of practice.

• Participates in the day-to-daydelivery of internal and externalservices and contracts.

• Participates in occupational healthand safety audit.

• Develops self through continuedprofessional development activities.

• Participates in the development ofthe occupational health and safetyteam.

• Adopts a patient-focused approachin service delivery.

• Uses networking and politicalawareness to contribute to servicedevelopment.

• Contributes to the development ofoccupational health standards andpolicies, and assists in developing andestablishing protocols and proceduresat operational level, and develops andleads on safe and competent practice.

• Manages conflict situations insensitive and mediating way.

• Able to initiate, change and developpractice and evaluates changes inpractice.

• Able to identify how a local andnational political agenda impact on theprovision of the service, and developsservices that meet current politicalagendas.

• Able to delegate appropriately andto give feedback to colleagues.

• Able to lead service development byparticipating in multidisciplinary teamand committee work.

• Able to manage a limited budgetand range of external contracts.

• Able to implement and lead ondepartmental occupational healthaudits.

• Develops self and others throughcontinued professional developmentactivities.

• Participates and leads on specificprogrammes in the development of theoccupational health and safety team.

• Uses and develops patient-focusedapproaches in service delivery.

• Uses networking and politicalawareness to develop services.

• Able to develop, lead and establishprotocols and procedures atoperational and strategic levels, and toinnovate, develop and lead on safe andcompetent practice.

• Plays a major role in developing andimplementing occupational health andsafety standards and policies atoperational and strategic levels.

• Able to develop and leadoccupational health audit, and toproblem solve in an ethical, reflectiveand evidence-based manner.

• Facilitates the development ofinnovations in practice, and pushesforward the boundaries by visionaryapproaches to occupational healthnursing, and communicates practiceinnovations at local, national andinternational level.

• Able to appraise the performanceand facilitate personal development ofothers involved in the delivery of theservice.

• Able to manage and leadmultidisciplinary occupational healthdepartments.

• Able to secure and manageresources for the occupational healthdepartment.

• Able to manage complexdepartmental budgets and extensiverange external contracts.

• Able to provide clinical leadershipthrough self-development, and guideand develop others through continuedprofessional development activities.

• Able to provide operational andstrategic leadership in developing theoccupational health and safety team.

• Uses networking and politicalawareness to lead and developoccupational health services.

3. Core leadership and management skills



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• Participates and contributes to theaudit process and continuouslyevaluates own interventions.

• Participates in improving the patientexperience through a patient-focusedapproach to benchmarking.

• Participates in, and contributes to,evaluating patients’ experiences, anduses patient-focused benchmarks inimproving the patient experience.

• Participates in clinical governancemechanisms.

• Uses a customer care approach topractice.

• Contributes to the implementationof local shared governance, localpriorities, policy formation andimplementation.

• Uses national targets and initiativesin own area of practice.

• Contributes to aspects of work-based research and evaluationprojects. Actively researches ownpractice through systematic reflectionand critique using clinical supervisionand co-operative inquiry.

• Uses a research supervisor/mentorfor support and challenge in relation toresearch contributions.

• Questions practice and critiquesresearch, identifying researchquestions with regard to own practice.

• Develops and uses audit tools andensures regular team audit and actionplanning.

• Introduces evaluation approachesthat provide feedback on the patients’experiences and team activity, andmaintains local action plans forreviewing actions from audit andevaluation.

• Contributes to developing andimplementing clinical policy formation,and facilitates the delivery of effectivecustomer care by the team.

• Contributes to achieving nationaltargets and initiatives within own areaof practice.

• Contributes to the identification offuture priorities.

• Undertakes small localevaluation/research project in theworkplace, and able to co-superviseundergraduate projects andpractitioner-based research with amentor.

• Questions practice, and critiquesresearch, identifies research questionsrelating to team practice and specificcare of client group.

• Role-models systematic critiquerelating to developing and usingevidence in and from practice, andenables team members to contribute todifferent stages of the researchprocess.

• Provides opportunities for others tocontribute to practice-based research.

• Leads on clinical audit and developspractice through audit and evaluation.

• Promotes opportunities forinterdisciplinary audit and evaluation,and evaluates audit tools.

• Promotes and uses clinicalgovernance mechanisms.

• Develops local action plans toimprove service delivery using patient-focused benchmarks.

• Facilitates benchmarking of serviceagainst other departments.

• Provides a service that reflectsnational standards and patientbenchmarks.

• Facilitates developing andmonitoring local protocols andguidelines for the care of patients,through critical evaluation of theevidence for practice.

• Leads and develops clinical servicedevelopment, facilitates strategicplanning to meet the delivery andachievement of national targets andinitiatives.

• Leads a project that contributes to aprogramme of research and contributesto the evidence base for clinicalpractice by presenting and publishingpapers from practice-based research.

• Able to supervise undergraduateprojects and co-supervise post-graduate projects and practitioner-based research with a mentor.

• Identifies areas for research andcontributes to the corporate researchagenda in relation to client group andservice.

• Enables support, time and resourcesfor others to access, critically appraiseand disseminate evidence-basedinformation.

• Supports development of a serviceinfrastructure for using and organisingevidence-based care and research.

• Enables others to contribute topractice-based research with supportand supervision.

4. Core quality assurance and research skills


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• Uses basic understanding of thegeneral and specific health and safety,employment law and disabilitydiscrimination legislation, and able toapply basic understanding of statutoryand advisory guidance to ensure thehealth protection of the workingpopulation.

• Uses awareness of the DataProtection Act, and works todepartmental policies and proceduresas a guide to their ethical and legalpractice.

• Competent to manage inappropriaterequests to disclose personal healthinformation without informed consentof individuals, and to manage the safestorage and retrieval of occupationalhealth records.

• Able to maintain accurate andappropriate occupational healthrecords for individuals and groups.

• Able to recognise when to reportissues of conflict and seek appropriateguidance.

• Understands the scope of Duty ofCare and able to manage, investigateand care for the occupational healthand wellbeing of the individual clientsat departmental level.

• Uses transferable nursing skills toseek out evidence to inform ethical andlegal practice in occupational healthsettings.

• Able to advise at departmental andoperational levels on general andspecific health and safety, employmentlaw and disability discriminationlegislation.

• Able to interpret and communicatekey facts relating to the statutory andadvisory guidance governing the ethicaland legal aspects that ensure thehealth, safety and wellbeing ofemployers and employees.

• Able to apply, advise and guideemployers and employees on theprinciples of the Data Protection Act.

• Able to develop safe systems ofwork for the recording, retrieval andstorage of occupational healthinformation and records across clinicaland occupational settings.

• Uses appropriate knowledge andcommunication skills to protect andpromote the ethical and legalconsideration of occupational healthnursing practice.

• Works to the scope of Duty of Careand able to manage, investigate andcare for the occupational health andwellbeing of the individuals and groupsat departmental and operational levels.

• Assists in developing andimplementing legal and ethical policesand procedures at departmental andoperational levels.

• Evaluates and applies evidence toethical and legal occupational healthissues to inform practice.

• Has developed expertunderstanding and networks and isable to lead and advise atdepartmental, operational andstrategic levels on general and specifichealth and safety, employment law anddisability discrimination legislation.

• Remains abreast of new andemerging guidance and legislation thatgovern legal and ethical aspects ofoccupational health practice, and usesevidence-based practice to guideinterpretation of statutory and advisoryguidance to ensure the healthprotection of the working population.

• Plays a key role as part of amultidisciplinary team in developing,implementing and monitoring ethicaland legal strategies and policies atcorporate and departmental level.Provides leadership in the managementof conflict relating to confidentiality ofdata collection, recording, retrieval anddissemination.

• Able to generate and disseminateeffective management reports andother forms of verbal, written andvisual communication relating to theethical and legal considerations ofmanaging the health, safety andwellbeing the working population.

• Able to use the principles of clinicalgovernance, clinical supervision andclinical audit to lead, manage anddevelop the ethical and legal aspects ofoccupational health, safety andwellbeing.

5. Legal and ethical issues



13

• Contributes to risk reduction andhazard analysis at the level of theindividual.

• Maintains competence by keepingup-to-date with current clinical issues,and uses awareness of how theseimpact on risk assessment and practicein the department.

• Uses knowledge of policies, thenature of work risk and hazards, and isfamiliar with the theory and practice ofjob roles.

• Participates and contributes at abasic level to the monitoring, qualityassurance, and communication of riskassessment.

• Uses basic understanding of riskassessment concepts, goal setting,common and employment law, and theDisability Discrimination Act.

• Uses basic understanding ofcorporate risk and resource limitations.

• Undertakes basic workplace riskassessment under supervision andworking to protocols.

• Adheres to professionalaccountability and limitations andrefers as appropriate to higherauthority.

• Recognises the impact of culturaldiversity when assessing risk in anorganisation.

• Contributes to business objectivesin risk reduction and hazard analysis atan operational level.

• Assesses, critically appraises andapplies an evidence base for riskassessment, and promotes anenvironment for using evidence-basedcare.

• Has gained additional academic andtechnical knowledge of risk assessmentthrough personal and professionaldevelopment, and is able to provideadvice on risk assessment control anddesign.

• Able to assess and evaluate riskwith minimal supervision, andparticipates and contributes fully inmonitoring, quality assurance, andcommunicating risk assessment atoperational level.

• Uses experience to widenknowledge base on risk assessmentinformation, case law, EU legislation,impact of devolution, and operationalstrategies.

• Generates and analyses data toidentify employer/employee at risk.

• Uses health promotion activities tominimise risk.

• Recognises the impact of culturaldiversity when assessing risk in anorganisation.

• Able to manage limited array ofresources.

• Participates in strategicorganisational decisions andcontributes to organisational policydevelopment of risk assessment.

• Develops expertise of riskassessment through critical analysis ofown practice, and uses skills ofrecognition and control to contribute tothe development of risk and controlpolicy.

• Has in depth knowledge on which toprepare, plan, participate and consultat strategic, local and national level.Ensures that appropriate, evidence-based standards, benchmarks,protocols, clinical guidelines andprocedures are in place.

• Able to manage OH services, leadmultidisciplinary teams and manageresources and income generationrelated to risk assessment.

• Promotes awareness of riskassessment and influencesorganisational change by using clinicaland corporate governance,demographics and epidemiology, andeducational initiatives.

• Able to align OH service withbusiness objectives and advisesorganisation of risk and implication ofcorporate governance.

• Has political awareness and able toanalyse professional accountability andneeds assessment in order to developinter-dependent practice througheffective communication and lobbying.

6. Risk assessment


14


• Adheres to standards and policesand recognises limitations to owncompetence and scope of professionalpractice when implementing healthsurveillance programmes.

• Has empathetic listening skills; is acompetent and reflective listener;operates mainly in one-to-onerelationships with clients; participatesin pre-employment health screeningand assessment of fitness to work.

• Has understanding of legislationgoverning health protection andsurveillance and is able to screen pre-employment health questionnaires anddeclare fitness or refer when healthissues declared.

• Has specific training to undertakerange of basic healthprotection/surveillance activities underClient Group Directions and protocolsas required such as vision screening;audiometry; skin checks; spirometry;urinalysis; blood pressure;immunisations and administration ofmedicine.

• Accurately gathers and recordsworking history; workplace exposures;and re-call for health surveillancerequirements. Able to collect accuratehealth surveillance data and maintainaccurate records. Maintainsconfidentiality of individual healthinformation and security of healthrecords.

• Has knowledge of infection controland disposal of clinical waste in theworkplace, and first aid at workregulations.

• Understands needs of organisationsand industry, contractual obligations,and role of OHS and OHN in operationalcontext of organisation and keystakeholders.

• Builds on the basic skills of thecompetent nurse and demonstratesgreater analytical skills when assessinghealth and implementing healthsurveillance.

• Able to conduct full range of pre-employment health screening andassessment of fitness to work.

• Uses professional judgement anddiscretion to interpret healthsurveillance results and relates tooccupational exposures and healthprotection strategies.

• Has knowledge of, and interpretshealth and safety legislation relating tohealth protection and surveillance, anduses knowledge to raise awareness ofpopulation and individual need forhealth protection and surveillance.

• Understands business needs andculture, and contributes to theeconomic viability of the organisationby implementing appropriate healthprotection measures for the workingpopulation, and provides evidence-based programmes based on costbenefit analysis.

• Able to articulate health protectionand surveillance need at an operationallevel using negotiating skills andpolitical awareness.

• Influences by negotiation and withpolitical awareness of wider globalissues for health protection and healthsurveillance.

• Possesses corporate andoperational knowledge of organisation.Contributes to contract developmentand review. Manages and securesbudget for health protection andsurveillance.

• Incorporates clinical governance andclinical supervision in contractspecification for health protection andhealth surveillance.

• Able to establish, develop andevaluate health protection and healthsurveillance based on evidence.Produces benchmarks for best practice.Develops and implements policies andprocedures.

• Able to establish benchmarks forpre-employment health screening andassessment of fitness to work, and ableto generate and analyse data forcontinued improvements.

• Liaises and develops internal andexternal networks for support andreferral.

• Demonstrates leadership in reviewand audit of health surveillancestrategies.

• Communicates trends and adviseson action plans to meet statutory andvoluntary requirements for healthprotection, surveillance and statutoryreporting.

7. Health promotion, protection and surveillance



15

• Uses basic understanding of theDisability Discrimination Act andemployment law in assessment.

• Supports monitoring sickness andabsence as a part of holistic totalmanagement approach.

• Fosters good communications withhuman resources to maintainappropriate involvement ofoccupational health services in theassessment, support and rehabilitationof employees.

• Uses basic skills and competenciesto monitor and assess sickness andabsence. Constructs OHN care plans,and supports the rehabilitation ofemployees.

• Uses an awareness of theimportance of building up network ofexternal specialists and agencies tosupport employee rehabilitation.Liaises with external agencies thatsupport rehabilitation and early returnto work.

• Able to provide standardassessment of an employee to a set ofprotocols and to participate in sharedcase management in a multidisciplinaryteam.

• Able to generate data and producereports to agreed format.

• Uses good understanding of theDisability Discrimination Act andemployment law, and contributes topolicy development.

• Able to use experience of sharedcase management to monitor andassess sickness and absence.Constructs OHN care plans, andsupports the rehabilitation ofemployees as part of a holistic totalmanagement approach.

• Maintains good communicationswith human resources to ensure theappropriate involvement ofoccupational health services in theassessment, support and rehabilitationof employees.

• Liaises with, and maintains linkswith external agencies to supportrehabilitation and early return to work(e.g. physiotherapists, occupationaltherapists, occupational physiciansetc).

• Able to analyse data and identifytrends in sickness and absence, and togenerate reports and act on reportsprovided by others.

• Able to contribute to themanagement of sickness absence andrehabilitation in a business culture.

• Uses an evidence base, and expertunderstanding of the DisabilityDiscrimination Act and employment lawto advise and lead policy development.

• Develops strategies in a qualityassurance framework of clinicalgovernance and clinical supervisionrelating to sickness absencemanagement and rehabilitation.

• Able to generate data thatdemonstrates the cost benefit analysisof occupational health interventions inthe management of sickness absenceand rehabilitation.

• Communicates effectively atoperational and strategic levels, andmaintains good communications withhuman resources to develop theunderstanding and involvement ofoccupational health services in theassessment, support and rehabilitationof employees.

• Able to take the lead in monitoringsickness and absence as a part ofholistic total management approach.Able to manage the development ofskills and competencies required formonitoring and assessing sickness andabsence.

• Able to develop occupational healthcare plans to support rehabilitation andearly return to work of employees,which use the multidisciplinary teamand external agencies.

8. Sickness, absence and rehabilitation


16


• Uses knowledge of the principles ofprimary, secondary and tertiarymeasures required for mental healthcare in the workplace at organisation,individual and group levels.

• Able to consider research,legislation, organisational culture, workdesign, internal and external resources,and multidisciplinary team work whenassessing and controlling psycho-educational risk.

• Interacts with workplace managersand individual employees to assesspsycho-educational risk. Supportsdevelopment and interpretation ofpsycho-educational policies in theworkplace.

• Uses basic counselling skills whensupporting managers and employees.

• Able to profile specific groups in aworking population and identifyindividuals at potential psycho-educational risk.

• Able to plan and deliver psycho-educational health educationpackages.

• Able to identify and advise onexternal sources for specialist psycho-educational support.

• Adheres to standards and policesand recognises limitations to owncompetence and scope of professionalpractice related to psycho-educationalpractice.

• Uses knowledge and interprets theprinciples of primary, secondary andtertiary measures required for mentalhealth care in the workplace atorganisation, individual, and grouplevels.

• Able to draw on research,legislation, organisational culture, workdesign, internal and external resources,and multidisciplinary team work whenassessing and controlling psycho-educational risk.

• Interacts at organisation level aswell as with individual workplacemanagers and employees to assesspsycho-educational risk. Supportsdevelopment and interpretation ofpsycho-educational policies in theworkplace.

• Uses basic counselling skills withspecialist psycho-educational skills tosupport managers and employees.

• Able to work autonomously andindependently, collect and analysedata, accurately profile psycho-educational needs of the workingpopulation, identify groups andindividuals at potential risk.

• Able to plan and deliver psycho-educational health education packagesin a health promotional strategicframework, and identify, advise andrefer to external sources for specialistpsycho-educational support asappropriate.

• Able to contribute to thedevelopment of standards and policiesrelated to psycho-educational practice.

• Interprets and advises on research,legislation, organisational culture, workdesign, internal and external resources,and multidisciplinary team work in theassessment and control of psyhco-educational risk.

• Operates at a strategic level in theassessment of psycho-educational risk,and takes a key role in developing andimplementing psycho-educationalpolicies and standards in theworkplace.

• Able to work inter-dependently withothers.

• Uses specialist psycho-educationalskills when supporting workplacemanagers and employees.

• Develops links and workingarrangements with external sources forspecialist psycho-educational support.

• Supports others to workautonomously to collect and analysepsycho-educational data profiles. Ableto identify health trends that requireinterventions for groups andindividuals at risk.

• Uses business and managementskills to plan and deliver psycho-educational health education packagesin a strategic health promotionalframework.

• Develops and implements audit ofpsycho-educational interventions, anddemonstrates cost effectiveness ofinterventions.

9. Psychological and psychosocial interventions



17

• Uses transferable nursingknowledge of anatomy and physiologyto assess workers physical capability inworkplace environments.

• Able to identify potential issuesbetween medical assessment andperson-environment fit.

• Uses knowledge of organisationalbehaviour relating to person-environment fit and use of equipment.

• Uses awareness that task,equipment, environment, workorganisation and people are inter-dependent elements in ergonomicassessment.

• Has the basic skills and experienceto deliver training in manual handling.

• Uses basic understanding ofassessment and use of workplaceequipment to give advice.

• Uses basic understanding ofpersonal protective equipment (PPE)and able to apply understanding whenassessing person-environment risk.

• Uses transferable nursinginterpersonal skills for effectivecommunication of basic ergonomicprinciples.

• Building on competent practice, hasacquired good working knowledge ofrelevant legislation relating toergonomic assessment, control andadvice.

• Has clear awareness at operationallevel, of the business implications ofergonomic assessment andmanagement, and is able to influenceand advise on ergonomic factors and tosecure additional resources withinbudgetary constraints.

• Able to work autonomously andwithin teams, and mentors lessexperienced nurses and members ofthe workforce, in ergonomicassessment activities.

• Uses awareness of task, equipment,environment, work organisation andpeople when participating in ergonomicassessment.

• Able to identify specific and generalergonomic issues and able to presentsolutions for problems.

• Able to develop and use a networkof expert colleagues to support andenhance ergonomic practice.

• Works proactively and introducesergonomic preventative programmes inthe workplace.

• Will have developed knowledge andskills in ergonomics through personaland professional development, andmay, depending on role, meet theadmission criteria for membership of aprofessional body in the field ofergonomics.

• Able to participate at strategic levelin the development of operational andstrategic policy relating to ergonomicassessment and management.

• Able to analyse and articulates thecost benefit of adopting soundergonomic strategies in a businessculture, and is able to lead andparticipate in proactive ergonomicprogrammes across the organisation.

• Takes full account of task,equipment, environment, workorganisation and people in thedevelopment of ergonomic assessmentand management. Uses own expertisein conjunction with internal andexternal resources to evaluate,interpret and solve ergonomicproblems.

• Able to use expert ergonomicknowledge and a wide evidence basewhen responding to ergonomic issues.Able to develop extensive network ofprofessional and technical sources forergonomic advice, support and referral.

• Able to generate and communicateergonomic data by appropriatelydesigned evaluation trials and effectivedissemination.

• Practises, develops and leadsnursing and/or multidisciplinary teamsin sound ergonomic principles in aframework of clinical governance,supervision and audit.

10. Ergonomics


18


• Uses awareness of the effect of theenvironment on health and healthoutcomes (e.g. occupational-induceddiseases such as hearing loss and lungdisease) to provide advice.

• Uses basic understanding of controlmeasures for both personal andenvironmental protection (e.g. personalprotection, removal of hazard,ventilation; shielding, guarding,substitution), and basic knowledge ofprinciples of hazardidentification/definition, and theassessment of residual risk takingaccount of control measures to provideadvice.

• Understands the complementaryroles of the occupational health adviser(occupational health promotion and illhealth prevention); and that of theoccupational hygienist (occupationaland environmental measurements andcontrol). Contributes informationtowards departmental and operationalreports relating to occupationalhygiene and environmental surveys.

• Able to advise individuals onoccupational hygiene preventativemeasures, and to participate inenvironmental surveys with thesupport of others.

• Aware of and able to source andunderstand statute and advisorystandards relating to occupationalhygiene and environmental control.

• Able to contribute to occupationalhygiene measurement, control andeducation by following guidance inpolicies and procedures.

• Possesses and uses goodknowledge of occupational andenvironmental hazard identification,risk assessment and control measuresto provide advice.

• Assesses and uses specialistinformation and support for hazardidentification and risk control (e.g.noise assessments and ventilationassessment).

• Uses experience, skills andknowledge of the principles andpractice of risk assessment, to adviseon occupational hygiene matters bothto individuals and departments atoperational level.

• Able to advise when and whatspecialist occupational hygiene input isrequired, and is competent toundertake environmental surveys thatare applicable to the local requirementsof the employing organisation.

• Contributes to the management ofoccupational hygiene by participatingin multidisciplinary working across theextended occupational health team(including external agencies andadvisors).

• Uses accurate and up-to-dateinformation to inform practice, and isable to apply knowledge of statute andadvisory standards in the assessmentof occupational hygiene hazard/riskassessment.

• Able to produce accurate, effectiveand helpful occupational hygiene andenvironmental survey reports formanagement at operational level.

• Uses excellent skills and knowledgeof occupational and environmentalhazard identification, risk assessmentand control measures.

• Uses a wide and appropriateevidence base to inform a higher levelof occupational hygiene practice, and iscompetent to undertake detailedoccupational hygiene andenvironmental survey activities.

• Interprets statute and advisorynotices for occupational hygiene andoccupational environmental matters,and is able to provide occupationalhealth advice and leadership at thestrategic level of an organisation.

• Able to lead on development,implementation and management ofoccupational health nurse policies andprocedures in occupational hygieneand environmental survey activity.Contributes as a key partner to thedevelopment and implementation ofoccupational hygiene andenvironmental health policies andprocedures at the strategic level of theorganisation.

• Able to produce effectivemanagement reports that impact onoccupational hygiene andenvironmental safety activities andresources.

• Maintains and develops internal andexternal networks to informoccupational hygiene andenvironmental knowledge andactivities. Obtains and disseminatesknowledge and information onoccupational hygiene andenvironmental monitoring byattendance and contribution at nationaland international venues.

11. Occupational hygiene



19

• Requires induction and a personaldevelopment plan to developknowledge and skills in the areas ofhealth and safety legislation including:the Reporting of Incidence Diseasesand Dangerous OccurrencesRegulations (RIDDOR): organisationalsafety and training: accident reporting:report writing; pre-employmentselection and placement; health andsafety surveillance; organisational anddepartmental health and safety policiesand procedures.

• Practises under the guidance ofoccupational health nursing policiesand protocols, and is able to work tohealth and safety policies andprocedures.

• Able to gather information andcommunicate health and safetyinformation in the occupational healthteam and with clients.

• Acquires knowledge and skills to beable to provide basic advice on: safesystems of work; personal andprotective equipment (PPE);environmental safety; employee jobplacement safety; employee healthsurveillance; and rehabilitationfollowing health and safety-relatedsickness absence.

• Acquires knowledge and skills to beable to provide psychological supportfollowing accident/incidents, and toprovide health and safety education foremployees and groups in theorganisation.

• Builds on competent practice and isable to communicate and negotiate forhealth and safety strategies atoperational level, and to contribute tothe development and implementationof health and safety policy in anorganisation.

• Able to use experience andenhanced skills to interpret health andsafety legislation, apply the principlesof hazard and risk control, andundertake a range of risk assessmentstrategies without supervision.

• Able to gather and interpret healthand safety data, and to articulate costbenefit analysis of effective health andsafety behaviour to individuals andgroups.

• Able to advise on: safe systems ofwork; personal and protectiveequipment (PPE); environmentalsafety; employee job placement safety;employee health surveillance;rehabilitation following health andsafety-related sickness absence.

• Able to provide psychologicalsupport following accident/incidents,and to provide health and safetyeducation to employees and groups inthe organisation. Contributes to healthand safety promotion at a strategiclevel.

• Acts as an advocate for occupationalhealth and safety in the organisation,and works autonomously within aframework of clinical governance andclinical supervision.

• Possesses additional knowledgeand experience to provide expertinterpretation and advice on health andsafety legislation and hazard and riskcontrol.

• Able to communicate and negotiatefor health and safety strategies atoperational and strategic levels.Contributes to the development andimplementation of health and safetypolices throughout the organisationand in the occupational healthdepartment.

• Has advanced interpretative skills,and can manage and lead on thegathering, interpretation anddissemination of health and safetydata. Articulates the cost benefitanalysis of effective health and safetybehaviour for individuals and groups,and influences safety behaviour at anorganisational level.

• Competent in a wide range of riskassessment strategies and able togenerate and disseminate effectivehealth and safety management reports.

• Able to take the occupational healthnursing lead for advice on: safesystems of work; personal andprotective equipment (PPE);environmental safety; employee jobplacement safety; employee healthsurveillance; and rehabilitationfollowing health and safety-relatedsickness absence.

• Uses advanced practice whenproviding psychological supportfollowing accident/incidents, and leadson occupational health and safetypromotion at organisational andstrategic level.

12. Maintaining safety and accident control


20


References

Department of Health and former English National Board(1998) Occupational health nursing: contributing tohealthier workplaces, London: ENB/DH.

Department of Health (1999a and 2003) Agenda forChange: modernising the NHS pay system, London: DH.

Department of Health (1999b) Making a difference:strengthening the nursing, midwifery and health visitingcontribution to health and healthcare, London: DH.

Department of Health (2000) The NHS plan: a plan forinvestment, a plan for reform, London: DH.

Department of Health (2003) Taking a public healthapproach in the workplace- a guide for occupational healthnurses, London: DH.

Department of Health (2004) NHS knowledge and skillsframework (NHS KSF) and the development and reviewprocess, London: DH.

Manley K (1992) Quality assurance: the pathway toexcellence in nursing (chapter 7) in Bryzinska G & Jolley M(Eds) Nursing Care: the challenge to change, London:Edward Arnold.

Manley K (2001) Consultant nurse: concept, processes,outcome (unpublished PhD thesis), London: RCN LondonInstitute and University of Manchester.

Nursing & Midwifery Council (2004a) Standards forcommunity specialist public health nursing, London: NMC.

Nursing & Midwifery Council (2004b) Code of professionalconduct, London: NMC.

Roach S (1992) The human act of caring: a blueprint for thehealth professions (revised edition), Ottawa: CanadianHospital Association Press.

Royal College of Nursing (2004) Agenda for Change – aguide to the new pay, terms and conditions in the NHS,London: RCN. Publication code: 002 299.

Royal College of Nursing (2005) Agenda for Change andnurses employed outside of the NHS, London: RCN.Publication code 002 246.

West BJM, McBain M, Macduff C and Lyon M (2001)Occupational health nursing in Scotland: scope of practiceand future continuing professional development, researchreport submitted to the National Board for Nursing,Midwifery and Health Visiting Scotland, Aberdeen: RobertGordon University.

World Health Organization (2002) Good practice inoccupational health services – a contribution to workplacehealth, Copenhagen: WHO.

4

For information about the RCN Clinical LeadershipProgramme, email [email protected] or visitwww.rcn.org.uk


21

Glossary

RCN Royal College of Nursing

KSF Knowledge and Skills Framework

NMC Nursing & Midwifery Council

OHN Occupational Health Nursing

5

22


Nursing & Midwifery Council new standardsand registerIn 2004 the NMC decided to establish part three of theregister for specialist community public health nursesbecause this practice has distinct characteristics thatrequire public protection. These include the responsibilityto work with both individuals and a population, whichmay mean taking decisions on behalf of them withouthaving direct contact with every individual in thatcommunity. The primary purpose of standards forregistration is to provide the mechanism through whichthe NMC can exercise its main function of protecting thepublic.

Entry to part three of the registerPart three of the register is open to nurses designated ashaving a significant role as a public health nurse andOHNs have been identified as one group of nurses thatmeet this criteria.

OHNs who already hold an NMC recordable qualificationat certificate, diploma or degree will automatically betransferred to part 3 of the register. Nurses training asqualified OHNs will, in future, be required to complete

6

study at a minimum of first degree. This has to have NMC-approval to meet their standards of proficiency.

Go to www.nmc-uk.org for full information on the newpart three of the register and the Standards of Proficiencyfor Specialist Community Public Health Nurses.

Standards of proficiency Proficiency for entry to the register is reflected in the newSpecialist Community Public Health Nursing Programmefor OHN. This is underpinned by ten key principles ofpublic health practice that are grouped into four domains.The following tables have mapped these key principles anddomains against the RCN OHN competencies, which wereidentified by OHN stakeholders as the essential elementsfor practice.

MappingThe following mapping exercise demonstrates that there isa close correlation between the aspirations of key OHNstakeholders and the NMC on determining proficiency andcompetence to practise as a specialist OHN.

Appendices

Appendix 1: Mapping standards for specialist community public healthnursing against the RCN OHN competencies

NMC principle 1Carrying out surveillance and assessment of the

population’s health and wellbeing.

NMC domain 1: search for heath needs:

1. collect and structure data and information on thehealth and wellbeing and related needs of a definedpopulation

2. analyse, interpret and communicate data andinformation on the health and wellbeing and relatedneeds of a defined population

3. develop and sustain relationships with groups andindividuals with the aim of improving health and socialwellbeing

4. identify individuals, families and groups who are atrisk and in need of further support

5. undertake screening of individuals and populationsand respond appropriately to findings

Embedded in RCN OHN competency descriptors for:

• core transferable skills

• core quality assurance and research skills

• risk assessment

• health promotion, protection and surveillance

• sickness absence and rehabilitation

• ergonomics

• occupational hygiene.


23

NMC principle 2Collaborative working for health and wellbeing. Working

with, and for, communities to improve health and

wellbeing.

NMC domain 2: stimulation of awareness of health needs:

1. raise awareness about health and social wellbeing andrelated factors, services and resources

2. develop, sustain and evaluate collaborative work

3. communicate with individuals, groups andcommunities about promoting their health and wellbeing

4. raise awareness about the actions that groups andindividuals can take to improve their health and socialwellbeing

5. develop capacity and confidence of individuals andgroups, including families and communities, to influenceand use available services, information and skills, actingas advocate where appropriate

6. work with others to protect the public’s health andwellbeing from specific risks.



• core leadership and management skills


• health promotion, protection and surveillance

• risk assessment

• sickness absence and rehabilitation

• psychological and psychosocial interventions.

NMC principle 3Developing health programmes and services and reducing

inequalities. Developing an implementing policy and

strategy to improve health and wellbeing. Research and

development to improve health and wellbeing.

NMC domain 3: influence policies affecting health:

1. work with others to plan, implement and evaluate

programmes and projects to improve health and

wellbeing

2. identify and evaluate service provision and support

networks for individuals, families and groups in the

local area or setting

3. appraise policies and recommend changes to improve

health and wellbeing

4. interpret and apply health and safety legislation and

approved codes of practice with regard for the

environment, wellbeing and protection of those who

work with the wider community

5. contribute to policy development

6. influence policies affecting health

7. develop, implement, evaluate and improve practice on

the basis of research, evidence and evaluation.





• legal and ethical Issues

• risk assessment

• maintaining safety and accident control.

24


NMC principle 4Promoting and protecting the population’s health and

wellbeing. Developing quality and risk management in an

evaluative culture. Carrying out strategic leadership for

health and wellbeing. Managing self, people and

resources ethically to improve health and wellbeing.

NMC domain 4:

1. work in partnership with others to prevent the

occurrence of needs and risks related to health and

wellbeing

2. work in partnership with others to protect the public’s

health and wellbeing from specific risks

3. prevent, identify and minimise risk of interpersonal

abuse or violence, safeguarding children and other

vulnerable people. Initiate the management of cases

involving actual or potential abuse or violence where

needed

4. apply leadership skills and manage projects to improve

health and wellbeing

5. plan, deliver and evaluate programmes to improve the

health and wellbeing of individuals and groups

6. manage teams, individuals and resources ethically and

effectively.





• legal and ethical issues

• risk assessment

• psychological and psychosocial interventions

• ergonomics

• occupational hygiene.

Nursing & Midwifery Council (2004) Standards of

proficiency for specialist community public health nurses,

London: NMC.

www.nmc-uk.org

Royal College of Nursing (2005) Competencies: anintegrated career and competency framework foroccupational health nursing, London: RCN. Publicationcode 002 774

www.rcn.org.uk


25

Appendix 2: The 11 key functions of OH services

Functions of occupational health services:

1. identification and assessment of the health risk in the workplace

2. surveillance of work environment factors and work practices that affect workers’ health, including sanitaryinstallations, canteens and housing, when such facilities are provided by the employer

3. participation in the development of programmes for the improvement of working practices, as well as testing andevaluating health aspects of new equipment

4. advice on planning and organisation of work, design of workplaces, choice and maintenance of machinery,equipment and substances used at work

5. advice on occupational health, safety and hygiene, and on ergonomics and individual and collective protectiveequipment

6. surveillance of workers’ health in relation to work

7. promoting the adaptation of work to the worker

8. collaboration in providing information, training and education in the fields of occupational health, hygiene andergonomics

9. contribution to measures of vocational rehabilitation

10. organisation of first aid and emergency treatment

11. participation in the analysis of occupational accidents and occupational diseases.

World Health Organization (2002) Good practice in occupational health services – a contribution to workplace health,Copenhagen: WHO.

26


Nick James

Graham Johnson

Karen Johnson

Anne Kennaugh

Agatha Lyons

Margaret Mercer

Carol Miller

Linda Mulqueen

Angela Mummery

Jeanette Murray

Ann McLeod

Maureen McBain

Kate Naylor

Susan Nwawze

Paula Penn

Tracy Phillips

David Perry

Shirley Prenton-Jones

Eleri Roberts

Rachel Rowe

Joyce Spalding

David Stubbs

Julian Topping

Sue Trott

Debbie Twidgon-Williams

Tracy Watkins

Maureen Williams

Anne Ashlee

Ros Baah

Daphne Bagley

David Black

Tina Bond

Suzanne Bill

Christina Butterworth

Sharon Bond

Fiona Colgrove

Joanna Elliott

Suzanne Everton

Bob Foster

Mairi Gaffney

Rob Gorton

Charles Graham

Alex Grieve

Nancy Hamilton

Carol Hargreaves

Barbara Healey

Anne Henderson

Nita Hodgekinson

Sharon Horan

Elizabeth Hughes

Jane Ingham

Joyce Innes

Nola Ishmael

Bernie Jackson

Appendix 3: Full acknowledgements

This integrated career and competency framework for occupational health nursing has been developed in partnershipwith the RCN Society of Occupational Health Nursing and the RCN Occupational Health Managers Forum. Wideconsultation with RCN members and the involvement of key stakeholders working in occupational health settings hashelped to inform this framework. We would like to thank the following people, who have contributed significantly toits development:

We would also like to thank all those who participated in the early Values Clarification exercises; all who contributed to theThemes Workshop and helped refine the focus of the framework; and everyone who responded to our call for commentson the earlier drafts – their input was invaluable. Thanks also to RCN Administrator Carol Woodward, who assisted withtelephone calls and the administrative arrangements during the consultation phase of the development.

Carol BannisterRCN Professional Nurse Adviser – OHN

Jan MawRCN Professional Nurse Adviser – OHN

August 2005

Published by the Royal College of Nursing 20 Cavendish SquareLondon W1G 0RN

020 7409 3333

The RCN represents nurses and nursing, promotesexcellence in practice and shapes health policies

Publication code 002 774

Approved by the RCN Accreditation Unit untilDecember 2005

Documents

RCN competencies for occupational health nursing