Scope of practice

The term has two layers. The first is the legal scope of a profession: what the law allows members of that profession to do, such as prescribing or carrying out certain procedures. The second is your individual scope: the part of that profession in which you personally have the knowledge, skills and experience to work safely.

The HCPC defines scope of practice as the limit of your knowledge, skills and experience, made up of the activities you carry out in your role. It says you must stay within it at all times, that it is not just a list of tasks, and that it is not tied to a pay grade.

• UK: the NMC Code requires nurses, midwives and nursing associates to recognise and work within the limits of their competence, ask for help with anything beyond it and complete training before a new role. The GMC's Good medical practice (2024) likewise says doctors must recognise and work within the limits of their competence. HCPC registrants sign at each renewal that they still meet the standards of proficiency for their scope.
• Netherlands: the BIG Act lists reserved procedures, such as surgical and obstetric procedures, injections and anaesthesia, and says which BIG-registered professions may perform them independently. Others may perform some only under the responsibility of a registered professional.
• USA: every state and territory has a nurse practice act describing nursing scope, and its board of nursing writes the detailed rules. Nurses must know the act for every state where they hold a licence. See state licensure.

In the Netherlands, registered nurses may also prescribe within their field of expertise and can have that authorisation shown on the register, an example of scope being recorded publicly.

Tasks that were routine at home may sit outside the legal scope of your profession in the new country, or need an extra qualification. Medicines are a common example: the HCPC notes that working with medicines is tightly restricted by law, and prescribing rights appear as annotations on the register. Your individual scope also resets: you may be highly experienced, but if a system, device or protocol is new to you, it is outside your scope until you are trained.

1. Identify the new activity and check it is within your profession's legal scope.
2. Complete the training your employer and regulator expect.
3. Gain supervised experience before working independently.
4. Record it as CPD and reflect on it.
5. Check your indemnity cover applies to the new work.

• Being asked to do tasks you did at home but are not yet trained or permitted to do locally.
• Assuming a job description defines your scope. Your regulator's standards and the law do.
• Practising outside scope, which can become a fitness to practise concern.