Competency Achievement

The VeinTrain method is about setting you up to achieve competency and eventually go beyond comptency to expert practice.  We want you to share what we have taught you and what you know.  You attend a course with VeinTrain, gain the attendance certificate, request the accreditation certificate if required (additional fee), use your competency booklet to ensure theory and practice integration and application in your area, then once complete you are competent.  Easy! 




About the structured learning programme


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Route to Competency


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The programme has been developed by a group of healthcare professionals with an interest and expertise in venepuncture and cannulation. The aim of the programme is to provide a standardised approach towards training and assessment in order to encourage the use of these skills by well trained and appropriately placed members of the healthcare team. Additionally it should reduce the need for repeated training and assessments when practitioners move between healthcare organisations. NHS staff make the difference where it matters most and we have an obligation to patients and the public to enable them to make best use of their talents. Darzi (2008) High Quality Care For All: NHS Next Stage Review Final Report DoH. London. P 14

The pathway to competency is designed for multi-professional use and will provide learners with a structured, simple, but robust method of gaining competence and knowledge in venepuncture and/or cannulation, upon adult patients. Whilst the programme has been developed primarily for use within adult patient care, it can be adapted by healthcare organisations and specialities, to encompass competency achievement within specialised care areas, such as paediatrics and neonates. Once completed, the learner will have a solid foundation of knowledge and skills, with a record of their personal skill development, which can be recognised and therefore enable transfer of these skills across healthcare organisations.

The Authors of This Version:

Sarah Phillips (MD and Organisation Consultant). Former Lead Nurse, Multi-Professional Practice Education Chelsea and Westminster Hospital NHS Foundation Trust, London

Dr Lisa Dougherty OBE (Nurse Consultant IV Therapy), The Royal Marsden Hospital NHS Foundation Trust, London

Annie de Verteuil (Senior Clinical Skills Trainer), Royal Berkshire NHS Foundation Trust, Reading

Mary Collins (Lecturer Practitioner), Imperial College Healthcare NHS Trust, St Mary's Hospital

What is meant by competency?

Sarah Phillips our MD has debated and considered competency in practice and in the board room for decades.  The work she has done reflects the things learnt and are shared in the documents provided and presenations and teaching on VeinTrain courses.

At VeinTrain we believe the NMC offers excellent guidance by describing how to identify competent practice. It is more than a certificate; it is a whole process that the course along with a completed Structured Learning Programme provides:

"A bringing together of general attributes - knowledge, skills and attitudes. Skill without knowledge, understanding and the appropriate attitude does not equate with competent practice." NMC, 2008 guidance for delegation P3

Competence can sometimes be seen across a room.  However, in these skills it can be measured more precisely thanks to the objective structured clinical examiniation (OSCE).  This takes away the subjectivity involved with assessment within a complex situation.  We do find that experienced clinicans are harder on themselves during the supervised self assessment.  At other times senior clinicians can be harsh with junior staff who are struggling with one aspect of the skill.  The OSCE helps keep things focussed on the skill performance, while the theory and professional questions demonstrate wider and deeper understanding.


How do I demonstrate competency?

You will practice throughout the study day on the simulation equipment as well as palpation on each other so at the end of the day you will be well prepared to return to your clinical area to practice under supervision with patients. You will take your Structured Learning Programme away with you and use it as a passport to practice. It will take you from novice to expert using a simple and clear process. Theoretical knowledge is documented and all supervised practices are recorded by any competent practitioner in your clinical area. Once you are ready, a practitioner competent in these skills will do a final assessment with you. Ultimately you will have a clear record of your learning that you can use to demonstrate competence and use the same document when refreshing your skills or moving organisations.
The Structured Learning Programme has been adopted by over 40 NHS trusts and the whole of South Central SHA is a well recognized competency framework throughout the NHS. It was recently presented at NESC conference by Sarah Phillips who have adopted the booklet to help them improve practice in this field and encourage competency achievement. All learners who complete the booklet have their learning documented clearly including theory to practice. This method meets all the professional bodies' competency requirements. It also is learner focussed and considers organisational process. Most importantly it ensures the patient is safe from learning to competent and better still encourages a higher level of practice following competency achievement.

All our courses provide these booklets free of charge. 

Gaining competency after the study day

At Vein Train we recognise that to gain competency in these skills experience is vital so we ensure you not only leave the skills to practice safely with patients under supervision but we give you a Structured Learning Programme to help you on your way. You will also receive a certificate of attendance.   Certificates are easy to replicate but the evidence in the completed stuctured learning programme is clear about learning achieved and useful for revision.

If you take your booklet to a supervisor they are more likely to have seen it now there are over 60,000 in use.  This was the aim, to prevent skills stopping. A VeinTrain certificate of attendance is valuable too as our brand is known and Sarah Phillip's work is recognised in the field.

Competency booklet included when booking a Venepuncture and cannulation course.

How long does it take to get competent?

The theory section of the booklet can be completed soon after the study in about an hour. This is followed by a series of supervisions with patients until ready for a final osce (Objective Structured Clinical Examination.) Typically these range between 10 and 30 supervisions but can easily be 50 if required. Some learners coming back to the skill after a few years away, moving trusts or transferring from a similar skill base from can be assessed after as little as one or two supervised practices. It is really up to each individual and determined mostly by the learner.

Whether it takes you 10 practices or a 100 is irrelevant what is important is that you achieve competency at a pace that suits you. In reality it tends to be more related to how you feel. In Sarah's extensive experience of helping hundreds of learners achieve competency using this tool 3 weeks and between 10 and 30. It really depends on how frequently you can access the veins in a time frame that is neither too short nor too spread out.  


Why do I need to demonstrate competency?

Venepuncture and cannulation are two commonly practiced invasive procedures in the hospital and community setting that have remained unchanged despite technological developments of the past decades. These are not complex procedures, however there are a number of factors that contribute to correctly performing them, presented by the authors in this book. The wide variety of clinicians offering these skills to their patients is welcome and makes the most of the talent in the NHS, while offering patients choice and an efficient service. However, such diversity risks different types of practices evolving. It is therefore essential that a clear, concise yet informative text is available for clinicians to lead forward best practice in the most appropriate and informative way. 


 Forward in Phillips et al (2011)

Professor Lord Darzi PC, KBE, FMedSci, HonFREng

Professor Darzi holds the Paul Hamlyn Chair of Surgery at Imperial College London where he is Head of Division of Surgery. He is inter- nationally respected for his innovative work in the advancement of minimal invasive surgery and the development and use of allied tech- nologies. Research led by Professor Darzi is directed towards achieving best surgical practice through both innovation in surgery and enhanc- ing the safety and quality of healthcare. 

Organisation considerations:

  • "Intravenous cannula insertion will be carried out by trained and competent staff using strictly aseptic techniques" (DH, 2003).

Patient Considerations:

  • "Having a needle" was ranked as 6th most distressing during chemotherapy treatment. Coates et al (1983)
  • Repeated 1996 (Griffin, 1996) - Top 5 of side effects by women.



                                                        Competent Practice:

  • Nurses: "You must have the knowledge and skills for safe and effective practice when working without direct supervision" (NMC, 2008, p4)
  • Allied Health Care Professionals: "You must act within the limits of your knowledge, skills and experience and, if necessary, refer the matter to another professional" (HPC, 2004, p9).
  • Doctors: "You must keep your knowledge and skills up to date throughout your working life. You should be familiar with relevant guidelines and developments that affect your work. You should regularly take part in educational activities that maintain and further develop your competence and performance" (GMC, 2006, p12).
  • Health Care Support Workers: It is the responsibility of the employer or professional deciding to delegate to ensure appropriate training,
  • supervision and assessment. (NMC, 2008, p3).



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Managing Director, RN, Paramedic Training Co., Summer 2016

I just wanted to thank you and especially Paulette for an excellent course yesterday in Nottingham. I must say Paulette was a very skilled, experienced and professional trainer with a soft but firm manner. She expertly guided the conversation to learning points that related to the different work streams of the group, using her experience in the clinical field to support the students in their individual learning goals. A big thank you for a professional day.


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