Domain 4:

Leadership,
management and
team working

Page 4
 Domain 4: Leadership, management and team working
Competency Point of entry: Multi-choice Exam: Multi-choice Exam: OSCE's:
Essential knowledge, understanding and skill application required Generic Generic applied to nursing field Suitable items for testing
Essential skills cluster number and point specific

Competency 1. Responds appropriately when people want to complain, providing assistance and support.
All nurses must act as change agents and provide leadership through quality improvement and service OAC 12,2
development to enhance people's wellbeing and experience of healthcare. Y Y E*

Shares complaints, compliments and comments with the team in order to improve care.
OAC 12,5.

As an individual team member and team leader, actively seeks and learns from feedback to
enhance care and own and others professional development
OAC 12,8 Y Y Y

Actively consults and explores solutions and ideas with others to enhance care.
OAC14,6.
Y Y

Challenges the practice of self and others across the multi-professional team.
OAC,14,7
Y Y

Appropriately reports concerns regarding staffing and skill mix and acts to resolve issues that
may impact on the safety of service users.
OAC,17,9 Y Y

Reflects on and learns from safety incidents as an individual and as a team member and
contributes to team learning.
OAC,18,9 Y

Challenges others who do not follow procedures. NFM.30,5.

Participates in clinical audit to improve the safety of service users.

OAC,18,10
Y Y

Competency 2. Evaluates the effect of interventions taking account of people's and carers' interpretation of
All nurses must systematically evaluate care and ensure that they and others use the findings to help physical, emotional and behavioural changes.
improve peoples' experience and care outcomes and to shape future services. OAC,10,9 Y Y E

Acts autonomously and takes responsibility for collaborative assessment and planning of care
delivery with the person, their carers and their family.
OAC9,13. Y

Involves the person in review and adjustments to care, communicating changes to colleagues.
OAC10,10.
Y E
Competency Point of entry: Multi-choice Exam: Multi-choice Exam: OSCE's:
Essential knowledge, understanding and skill application required Generic Generic applied to nursing field Suitable items for testing
Essential skills cluster number and point specific

Competency 3. Prioritises the needs of groups of people and individuals in order to provide care effectively and
All nurses must be able to identify priorities and mange time and resources effectively to ensure the efficiently.
quality of care is maintained. OAC10,7. Y Y

Actively responds to feedback.

OAC12,6
Y

Demonstrates effective time management.

OAC17,7
Y

Manages time effectively.

OAC 16,5
Y

Negotiates with others in relation to balancing competing and conflicting priorities.

OAC16,6.
Y Y

Ensures that appropriate food and fluids are available as required.

NFM.30,8.
Y

Ensure appropriate assistance and support is available to enable people to eat.

NFM30,6.
Y

Manages overall environment to minimise risk.

IPC 22,11.
E

Competency 4 . Acts professionally to ensure that personal judgements, prejudices, values, attitudes and beliefs
All nurses must be self-aware and recognise how their own values, principles and assumptions may do not compromise care.
affect their practice. They must maintain their own personal and professional development, learning CCC3, 4. Y Y E
from experience, through supervision, feedback, reflection and evaluation.

Is acceptant of differing cultural traditions, beliefs, UK legal frameworks and professional ethics
when planning care with people and their families and carers.
CCC4, 5. Y E

Has insight into own values and how these may impact on interactions with others.
CCC5, 10.
Y Y

Recognises and addresses deficits in knowledge and skill in self and others and takes
appropriate action.
OAC15, 5. Y E E
Competency Point of entry: Multi-choice Exam: Multi-choice Exam: OSCE's:
Essential knowledge, understanding and skill application required Generic Generic applied to nursing field Suitable items for testing
Essential skills cluster number and point specific

Bases decisions on evidence and uses experience to guide decision-making.

OAC16, 3.
E Y

Competency 5. Acts as a positive role model in promoting a professional image.

All nurses must facilitate nursing students and others to develop their competence, using a range of CCC1,10.
professional and personal development skills. Y E

Acts as an effective role model in decision making, taking action and supporting others.
OAC14, 9.
Y E

Prepares, supports and supervises those to whom care has been delegated.
OAC15, 4.
Y

Takes responsibility and accountability for delegating care to others.

OAC15,3
Y Y

Acts as a positive role model for others.

OAC16,4
Y Y

Inspires confidence and provides clear direction to others.

OAC16, 1.
Y

Competency 6. Works autonomously, confidently and in partnership with people, their families and carers to
All nurses must work independently as well as in teams. They must be able to take the lead in ensure that needs are met through care planning and delivery, including strategies for self care
coordinating, delegating and supervising care safely, managing risk and remaining accountable for the and peer support. Y Y Y
care given. CCC2,13.

Acts as a role model in developing trusting relationships, within professional boundaries.

CCC1,11
Y Y

Actively consults and explores solutions and ideas with others to enhance care.
OAC14, 6.
Y Y

Works inter-professionally and autonomously as a means of achieving optimum outcomes for

people.
OAC14,10. Y Y

Safeguards the safety of self and others, and adheres to lone working policies when working in
the community setting and in peoples homes.
OAC14,11. Y
Competency Point of entry: Multi-choice Exam: Multi-choice Exam: OSCE's:
Essential knowledge, understanding and skill application required Generic Generic applied to nursing field Suitable items for testing
Essential skills cluster number and point specific

Works within local policies when working in the community setting including people's homes and
ensures the safety of others.
OAC17,12 Y

Identifies suitable alternatives when isolation facilities are unavailable and principles have to be
applied in unplanned circumstances.
IPC23,8. Y

Ensures that people including colleagues are aware of and adhere to local policies in relating to
isolation and infection control procedures.
IPC,23,7 Y

Works within national and local policies and ensures others do the same.
MM40,2
Y

Works confidently as part of the team and, where relevant, as leader of the team to develop
treatment options and choices with the person receiving care and their carers.
MM.35,9 Y

Works within the requirements of the code (NMC 2008) in delegating care and when care is
delegated to them.
OAC15, 2. E

Competency 7. Assists in preparing people and carers for transfer and transition through effective dialogue and
All nurses must work effectively across professional and agency boundaries, actively involving and accurate information.
respecting others' contributions to integrated person-centred care. They must know when and how to OAC13,1. Y Y Y
communicate with and refer to other professionals and agencies in order to respect the choices of
service users and others, promoting shared decision making, to deliver positive outcomes and to
coordinate smooth, effective transition within and between services and agencies. Reports issues and people's concerns regarding transfer and transition.
OAC13,2.
Y

Assists in the preparation of records and reports to facilitate safe and effective transfer.
OAC13,3.
Y
 Online Resources
Below are some useful online links which can be used to support preparation for the NMC's Test of Competence (A - Z). These online
links are not exhaustive, and many other useful sources will exist. The links are designed to help candidates identify gaps as they explore
each domain and competence. Candidates should consider the need for revision and consolidation of knowledge before taking the test of
competence. Please copy and paste the links into your web browser to access the information.
http://patientsafety.health.org.uk/resources
http://personcentredcare.health.org.uk/?gclid=CKGZhcq_x8ACFZMRtAod-xoAbQ
http://www.england.nhs.uk/ourwork/qual-clin-lead/clinaudit/
http://www.flyingstart.scot.nhs.uk/learning-programmes/safe-practice/clinical-governance/
http://www.hscic.gov.uk/clinicalaudits
http://www.legislation.gov.uk/uksi/2001/3998/contents/made
http://www.nhsbsa.nhs.uk/Documents/SecurityManagement/Lone_Working_Guidance_final.pdf
http://www.nmc-uk.org/Nurses-and-midwives/Revalidation/
http://www.patientsafetyfirst.nhs.uk/content.aspx?path=/
http://patientsafety.health.org.uk/
http://www.rcn.org.uk/development/practice/clinical_governance/
http://www.rcn.org.uk/development/practice/infection_control
http://www.rcn.org.uk/development/practice/principles/the_8_principles/principle_b
http://www.who.int/topics/infection_control/en/
https://www.evidence.nhs.uk/search?q=patient%20transfer%20between%20hospitals
https://www.rcn.org.uk/__data/assets/pdf_file/0004/377365/Nursing_Standard_Principle_D_April11_560KB.pdf
https://www.rcn.org.uk/development/practice/clinical_governance/leadership