Framework for Nursing in General Practice

Guidance and support materials fro general practices on the employment and development of nurses

Framework for Nursing in General Practice

2 Standards for Nursing in General Practice

1 Fair and Consistent Treatment

Standard statement

1.1 There is a robust process for the recruitment of practice nurses which aspires to best Human Resources practice and meets employment legislation.


Vacancies for the post of practice nurse are advertised.

Job descriptions and person specifications are produced for all vacancies.

The recruitment of applicants is carried out by a multidisciplinary panel which should, if possible, include a nurse of appropriate experience and level of practice.

The practice checks that the nurse is registered with the NMC on the appropriate part(s) of the register.

The practice checks at interview the qualifications of potential practice nurses, checks personal identity and also takes up references.

The practice ensures that a new practice nurse has a check carried out by Disclosure Scotland prior to commencing employment.

The practice complies with current legislation on employment rights and discrimination.

The practice ensures that the work of all nurses working in the practice is covered by appropriate employers liability insurance.

Standard statement:

1.2 There is a fair process for the employment of practice nurses which aspires to best Human Resources practice and meets or exceeds the minimum legal requirements.


The practice nurse has a job description that reflects the job purpose, role, principle responsibilities, and accountability, communication and working relationships.

The practice nurse has a contract stating the written terms and conditions of employment which conforms to or exceeds the statutory minimum.

There is an agreed disciplinary & grievance procedure that adheres to the ACAS code of practice.

Accurate and complete personnel records are kept and there is a system whereby practice nurses can access them on request.

There is a written procedures manual that includes staff employment policies including Equal Opportunities, Bullying and Harassment, Maternity Leave and Sickness Absence (including illegal drugs, alcohol and stress) to which staff have access.

The practice nurse has the right to join the NHS Superannuation Scheme.

There is a system in place for identifying and dealing with poor performance.

The practice checks on a regular basis that the nurse is registered with the NMC on the appropriate part of the register.

A locum practice nurse is subject to the same professional checks as a permanent member of staff.

The practice nurse has access to NHS child care facilities where these are available.

There is a degree of flexibility in working arrangements to cope with unexpected family issues.

Practice nurses work in a safe environment.

Standard statement:

1.3 Practice nurses are rewarded for increasing role and responsibilities in line with the principles of Agenda for Change.


The terms and conditions of employment of practice nurses reflect the Agenda for Change principles.

The practice nurse is rewarded for improving his/her knowledge and skills through appraisal using the Knowledge and Skills Framework.

2. Induction and Initial Preparation for Role

Standard statement:

2.1 All nurses moving into a new post in General Practice undertake a formal period of induction and support to ensure that they are adequately prepared for their role.


An appropriate named person within the practice takes responsibility for the induction of each new member of nursing staff.

Induction covers a range of core topics essential to allow the practice nurse to function effectively in the new post.

Job description and person specifications identify the specific skills and knowledge necessary for each post.

Individual learning objectives for the induction period are identified based upon a learning needs assessment.

The length of the induction period is tailored to reflect the learning needs of the nurse.

A mentor is identified for each new practice nurse who provides support to the new nurse during the induction period.

The mentor assists and supports work based learning, encouraging personal and professional development.

All team members contribute where appropriate to the induction process.

A record of induction is kept on the staff record.

Locum practice nurses are provided with a tailored induction programme appropriate to their knowledge, skills and competency.

3. Developing the Nursing Team

Standard Statement:

3.1 Practices make safe and effective use of the skills of the whole nursing team, ensuring that adequate attention is given to developing and implementing new and advanced nursing roles.


Practice nursing roles are informed by the needs of patients and communities and complement the roles of other primary health care team members.

Developments in nursing practice take place within legal, ethical and regulatory frameworks to ensure patient safety is maintained.

Developments in practice nursing roles are evidence-based and build upon the body of nursing knowledge.

Practice nurses have access to training and education that adequately prepares them for their roles.

Planned and structured support mechanisms, including mentorship and supervision are in place to support nurses undertaking enhanced roles.

Clear responsibilities and lines of accountability for practice are established with all nurses.

There is a system in place for the practice nurses to maintain and develop their professional competence.

Practice nurses are appropriately rewarded for their roles and for taking additional responsibilities.

Practices and nurses ensure that nurses are adequately covered by indemnity insurance.

Standard Statement

3.2 Practice nurses have access to professional nursing leadership which supports their development and promotes safe clinical practice.


All practices and practice nurses have access to professional nursing advice at CHP or primary care division level.

Practice nurses should, if possible, have professional nursing input to their annual appraisal and personal development plans.

Practice nurses are supported to develop clinical leadership roles and skills relevant to their area and level of practice.

Practice nurses are able to use their clinical leadership skills to help inform developments within the practice clinical team.

4. Learning and Personal Development

Standard statement:

4.1 There is a systematic process to support the ongoing learning of the practice nurse in response to patient, community and practice needs.


All practice nurses have personal development plans which are reviewed at annual appraisal.

Personal development plans are developed to reflect the nurses learning needs in line with practice development plans, reflecting job description and competencies.

There are opportunities for professional nursing input to development and review of personal development plans.

Personal development plans are part of a continual process of planning, monitoring, assessment and support to help practice nurses develop their capabilities and potential.

The practice agrees the identified learning needs of the practice nurse, including appropriate access to education programmes and resources and study leave.

Practice nurses benefit from protected time for learning in line with their identified Personal development plans.

Practice nurses maintain a portfolio of learning, that meets the requirements of the NMC and demonstrates achievement of the minimum standard of five days study every three years.

There are opportunities for work based and multidisciplinary learning within the practice team.

Practice nurses have access to statutory training updates on a periodic basis.

Standard statement:

4.2 Practice nurses are supported to undertake reflective learning.


The practice nurse has access to clinical supervision with professional peer(s) where appropriate.

The practice nurse is involved in learning through significant event analysis within the practice.

The practice nurse, as part of the team, is involved as appropriate in the practice review of patient complaints and suggestions.

5. Communication and Teamwork

Standard statement:

5.1 Communication systems within the practice and with the wider NHS, partner agencies and other practices support the role of the practice nurse as a core member of the primary health care team.


The contribution of practice nurses to the strategic development of the practice is recognised and supported.

The practice has a means to ensure that practice nurses are well informed about all decisions that affect them and encouraged, where appropriate, to contribute to the decision making process.

The practice nurse has active engagement into the discussion and agreement of written policies covering clinical and administrative procedures.

Regular team meetings take place to discuss clinical issues and policies. Records are kept of the meetings which are available to all team members.

There is a system in place to ensure the appropriate sharing of clinical information between all team members.

There is an effective system to ensure that practice nurses receive relevant information originating from outwith the practice.

There are opportunities for informal networking within the wider primary health care team and more widely

Standard statement:

5.2 Practice nurses have ready access to Information Technology including email and the internet.


The practice nurse has access to the clinical computer system during every clinical contact.

Access to computer data is password controlled and each practice nurse has an individual password.

The practice nurse has access to e-mail and an individual e-mail address.

The practice nurse has access to internet, intranet and NHSnet resources outside clinical sessions in order to inform her practice.

6. Accountability for Professional Practice

Standard statement:

6.1 Practice-employed nurses and General Practitioners have a clear understanding of nurses' professional accountability for their practice.


Nurses have a personal copy of the Nursing and Midwifery Council's Code of Professional Conduct and understand it's implications for their practice.

GPs are aware of the NMC code of Professional Conduct and understand their responsibility as an employer to provide a working environment in which nurses can exercise their professional accountability.

GPs who delegate new duties to nurses ensure that they have access to appropriate education and training, and are competent to carry them out safely.

Nurses ensure that they only take on new duties for which they can demonstrate competence.

Nurses ensure that Health Care Assistants are competent to undertake any duties that they delegate and retain accountability for the performance of those duties.

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