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Diabetes Nursing


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Career and competency framework for diabetes nursing

Eileen Turner
, Margaret Tipson

An increase in the number of people with diabetes has resulted in a rise in the number of nurses involved in their care at different levels. This has highlighted the need to develop a career and competency framework for diabetes nursing. Several diabetes nursing interest groups and associations are now involved in a project designed to look into this issue, assessing the roles of diabetes nurses and identifying the key competencies required at their different career levels.

This paper aims to demonstrate and clarify the process that has been undertaken to begin to develop an integrated career and competency framework for diabetes nursing. The project is a collaboration, involving the Royal College of Nursing (RCN) Diabetes Nursing Forum, the RCN Paediatric Diabetes Interest Group, The UK Association of DSNs and Diabetes UK. It is supported by the RCN Practice Development Unit and led by Dr Kim Manley, Head of Practice Development.

The need for an integrated career and competency framework for diabetes nursing is highlighted by the current political context:

  • Agenda for Change (Department of Health, 1999) identifies three pay spines with six benchmarks for nursing: healthcare assistant, newly registered, practitioner, expert, consultant and executive nurse.
  • The need for leadership in specialist nursing.
  • The need for the development of standards.
  • The NHS Plan (Department of Health, 2000) identifies the need to demonstrate continuous quality improvement, and continuous effectiveness and competency.
  • An increased focus on work-based and lifelong learning, plus supervision.
  • The changing focus towards professional rather than academic accreditation.

The current group set out to address this need by first assessing what nurses saw their roles to be and then clarifying what competencies are needed at different levels of the nursing career.

Values clarification exercise
More than 50 nurses involved in providing diabetes care in different settings participated in a workshop in York. Three service users also participated so as to provide a patient perspective.

The participants worked on a values clarification exercise in small groups, responding to the following prompts:

  • I/we believe the purpose of diabetes nursing is…
  • I/we believe the purpose can be achieved by…
  • I/we believe the settings in which diabetes nursing can take place include…
  • Other values and beliefs I/we hold about diabetes nursing are…

Colleagues who were unable to attend the workshop were encouraged to participate in the exercise and send their contributions to the steering group.

Workshop evaluation
The steering group (facilitated by Dr Kim Manley) met to carry out a content analysis of the data set, in order to identify key themes from the values clarification exercise. The data were placed into categories and grouped into themes (Figure 1).

The key message identified from the York workshop was that:

Diabetes nursing is essential for people with diabetes

Interventions specific to diabetes nursing (see examples given in Figure 1) were then used in an attempt to clarify the specific competencies expected at different levels of the career framework. An illustrative example is given (Figure 2).

Where next?
The work undertaken by the steering group needs to be validated and developed by the York participants and a wider audience. Two further workshops are planned for York/Leeds and London in February  2003 (details to be confirmed). These workshops will aim to:

  • Validate the work to date.
  • Continue with competency development.
  • Identify how practitioners will demonstrate and get accreditation for the competencies. 

If you are interested in contributing to this work please contact any member of the steering group: 

  • Debbie Hicks
  • Lorraine Shaw
  • Margaret Tipson
  • Eileen Turner.

We acknowledge the financial support of Novo Nordisk, Lilly and Roche for this project.


Department of Health (1999) Agenda for Change: Modernising the NHS Pay System. DoH, London
Department of Health (2000) The NHS Plan; A plan for investment; A plan for reform. DoH, London

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