Occupations and Terms of Reference › Practice nurse (immunisation, chronic care)
Universal terms of reference · POS-232 · version 1.0 · status: draft · next review 2027-10-27
Practice nurse (immunisation, chronic care)
To give immunisations and support people with long-term conditions, so that they stay well and protected in the community.
Each part of this page links to the related trainings, competencies and policies. The links are the same for every facility, so an organisation can see at a glance what a role requires and what it is trained in.
Job description
Job summary. You give vaccinations and support people with long-term conditions. You keep vaccines cold and safe, manage recall lists, monitor chronic care, and teach patients to self-manage.
Reports to: Family physician (GP) lead.
Leads or supervises: No direct reports.
What you do on a typical day
- Give immunisations to protocol.
- Manage the cold chain and stock.
- Run chronic care reviews.
- Manage recall lists.
- Teach self-management.
Working conditions and demands
- Vaccine safety and cold chain are critical.
- Patients may be anxious.
- Long-term follow-up.
What good looks like
- Immunisation is safe and recorded.
- Vaccine cold chain is intact.
- Chronic care reviews are on time.
Place in the organogram
Reporting line, from the top: see the organogram on the Occupations page. The lines above and below this role are listed in section 3.
1. Golden rules
These rules apply in every setting.
- Every client or patient is assessed before they start any service, and the service is adjusted to their needs.
- Services stay within the scope of training and licence; anything beyond it is referred.
- Consent is informed and recorded before any procedure or programme.
- Adverse events and complaints are reported the same day and learned from.
- Clients' privacy and records are protected at all times.
- Prices, claims and promotions are honest and match what is delivered.
- Staff are trained and competent for their role before they work alone.
- Where the client's health or safety is at risk, work stops and the right person is called.
2. Identification
| Item | Detail |
|---|---|
| Position code | POS-232 |
| ISCO-08 | 2221 (skill level 4) |
| ESCO | to map |
| Department | Ambulatory clinic |
| Facility types | Ambulatory |
3. Reporting line and working relationships
Reports to: POS-233. Supervises: .
| Works with | Nature of the relationship |
|---|---|
| Family physician (GP) lead | Clinical plans. |
| Infection prevention and control (IPC) lead | Cold chain and infection control. |
| Patient services manager | Recall and appointments. |
4. Key accountabilities
| Domain | Accountability | Evidence of delivery | Checked | Linked competencies | Linked trainings | Linked policies | Standards |
|---|---|---|---|---|---|---|---|
| Immunisation | Gives immunisations to protocol and records them. | Records complete 100%; audit at standard | Monthly | C-01 | T-05 | POL-SAFEG | 2 |
| Cold chain | Keeps the vaccine cold chain intact. | Temperature records complete daily | Daily | C-01 | T-05 | POL-SAFEG | 2 |
| Chronic care | Runs chronic care reviews on schedule. | Reviews on time 90% or more | Monthly | C-02 | T-08 | POL-EQUAL | 2 |
5. Decision rights
| The post holder decides | Consults or escalates |
|---|---|
| Immunisation schedule within national rules | Adverse reactions (family physician) |
| Recall order within the plan | Cold chain failure (IPC lead and pharmacist) |
6. Qualifications and experience
| ID | Qualification | Mandatory | Validity |
|---|---|---|---|
| Q-01 | Registered nurse licence, current | Yes | per regulator |
| Q-02 | Immunisation and chronic care certificate | Yes | Lifetime |
| ID | Experience | Minimum years | Mandatory |
|---|---|---|---|
| E-01 | Primary care nursing | 2 | Yes |
7. Training requirements
Recommended common practice. Each facility adapts the list to its national law. Essential items apply in every setting; recommended items apply where resources allow.
| ID | Training | Tier | When | Validity | Linked policies | Linked competencies |
|---|---|---|---|---|---|---|
| T-01 | Facility induction | essential | at_entry | Once | POL-WHISTLE · POL-EQUAL · POL-DATA | – |
| T-02 | Safeguarding adults | essential | periodic | Every 3 year(s) | POL-SAFEG | – |
| T-03 | Safeguarding children | essential | periodic | Every 3 year(s) | POL-SAFEG | – |
| T-04 | Data protection and confidentiality | essential | annual | Every 1 year(s) | POL-DATA | – |
| T-05 | Incident reporting and open disclosure | essential | periodic | Every 2 year(s) | POL-INC | C-01 |
| T-06 | Governance, accountability and assurance | recommended | periodic | Every 3 year(s) | – | – |
| T-07 | Emergency and major incident command | essential | annual | Every 1 year(s) | POL-INC | – |
| T-08 | Speaking up, inclusion and equality leadership | essential | periodic | Every 2 year(s) | POL-WHISTLE · POL-EQUAL | C-02 |
8. Health, fitness and language
| ID | Requirement | Frequency | Tier | Minimum in low-resource settings |
|---|---|---|---|---|
| H-01 | Immunity to vaccine-preventable diseases relevant to the setting, documented at entry | At entry or as set | essential | Documented hepatitis B status at entry |
| H-02 | Tuberculosis screening at entry, then as the national rule requires | At entry or as set | essential | Symptom screening at entry and after exposure |
| H-03 | Fitness-to-work assessment at entry and after serious illness or injury | Every 12 months | recommended | Fitness check at entry |
| Language | Level | Mandatory |
|---|---|---|
| Official language of the country of practice | professional | Yes |
| English | working | Yes |
9. Competencies by level
| ID | Competency | Foundation | Practitioner | Expert | Assessed by | Revalidate | Linked trainings |
|---|---|---|---|---|---|---|---|
| C-01 | Immunisation practice | Gives immunisations | Manages vaccine cold chain | Designs immunisation practice | Immunisation audit | Every 12 months | T-05 |
| C-02 | Chronic condition care | Reviews patients | Leads chronic care plans | Designs chronic care pathways | Chronic care audit | Every 12 months | T-08 |
10. Performance evaluation
- Probation: 6 months, with a sign-off review (recommended value).
- Appraisal: every 12 months against the competencies and indicators below.
| ID | Indicator | Target | Data source | Frequency |
|---|---|---|---|---|
| PI-01 | Immunisation records complete | 100% | vaccine records | Monthly |
| PI-02 | Cold chain records complete | 100% | temperature log | Daily |
| PI-03 | Chronic care reviews on time | 90% or more | care register | Monthly |
11. Career ladder and promotion
| Level | Role | Minimum experience to move on | Qualifications | Competency minimums | Trainings required | Assessment |
|---|---|---|---|---|---|---|
| Executive | Practice nurse (immunisation, chronic care) | 3 years (recommended) | Q-01, Q-02 | C-01 practitioner, C-02 practitioner | T-05 | Executive appointment and performance review |
12. Policies the post holder follows
Each policy is a standard template that the facility adopts and adapts. Templates are maintained centrally, so every facility works from the same version.
POL-SAFEG · Safeguarding adults and children
Purpose: Protect patients from abuse, neglect and harm, and make sure every concern is recognised and acted on.
Scope: All staff, volunteers and contractors.
Key rules:
Scope: All staff, volunteers and contractors.
Key rules:
- Recognise signs of abuse and neglect and record them factually.
- Report every concern to the designated safeguarding lead the same shift.
- Do not investigate alone.
- Share information only as the safeguarding procedure allows.
POL-DATA · Data protection and confidentiality
Purpose: Keep patient and staff information private, secure and used only for care and legal purposes.
Scope: All staff who access records or systems.
Key rules:
Scope: All staff who access records or systems.
Key rules:
- Access only the records needed for your work.
- Keep records secure; do not leave screens or paper unattended.
- Do not share information without a lawful basis.
- Report any breach to the data protection officer within 24 hours.
Linked trainings: T-10 · Review every 12 months · Template 0.1 (draft)
POL-WHISTLE · Speaking up (whistleblowing)
Purpose: Let staff raise patient safety or conduct concerns without fear of reprisal.
Scope: All staff.
Key rules:
Scope: All staff.
Key rules:
- Raise a concern with your line manager or the named speaking-up officer.
- If that route fails, escalate to the board or the national regulator.
- Retaliation against anyone who speaks up is a disciplinary offence.
- Concerns are recorded, investigated and the outcome given to the person raising them.
Linked trainings: T-01 · Review every 12 months · Template 0.1 (draft)
POL-EQUAL · Equality, diversity and inclusion
Purpose: Give every patient and colleague fair access, respectful treatment and reasonable adjustments.
Scope: All staff and patients.
Key rules:
Scope: All staff and patients.
Key rules:
- Treat every person with dignity regardless of background.
- Make reasonable adjustments, including interpreters, for language and disability.
- Report discrimination through the speaking-up route.
- Monitor access and outcomes by group.
Linked trainings: T-01 · Review every 24 months · Template 0.1 (draft)
POL-INC · Incident reporting and open disclosure
Purpose: Report and learn from incidents and near misses, and tell patients honestly when things go wrong.
Scope: All staff.
Key rules:
Scope: All staff.
Key rules:
- Report every incident and near miss the same shift.
- Give the patient and family an honest account and an apology where appropriate (open disclosure).
- Take immediate action to protect others.
- Learn: contribute to the review and follow the agreed actions.
13. Standards that name this role
14. Record history
| Date | Change | Approved by |
|---|---|---|
| 2026-10-27 | Draft record, batch 1 of the position build | Awaiting approval |