This article relates to the CQC key question: Is your practice effective? and Is your practice well-led?
We consider what arrangements the GP practice has for supporting and managing staff to deliver effective care and treatment. This includes arrangements for clinical supervision for nurses.
The purpose of clinical supervision is to provide a safe and confidential environment for staff to reflect on and discuss their work. The focus is on supporting staff in their professional development and in reflecting on their practice. It should sit alongside good practices in recruitment, induction and training so that GP practices ensure staff have the right skills and support to provide effective care and treatment.
There are a number of different models of clinical supervision, including one to one, group or peer supervision, or a combination of these. The appropriate model will vary between different GP practices and the process should be developed by nurses and their managers according to local circumstances.A one-size-fits-all approach would not be appropriate for nurses working in general practice due to the varying clinical roles and size of nursing team within the practice.
Examples of clinical supervision in general practice might be:
- a regular meeting between a nurse prescriber and a GP to discuss prescribing practice and continuing professional development needs
- practice nurses having protected time to meet regularly to discuss professional issues.
Where a GP practice employs one nurse, a system should be in place to ensure he/she has the opportunity to receive appropriate clinical supervision; this might be by networking with neighbouring practices.
Training and continuing professional development (CPD)
In order to register with the Nursing and Midwifery Council (NMC) every three years, nurses must have undertaken CPD. This must be at least 35 hours of learning activity relevant to the nurse’s practice. The NMC also requires the nurse to maintain a personal professional profile that shows how the learning activity has informed and influenced practice. Practice nurses should be supported by their employer to fulfil these NMC requirements.
GP practices should ensure that staff, including practice nurses, have the skills, knowledge and experience to deliver effective care and treatment. This includes ensuring that:
- staff have the right qualifications, skills, knowledge and experience to do their job,
- their learning needs are identified
- they receive appropriate training
- they are encouraged and given opportunities to develop.
GP practices are responsible for ensuring staff are supported to deliver effective care and treatment, including through effective appraisal. Staff should have had an appraisal in the last 12 months and be able to describe the impact this has had on their practice. The appraiser will vary depending on the individual practice.
In a larger nursing team it is likely there will be a lead nurse or nurse manager who can fulfil this role, but in many GP practices this will not be possible and nurses’ appraisals will be carried out by a GP, a practice manager or both.
Nurses cannot legally practise in the UK unless they are registered with the NMC. A GP practice employing nurses must ensure that nurses they employ are registered before they begin work and their registration should be regularly checked throughout their employment. This includes locums and temporary staff.
If a nurse is an independent prescriber, this should be recorded on the NMC register. The employer should use the NMC registration confirmation service rather than relying on any paperwork the nurse provides as this is only valid on the day it was issued.
- Elaine Biscoe is national practice nurse advisor at the CQC
More CQC resources
- View the full CQC Essentials series on Medeconomics
- CQC's recommended reading to help practices meet regulations and prepare for an inspection