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Annexe A: Communication and relationship management skills

Last Updated 29/10/2026

The communication and relationship management skills that a newly registered nurse must be able to demonstrate to meet the proficiency outcomes outlined in the main body of this document are set out in this annexe.

Effective communication is central to the provision of safe and compassionate person-centred care. Registered nurses in all fields of nursing practice must be able to demonstrate the ability to communicate and manage relationships with people of all ages with a range of mental, physical, cognitive and behavioural health challenges.

This is because a diverse range of communication and relationship management skills is required to ensure that individuals, their families and carers are actively involved in and understand care decisions. These skills are vital when making accurate, culturally aware assessments of care needs and ensuring that the needs, priorities, expertise, and preferences of people are always valued and taken into account.

Where people have special communication needs or a disability, it is essential that reasonable adjustments are made to communicate, provide and share information in a manner that promotes optimum understanding and engagement, and facilitates equal access to high quality care.

The communication and relationship management skills within this annexe are set out in four sections. For the reasons above, these requirements are relevant to all fields of nursing practice and apply to all care settings. It is expected that these skills would be assessed in a student's chosen field of practice.

The skills outlined in Annexe A, Section 3: Evidence-based, best practice communication skills and approaches for providing therapeutic interventions, also apply to all registered nurses, but the level of expertise and knowledge required will vary depending on the chosen field of practice. Registered nurses must be able to demonstrate these skills to an appropriate level for their intended field(s) of practice.

At the point of registration, the registered nurse will be able to safely demonstrate the following skills:

1. Underpinning communication skills for assessing, planning, providing and managing best practice, evidence-based nursing care

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1.1actively listen, recognise and respond to verbal and non-verbal cues

1.2use prompts and positive verbal and non-verbal reinforcement

1.3use appropriate non-verbal communication including touch, eye contact and personal space

1.4make appropriate use of open and closed questioning

1.5use caring conversation techniques

1.6check understanding and use clarification techniques

1.7be aware of own unconscious bias in communication encounters

1.8write accurate, clear, legible records and documentation

1.9confidently and clearly present and share verbal and written reports with individuals and groups

1.10analyse and clearly record and share digital information and data

1.11provide clear verbal, digital or written information and instructions when delegating or handing over responsibility for care

1.12recognise the need for, and facilitate access to, translator services and material.

2. Evidence-based, best practice approaches to communication for supporting people of all ages, their families and carers in preventing ill health and in managing their care

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2.1share information and check understanding about the causes, implications and treatment of a range of common health conditions including anxiety, depression, memory loss, diabetes, dementia, respiratory disease, cardiac disease, neurological disease, cancer, skin problems, immune deficiencies, psychosis, stroke and arthritis

2.2use clear language and appropriate written materials, making reasonable adjustments where appropriate in order to optimise people's understanding of what has caused their health condition and the implications of their care and treatment

2.3recognise and accommodate sensory impairments during all communications

2.4support and manage the use of personal communication aids

2.5identify the need for and manage a range of alternative communication techniques

2.6use repetition and positive reinforcement strategies

2.7assess motivation and capacity for behaviour change and clearly explain cause and effect relationships related to common health risk behaviours including smoking, obesity, sexual practice, alcohol and substance use

2.8provide information and explanation to people, families and carers and respond to questions about their treatment and care and possible ways of preventing ill health to enhance understanding

2.9engage in difficult conversations, including breaking bad news, and support people who are feeling emotionally or physically vulnerable or in distress, conveying compassion and sensitivity.

3. Evidence-based, best practice communication skills and approaches for providing therapeutic interventions

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3.1motivational interview techniques

3.2solution focused therapies

3.3reminiscence therapies

3.4talking therapies

3.5de-escalation strategies and techniques

3.6cognitive behavioural therapy techniques

3.7play therapy

3.8distraction and diversion strategies

3.9positive behaviour support approaches.

4. Evidence-based, best practice communication skills and approaches for working with people in professional teams

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4.1Demonstrate effective supervision, teaching and performance appraisal through the use of:

4.1.1clear instructions and explanations when supervising, teaching or appraising others

4.1.2clear instructions and check understanding when delegating care responsibilities to others

4.1.3unambiguous, constructive feedback about strengths and weaknesses and potential for improvement

4.1.4encouragement to colleagues that helps them to reflect on their practice

4.1.5unambiguous records of performance

4.2Demonstrate effective person and team management through the use of:

4.2.1strengths-based approaches to developing teams and managing change

4.2.2active listening when dealing with team members' concerns and anxieties

4.2.3a calm presence when dealing with conflict

4.2.4appropriate and effective confrontation strategies

4.2.5de-escalation strategies and techniques when dealing with conflict

4.2.6effective coordination and navigation skills through:

4.2.6.1appropriate negotiation strategies

4.2.6.2appropriate escalation procedures

4.2.6.3appropriate approaches to advocacy.