How this supporting information applies to you
We know that the majority of our professionals conduct assessments safely and effectively and in line with our standards. We want to help those who engage in, or are considering, taking on the role of a nurse assessor for people who have made a claim for (but not limited to) NHS continuing healthcare (CHC), Hospital Based Complex Clinical Care (HBCCC) and Personal Independence Payments (PIP) to deliver the best and safest care.
Nurse assessors use their clinical knowledge and skills to assess the impact that a person’s health or disability has on their day to day life. They make recommendations which help to determine whether a person is eligible for financial support. They often work within a multidisciplinary team of health and social care professionals to conduct a comprehensive assessment of an individual’s care needs. They use a person-centred approach with the informed and active participation of the individual wherever possible.
This supporting information highlights the requirements that are most relevant to nurses conducting this type of assessment. These requirements are underpinned by the professional standards presented in the NMC Code that registered nurses and midwives in the UK, and nursing associates in England must uphold at all times.
You must act in line with the NMC Code in everything you do.
- All nurse assessors are accountable for their professional practice and must take individual responsibility for their decisions and actions.
The key considerations included in the Code that specifically apply when acting as a nurse assessor are:
- Being honest and acting with integrity at all times (see 20.2,The Code).
- Putting the interests of people in your care first (see 4, The Code).
- Having the right knowledge, skills and experience to conduct this type of assessment. This might mean completing additional education and training where necessary (see 6.2, 13.5 and 22.3, The Code).
- Working within the limits of your training and competence and in accordance with your professional scope of practice (see 13, The Code).
- Following relevant laws, frameworks and guidelines used for assessments, wherever you practise in the UK (see 20.4, The Code).
- Undertaking full and accurate person-centred assessments, ensuring you are knowledgeable about the individual’s health and social care needs (see 1 and 3, The Code).
- Not allowing any financial or commercial interests to affect your professional practice, decisions and actions (see 21.3, The Code).
- Obtaining and recording informed consent at each stage of the assessment process. If an individual does not have the capacity to give consent or make decisions, you must comply with relevant mental capacity legislation, wherever you practise in the UK (see 4.2, 4.3 and 17.3, The Code).
- Taking account of an individual’s needs, wishes and expectations (see 1.3, 1.5, 2, 2.1, 3 and 20.2, The Code).
- Working proactively in partnership with multidisciplinary and multiagency professionals, as appropriate, to follow the assessment process and make a recommendation of eligibility to the decision-making body (see 8, The Code).
- Recognising and respecting the contribution that different disciplines make from the very beginning of any multidisciplinary and multiagency assessment process, dealing effectively with differences of professional opinion in a considerate and professional manner (see 9.3, The Code).
- Keeping an accurate record of decisions and the reasons for them (see 10, The Code).
- Being open and honest if there has been a misunderstanding or where incorrect assumptions have been made and act to put the situation right (see 14, The Code).
- Acting on all concerns raised to you and cooperate with all investigation and complaints procedures (see 23 of the Code for more details and our joint guidance Openness and honesty when things go wrong: the professional duty of candour)
And you may find it useful to keep these key points in mind:
- As far as is possible, you should endeavour to be transparent with individuals, their carers and representatives about the assessment process and evaluation of an individual’s health and social care needs.
- Where possible, ensure that there is clarity between the individual, their family, carers or representatives (where consent is given) about the conclusion of the assessment.
- There may be occasions when an individual and their family disagree with the outcome of the assessment or what has been written. This does not always mean the outcome or what has been written is wrong or that anyone else would have done things differently. Listen and acknowledge the views of individuals and their families and effectively communicate the reasons for your recommendation.
- As far as is possible, have knowledge and understanding of the policies and protocols for making a complaint or appealing a decision about funding and be able to signpost individuals and families to the appropriate body and relevant sources of advice and support.
We encourage you to reflect on and review your practice against the NMC Code and act on any feedback you receive to improve your practice. You should do this as part of your continuing professional development (CPD) and revalidation and seek advice if you are unsure.
Remember, if at any time you feel that public safety is being put at risk or if you’re being asked to work outside of the requirements of the Code, your scope of practice or any other national standards, you’re empowered under the Code to speak up and raise your concerns (see 16.1 of the Code for more details and our guidance on raising concerns)
Other sources of information and guidance
Department of Health & Social Care (2022), National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care
Department for Work & Pension, PIP assessment guide part 1: the assessment process
Department for Work & Pension, DWP factual medical reports: guidance for healthcare professionals
Department of Health (2019), Northern Ireland Single Assessment Tool and Guidance
Care Information Scotland, Assessment of your care needs
Scottish Government (2014), Self-directed Support: Practitioners Guidance
Mygov.uk, Adult Disability Payment
Welsh Government (2022), Continuing NHS Healthcare, the national framework for implementation in Wales