NMC Annexe B Nursing Procedures: How to Document Clinical Proficiencies

A practical roadmap for students and Practice Assessors to evidence procedural competencies accurately.

By Reportica Pulse Clinical Skills Faculty • Reviewed by Reportica Pulse Editorial Team • Last updated March 2026 • 10 min read

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Key Clinical Takeaway

NMC Annexe B specifies the mandatory clinical and procedural proficiencies every UK student nurse must demonstrate to register as a Future Nurse. Divided into Part 1 (procedures for assessing needs) and Part 2 (procedures for planning, providing and evaluating care), Annexe B covers invasive skills like venepuncture, cannulation, bladder catheterisation, ANTT, and enteral feeding that must be evidenced in Practice Assessment Documents (PAD/MYEPAD).

NMC Future Nurse Standards: Annexe A vs. Annexe B Proficiencies

Component	Annexe A (Communication & Relationship)	Annexe B (Nursing Procedures)
Primary Domain	Interpersonal skills, therapeutic relationships & de-escalation	Clinical interventions, physical examinations & diagnostic tests
Evidence Format	Reflective accounts, patient feedback & direct observations	Skills sign-off sheets, procedure checklists & supervisor countersignatures
Simulation Permitted	Rarely: requires live interpersonal clinical interactions	Permitted under ASPiH guidelines for selected invasive competencies
Core Clinical Examples	Breaking bad news, motivational interviewing, sensory adjustments	Aseptic Non-Touch Technique (ANTT), male catheterisation, blood cultures
Regulatory Foundation	NMC Standards of Proficiency (2018) Platform 2 & 4	NMC Standards of Proficiency (2018) Platform 4 & 6

Under the NMC (2018) Standards of Proficiency for Registered Nurses, Annexe B sets out the mandatory clinical procedures that every newly qualified nurse (NQN) must be competent to safely perform upon joining the register. Unlike previous curricula where certain invasive procedures were postponed to post-registration preceptorship, skills such as venepuncture, cannulation, male/female catheterisation, and nasogastric tube verification are now core pre-registration proficiencies.

1. Structure of Annexe B: Part 1 vs Part 2

Understanding how procedures are grouped in your PAD

Annexe B is divided into two clinical domains:

• Part 1: Procedures for assessing needs (e.g., 12-lead ECG recording, neurological Glasgow Coma Scale assessments, urinalysis, point-of-care blood glucose monitoring, respiratory peak flow).

• Part 2: Procedures for planning, providing and evaluating care (e.g., surgical aseptic non-touch technique, enteral nutrition, bladder catheterisation, chest drain monitoring, subcut/intramuscular injections, wound debridement).

2. High-Risk Procedures: How to Structure Audit-Proof Evidence

Avoiding rejection by university external examiners

When documenting an Annexe B skill in your e-portfolio, examiners expect four key elements:

1. Patient Consent & Capacity: Confirmation of valid informed consent and mental capacity assessment.

2. Infection Prevention: Explicit mention of hand hygiene (WHO 5 Moments) and standard/surgical ANTT compliance.

3. Procedure Execution: Correct equipment selection, patient positioning, and anatomical landmark verification.

4. Post-Procedure Monitoring & Escalation: Patient comfort assessment, safe sharps disposal (EU Sharps Directive 2010), and accurate documentation in clinical nursing notes.

Clinical Tip: Never log "Administered IV medication independently." Student nurses must always operate under the direct oversight of a qualified nurse when managing intravenous lines and controlled drugs.

Frequently Asked Questions

Can a skill be signed off in a simulation lab rather than real practice?

Certain university programmes permit simulated practice learning (SPL) for specific invasive skills where clinical exposure on placement is unpredictable (e.g., adult male catheterisation). Check with your Academic Assessor whether simulation sign-off is permitted in your specific PAD part.