Launch of the Integrated Career and Competency Framework

The Integrated Career & Competency Framework for Diabetes Nursing (UK Association of Diabetes Specialist Nurses and Royal College of Nursing, 2005; Figure 1) was launched at the Diabetes UK Annual Professional Conference, Glasgow, in April 2005, after almost 5 years of collaboration between the professional bodies representing diabetes nursing, people living with diabetes and other key stakeholder groups.

The project was led by a steering group comprising representatives from the UK Association of Diabetes Specialist Nurses, the Royal College of Nursing (RCN) Diabetes Nursing Forum, the RCN Paediatric Diabetes Interest Group and Diabetes UK and had support from Dr Kim Manley and the Practice Development Team at the RCN. The work was funded by educational grants from Novo Nordisk, Eli Lilly and Roche Diagnostics.

Why did we need this framework?
Tipson and Turner (2002) stated that the development of the Integrated Career & Competency Framework for Diabetes Nursing was prompted by several contextual factors. These included health policy such as The NHS Plan (Department of Health [DoH], 2000), the need for vision and leadership in diabetes specialist nursing, an increased focus on work-based and lifelong learning and the shifting emphasis towards professional as well as academic accreditation.

In addition to these factors, the increasing number of people living with diabetes led to developments in systems of care, with a resulting rise in the number of nurses involved in diabetes care, across different levels and within a variety of care environments. This trend highlighted the need for guidance in respect of diabetes-specific skills and competences at a range of levels.

Development of the Framework
The development of the Framework began with a values clarification exercise facilitated by Dr Manley that allowed both generalists and specialist nurses, as well as those living with diabetes, to determine their values and beliefs about diabetes nursing. From this exercise, the purpose of diabetes nursing was defined and specific interventions at five levels were developed in order to achieve the stated purpose (Table 1). This process is more fully described by Tipson and Turner (2002).

Using the Framework
The Integrated Career & Competency Framework for Diabetes Nursing focuses on nursing care that is specific to managing diabetes and should be used in conjunction with generic frameworks that highlight core nursing skills and competences (Table 2) such as the RCN Core Competency Framework (RCN, 2004). The Framework should also be used alongside The NHS Knowledge and Skills Framework (DoH, 2004) in order to facilitate career progression. Additionally, the document is cross-referenced against the Diabetes National Workforce Competence Framework Guide (Skills for Health, 2004), which considers the multidisciplinary skills and competences needed by the workforce to deliver diabetes services across all healthcare and social care settings.

Although the foremost function of the Framework is to help nurses to deliver high-quality diabetes care and plan their professional development, the document can also be a useful guide for employers both in relation to expectations surrounding staff competences and as a constructive reference point for planning educational activity.

Conclusion
The Integrated Career & Competency Framework for Diabetes Nursing aims to help all nurses involved in diabetes care to achieve the purpose of diabetes nursing as defined by the participants involved in this project. As with all frameworks, its value will depend on how individuals choose to use the contents, but it is anticipated that constructive feedback from practitioners will result in a responsive, dynamic competency framework developed for, and used by, nurses involved in diabetes care.