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Clinical Nurse Specialist/Nurse Practitioner (Level 6)

Clinical Nurse Specialists (CNSs) and Nurse Practitioners (NPs) are registered nurses with relevant experience and post-registration education for working within a specific area of practice. They assess, manage, deliver care, advise on, and support the care for people within a specialist area (Chief Nursing Officer Directorate, Transforming Roles Paper 8, 2021)

Across NHSGGC there are over 200 Clinical Nurse Specialists and Nurse Practitioners practising in a wide variety of different areas including:

Oncology, Cardiology, Dermatology, Diabetes, Minor Injuries, Gastroenterology, Nutrition, Gerontology, Orthopaedics, General Surgery, Pain, Palliative Care, Respiratory, Rheumatology, Sexual Health, Vascular, Urology, HIV, Diabetes, Osteoporosis, Parkinson’s disease, and Stoma Care The recently published CNO’s Transforming Roles Paper 8 provides an updated definition.

Definition

“A registered nurse with relevant experience and post-registration education for working within a specific area of practice. Educated in an appropriate subject to the level of graduate certificate (honours degree) at a minimum, although a postgraduate certificate is recommended, they are assessed as clinically competent in their defined area of practice. They assess, manage, deliver care, advise on, and support the care for people within a specialist area.

As a Level 6 Senior Practitioner they work under guidance in a peer relationship with other members of the multidisciplinary team. They have the autonomy to act and accept responsibility and accountability for their actions, acting as a skilled advisor or resource for others. This includes specialist assessment, informed decision making, and treatment using a personalised approach to care for patients’ multidimensional presentations. This may require supporting specialist care over a prolonged period of time. They have the authority to refer patients, and may admit or discharge within appropriate clinical areas of practice. This is characterised by a level of decision making based on detailed knowledge and understanding of their area of practice.

As part of the multidisciplinary team they can work in or across many settings, including non-clinical, depending on their area of expertise and scope of practice.” (CNOD 2021)

Training

CNSs and NPs train in post for the role. Increasingly, CNSs and NPs are being formally employed in training posts (using Annex 21 from Agenda for Change) while they learn. Trainee CNSs and NPs are supervised whilst they learn and will also undertake appropriate post-registration education at university to support their learning. Trainees will build a portfolio of evidence to demonstrate they are competent to practice which is formally assessed at the end of their training.

Competency Framework

Transforming Roles Paper 8 sets out the core competencies for any CNS or NP. To these additional specialist competencies are added. The competency framework needs to be completed before a new CNS or NP can be regarded as appropriately prepared.

Agenda for Change

CNSs/NPs are paid at a minimum of Band 6