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Presentation title
AHPs
into
Local
Action
Sarah Cooper
Clinical Fellow to the Chief Allied Health Professions
Officer
@sarahlcooper
12th November 2019 NHS England and NHS Improvement
2 | 2 |
The AHP community
#StrongerTogether
#WeAreAHPs
3 | 3 |
Suzanne Rastrick
Chief Allied Health Professions Officer for England
Beverley Harden
Lead Allied Health
Professional
Thomas Kearney
Deputy Chief Allied Health
Professions Officer
Policy and System
Transformation
Sarah Cooper
AHP Clinical Fellow
Dr Joanne Fillingham
Clinical Director Allied
Health Professions
Delivery and Innovation
Linda Hindle
Lead Allied Health
Professional &
Deputy Chief AHP Officer
Caroline Poole
Professional Head of AHPs –
Improving Care Paula Breeze
Amanda Hensman-Crook
AHP Clinical Fellows
Rosalind Campbell
AHP Workforce Productivity
lead
Improvement Directorate
Paul Chapman
AHP National Programme
Manager
Steve Tolan
Regional AHP Lead
London
Stuart Palma
Professional Head of AHPs –
Professional Leadership
Ally Roberts & Louise
Kenworthy
AHP Clinical Advisors
Denotes regional post
NHS England and NHS Improvement Health Education England Public Health England
Helen Ross
Senior Business and
Policy Manager
Aimee Robson
AHP Clinical Advisor
Laura Leadsford- Regional
Head of AHPs London
Helen Marriott - Regional Head
of AHPs Midlands and East
David Marsden – Interim AHP
workforce lead- North East &
Yorkshire
National AHP leadership
Laura Hammond
Hannah Lark
Vittoria Romana
AHP Clinical Fellows
Laura Charlesworth
AHP Clinical Advisor
Carrie Biddle – Leadership
Fellow South West
Lucy Lock- Leadership Fellow
South East
Naomi McVey - AHP workforce
lead- North West
4 | 4 |
AHPs into Action framework
5 | 5 |
The NHS Long Term Plan
Ambitions
4
1
•
• Doing things differently, through a new service model
2
• Preventing illness and tackling health inequalities
3 • Improve Care quality and outcome
for major conditions
4 • Backing our workforce
5
• Making better use of data and digital technology
6 • Ensure we get the most out of
taxpayers’ investment in the NHS
6 | 6 |
Priorities / Gaps alignment
System Processes People
Policy and Strategy
Systems and Commissioning
Workforce
Performance and Delivery
Prevention
Aligning Strategies and work programmes
for the future…
National Local
7 | 7 |
Chief Allied Health Professions Officer workstreams on a page
NHS England & Improvement
Professional Leadership
Leadership of Allied Health Professions in trusts: what
exists and what matters
National AHP Virtual network
Chief AHP Regional Leadership Conference
Clinical Leadership- a
framework for action
Policy and Strategy
Ensure government policy related to AHPs responds to the requirements of the
NHS Long Term Plan
Delivery of regulatory & statutory changes for
mechanisms for medicine supply/prescribing
Collaboration with HCPC on:
a) Legislative changes to entry level of Paramedics
to the register b)Practitioner use of social media c)Practitioner self referral to the regulator
Commissioning and Systems
AHP Digital Framework
Improving Care
Collaboratives AHPs Supporting Patient
Flow AHPs4Public Health
Quality Orthotics Closing the gap
Quick Guide: Allied Health Professions supporting
patient flow
Chief AHP Action Learning Sets
Investing in chief AHPs: insights from trust executives
Developing AHP leaders: a guide for clinicians and trust
boards
Job planning the clinical
workforce-allied health
professions
NHS electronic staff record
How to ensure AHPs are coded correctly
E job planning the clinical workforce: Levels of attainment and meaningful use standards
AHP Workforce
AHP Model Hospital compartment
Quick guide: AHPs
supporting people to live well with and beyond
cancer
Quick guide – AHPs
supporting the enhancing health in care homes
framework
Equality and Diversity
ICS AHP systems developing AHP Voice
and Supporting transitions to ICS
Primary Care Networks Guidance
Long Term Conditions Investment
Community Services Data Set
AHP Extended Role Mental Health pilots
#WearetheNHS
Commissioning guidance for rehabilitation
Improving the quality of orthotics services in
England
Sonography
Public Health England
UK Allied Health Professions Public Health Strategic Framework 2019-2024
AHP Public Health Strategy 2015-2018 Impact report
Guidance: Public Health content within the Pre-Registration Curricula for Allied
Health Professions
Driving forward social prescribing: A framework for Allied Health
Professionals
Health Education England
Multi-professional framework for advanced clinical practice in England
Making AHP Careers, careers of choice- The WoW show, Inspiring the future, NHS ambassadors , Virtual Reality AHP careers
work experience
Enabling the workforce to deliver and grow: Allied Health professions careers'
resource, Consultant practice workstream
Resources to help you promote AHP careers
8 | 8 |
‘AHPs should be represented in the
decision making processes for STPs
to ensure they have a strong voice
in the redesign of health, social and
the wider care system.’
Priority 1: AHPs can lead change
1
Doing things differently, through a new service model
9 | 9 |
Local AHP involvement &
strategies developed since AHPs
into Action
10 | 10 |
Newly emerging roles- Director of AHPs
11 | 11 |
Other leadership roles
12 | 12 |
Developing and sustaining AHP leadership capacity & capability
What leadership capability are providers
seeking and what is the leadership
development pathway for those leaders?
What trust boards should
consider
Trusts looking to strengthen
leadership arrangements
and subsequent benefits
should consider:
• Appointing a senior
AHP with a strategic
focus
• Harnessing the AHP
workforce’s potential for
system redesign
• Demonstrating AHPs’
value
What AHP leadership is currently in
place, and what is the impact on quality
and productivity?
13 | 13 |
It is essential that AHP professions are represented at the right forums in the organisation. Executive and senior clinical leaders need to understand the impact these professions have on patient outcomes, experience and patient flow and it is our job as AHPs to help them develop that understanding.
“I feel like I may have spent 20
years not appreciating what the
AHP workforce can contribute
(since putting a chief AHP role in
place).”
The number of trusts with chief AHPs has continued to grow. However, significant system-wide barriers remain to creating them.
Project sought honest insights from trust executives, who have a Chief AHP in their organisation
Overwhelming recognition that once chief AHP leadership is in place, the value and contribution of the AHP workforce is immediate.
Investing in clinical and AHP
leadership
14 |
Developing AHP leaders
Published 8th
October 2019
The guide has been developed for:
• AHPs with leadership aspirations
• those supporting the development
of future AHP leaders
• those developing AHP leadership
capacity and capability in their
organisation and system
• those supporting AHP workforce
appraisal processes
• career coaching and mentoring
conversations
15 | 15 |
National AHP Virtual Hub
• Chief AHPs from all 231 Trusts in England
• Over 60 discussion threads
• Over 200 documents/resources shared
• Forum for discussing Chief AHP relevant content, challenges, issues and sharing of resources
• 75 Sign ups for first wave of Chief AHPs Action Learning
Chief AHP Virtual network
• 20 Trusts signed up to a ‘deep Dive’ into T&O improvement
• Platform is used to work with the Trusts directly, provide resources and collect up to date data submissions
Trauma & Orthopaedics
Pathway Improvement Pilot
• A virtual space for STP/ICS AHP Councils
• Over 20 councils utilising the space
• Resource libraries and discussion forums
STP/ICS AHP Council
Networks
AHP Shelford (Safer
Staffing) Network
Digital AHP Forum
• Space for the Shelford Chief AHPS
• 95 ‘Nominated Digital AHP leads signed up
• Forum for discussing/sharing digital opportunities
16 | 16 |
AHPs supporting transition to integrated care systems
STP Executive
Leadership Group
STP LWAB
Clin
ical
Cab
inet
AH
P C
ou
ncil
STPs Collective Engagement
NHS Regional Delivery
AH
P R
eg
ion
al L
ead
ers
Gro
up
(Co
alitio
n)
• Written for STP / ICS systems
• Draws attention to AHP support and capability
• Outlines key areas of LTP for AHPs to support
transition to ICS
• Provides proposed architecture and engagement
of AHPs
17 | 17 |
AHPs role in Primary Care networks
• FCP guidance to the system being
developed
• GP contract details workforce need for
2500 paramedics and 5000
physiotherapists
• Regional governance and oversight is being developed
18 | 18 |
First point of contact
musculoskeletal roles in primary care
41
STPs in
England have
been tasked
with setting up
pilots
If you’re not a CSP member, please email [email protected] for access
19 | 19 |
‘AHPs are developing wider skills
which complement their specialisms
and provide flexibility.’
Priority 2: AHPs’ skills can be
developed further
4 Backing our workforce
20 | 20 |
Vision
Deliver an effective supply of AHPs, ensuring robust deployment and development of staff, whilst placing a focus on the
retention of the workforce, across professions and geography, to ensure the system has the right workforce with the right skills
in the right place to deliver high quality care by 2024.
Stimulate Demand Make AHPs a career of choice.
Increase Capacity Increase capacity, applications and acceptance on
AHP courses
Future Supply position
Support and pathways Explore and support different entry routes into AHP roles
Bridging the gap between education and employment
Effective Deployment Effectively deploy AHPs in a way that recognises the needs of the system and population
Support Development Support AHPs to develop throughout their career
Retention Support to the AHP workforce to retain AHPs – Making the NHS the best place to work
Enabling the workforce to
deliver and grow
The Interim NHS People Plan -
AHP workforce
Metric
As a result of our combined interventions there will be fewer AHP vacancies nationally with an ambition to improve aggregate
AHP vacancy rates to an operational position of 4% (current level, Feb 2019, 8.5%).
21 | 21 |
Making AHP careers, careers of choice
22 |
Supporting the transition between education and employment
23 | 23 |
The Four Pillars: • Clinical Practice • Leadership and Management • Education • Research
Advanced and consultant
practice
The ten year vision is:
• Consultant and Advanced Clinical
Practice roles are defined,
recognised, valued and supported
within the multi professional team
• All ACPs are credentialed, across
the range of service requirements
• Career pathway to ACP and
consultants role are in place
• Roles drive implementation of
personalisation, prevention and
service transformation
24 | 24 |
AHP prescribing, supply and
administration of medicines
Exemptions PGDs Supplementary
Prescribing
Independent
Prescribing
Dietitians
Occupational
Therapists
Orthoptists
Paramedics
Physiotherapists
Prosthetists and
Orthotists
Podiatrists
Therapeutic
Radiographers
Diagnostic
Radiographers
Speech and
Language Therapists
Current work:
• enable the use of patient group directions by
operating department practitioners to supply
and administer medicines
• amend of the list of controlled drugs that can
be prescribed by physiotherapist
independent prescribers
• amend of the list of controlled drugs that can
be prescribed by podiatrist independent
prescribers
• amend of the list of medicines that
paramedics can administer under
exemptions
25 |
Equality and diversity in the AHP
workforce
26 | 26 |
‘There needs to be routine collection of
consistent and comprehensive data on
the impact of AHPs on the quality of care
to individuals and populations.’
Priority 3: AHPs evaluate,
improve and evidence the impact
of their contribution
6 Ensure we get the most out of taxpayers’ investment in the NHS
Improve Care quality and outcome for major conditions 3
27 | 27 |
By 2021, NHS Improvement will support NHS trusts and foundation trusts to deploy electronic rosters or e-job plans.
A quarterly poll to AHP
Leads in acute trusts shows
progress is being made.
76 trusts are now in the
process of implementing job
planning for OTs, PTs, SLTs
and Dietitians.
28 | 28 |
Be AHP be counted – AHP Guide to ESR’
29 | 29 |
Priority 3: AHPs evaluate,
improve and evidence the impact
of their contribution
3 Improve Care quality and outcome for major conditions
30 | 30 |
AHPs evidencing the impact of their contribution
31 |
• Contributing to the national ambition to reduce longer lengths of stay (LLOS)
• 90-day improvement collaboratives (two cohorts)
• AHP leaders from 44 trusts/systems leading multidisciplinary/multiagency
improvement
• Range of new ways of working in the community, and at the front/back door
• 9.5% reduction in LLOS from cohort 1 trusts compared with 2.2% nationally
Enabling AHPs to lead change makes a tangible difference in patient flow
AHP Improvement Collaboratives
#QualityOrthotics #Homefirst
Coming soon #Personalisedcare
32 | 32 |
Quick Guide: Allied Health Professionals enhancing health for people in care homes
6. Support care homes to take structured approaches to common health issues to support demand management
5. Consider multi-professional approaches to support for care homes with high levels of demand on NHS services
4. Develop whole home approaches to commissioning
3. Understand ease of access to AHP services that cannot be delivered in the care home
2. Equity of access for people living in care homes
1. Review ease of access to AHP services
33 | 33 |
Use of outcomes in acute therapies
0%
5%
10%
15%
20%
25%
30%
35%
Does your commissioner require you to collect anyoutcome measures
Does your commissioner require you to collect any
outcomes measures
Dietetics
Occupational Therapy
Physiotherapy
Speech and Language therapy
No [PERCEN
TAGE]
Yes [PERCEN
TAGE]
Partial [PERCEN
TAGE]
Interoperability of AHP digital systems with wider health care
systems
34 | 34 |
Outcome measures used by acute therapies
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Dietetics Occupational Therapy Physiotherapy Speech and Language therapy
35 | 35 |
Evidencing the impact of AHP interventions
Current Challenges Path to Improvement Benefits
• Wide variety of measures used
• Lack of consistency in measures
used by AHPs in clinical pathways
• Availability / interoperability of
Data Systems
• Lack of visibility of impact of AHP
services at provider, ICS and
national level
• Inability to identify unwarranted
variation
• Reduction in number of
measures used
• Decreased burden on
practitioners
• Identification of unwarranted
variation
• Visibility of AHP impact at
provider, ICS and national level
• Improved patient care
• Selection of measures across
system and clinical pathways
• Use of a single PROM across
AHP services
• Integration of measure into
CSDS
• Data enabled AHP services
Clinical Outcomes
36 | 36 |
‘Clinically led improvement, enabled by new technology, is transforming the delivery of health care and our management of population health. Working with AHPs to develop appropriate technologies should be a priority.’
Priority 4: AHPs can utilise information and technology
5 Making better use of data and digital technology
37 | 37 |
Developing digital leaders
Launched April 2019
• First AHP Digital forum event – ‘Digital ready AHP
services’ held August 19
• Future AHP digital forum events to be held in next 6
months
Digitally Mature AHP Services
Digitally Enabled AHP Services
• Encouraging all Trusts to identify an AHP digital leader
AHP
Digital
Forum
38 | 38 |
Impact 1: improve the health and
wellbeing of individuals and
populations
“AHPs and service users, their families and carers must
work together and employ strategies to manage demand,
prevent dependency and support individuals and their
families to live healthy fulfilling lives at home, or as close
to home as possible, for as long as possible.”
2 Preventing illness and tackling health inequalities
39 | 39 |
• Impact report details progress made to embed public health into AHP practice
• Profile of AHP input to public health agenda raised
• All HEI’s include public health as part of pre- registration training
• Increased AHP research in public health
• New AHP strategy has emphasis on
developing AHP public health leadership
career pathways in public health
role of AHPs on public health in the workplace setting
AHPs4PH developed an animation about the new strategy
•
AHPs supporting prevention, health and wellbeing
40 |
Social prescribing a framework for AHPs
AHPs need to:
• Continue to embed holistic care
using social prescribing as part of
this.
• Connect with local link workers to
understand the applicable social
prescribing opportunities
• To champion social prescribing
and share good practice examples.
• Support social prescribing through
provision of services, pathways
development, training, supervision
or advice.
Social Prescribing Framework Launched 12th July 2019
41 | 41 |
AHPs Caring for those
that care
AHPs supporting recovery
in Mental health
AHPs making an impact in
Cardiovascular and
Respiratory disease
AHPs making impact in
Learning Disability and Autism
Coming Spring 2020
Call for evidence
42 | 42 |
“AHPs can significantly support the demand
profile the NHS faces ……..The Chief Allied
Health Professions Officer will further
develop the national AHP strategy AHPs
into Action to focus on the delivery of the
long term plan”
The NHS Long Term Plan 2019
43 | 43 |
References: 1. AHPs into Action 2. The NHS Long Term Plan 3. The NHS long Term Plan website 4. framework maximising appropriate use of care homes 5. Developing People Improving Care 6. Leadership of Allied Health Professions in trusts: what exists and what matters 7. Clinical leadership: a framework for action 8. Investing in chief AHPs: insights from trust executives 9. Chief AHPs’ virtual network – for access contact [email protected] 10.Developing AHP leaders 11.Investment and evolution: A five-year framework for GP contract reform to implement the NHS long term plan 12.Multi-professional framework for advanced clinical practice in England Musculoskeletal core skills framework 13.Person Centred Approaches E learning 14.Interim NHS People Plan 15.IPP future AHP workforce 16.The WoW Show Health Care special 17.NHS Ambassadors-inspire the future 18.Allied health professionals career resource 19.Multi-professional framework for advanced clinical practice in England 20.Job planning the clinical workforce-allied health professions 21.NHS electronic staff record – How to ensure AHPs are coded correctly 22.E-job planning the clinical workforce 23.Commissioning guidance for Rehabilitation 24.Quick guide: allied health professions supporting patient flow 25.Quick Guide: the role of allied health professionals in supporting people to live well with and beyond cancer 26.Nice into Action webinars 27.Act now e learning 28.Quick guide – AHPs supporting the enhancing health in care homes framework 29.A digital framework for Allied Health Professionals 30.The Topol Review 31.AHP Public Health Strategic Framework 32.AHP Public Health Strategy Impact Report 33.AHP Social Prescribing Framework 34.Allied Health Professions home page 35.NHS Improvement – Search ‘AHP’ for associated resources
Our Allied Health Professional Job Planning Journey
Nick Lane – Head of Therapies
Anneka Edmondson – Deputy Head of Therapies
Supporting Evidence
Staff survey feedback on satisfaction with balance of time for professional responsibilities
Retention & succession planning
Quality improvement drive
Re-launch of Trust supervision policy
Staff clinically ‘fire-fighting’
Clarity of true clinical capacity for staffing proposals
Clarity & consistency of expectations & accountability
Why did we embark on job planning?
Commenced August 2017
5 AHP professions: PT / OT / Podiatry / SLT/ Dietetics
Led by DHOT & Service Managers
Initial attendance at team meetings to introduce concept
Standardised format for all
Excel spreadsheet converted into word document at completion
1:1 for each staff member with Line Manager
‘Owned’ by staff member & linked to personal development plan
Reviewed at least annually at appraisal or when changes are indicated
Final sign off on any alterations by Manager
Our Approach
Categories:
- Supporting professional activity of self (SPA s)
- Supporting professional activity of others (SPA o)
- Indirect clinical care (IDCC)
- Direct clinical care (DCC)
- Managerial responsibilities (MR)
- Additional responsibilities (AR)
Responsibilities underpinning each category identified
Duration & frequency allocated
Expectations of activity within DCC discussed
Time converted into an ‘average’ working week timetable
Job plan Content
Example B7 Rheumatology OT
Job Plan
Lack of automated system/
– varying levels of IT literacy!
Early engagement of staff /
2 way process
Re-gaining focus on time /
activities outside of DCC
Challenges
“Please spend time discussing job plans individually especially with new starters so that they understand the importance and necessity of it. Staff felt initially confused when the job plans arrived in their in-box without having any prior knowledge of its purpose.”
“I think the job plan concept is great. I feel the documentation to complete it is off-putting for people. It is not very easy to understand so takes a lot of concentrating!”
“Difficult to implement job plans due to all the competing priorities. Staff understandably put patient care first & often prioritise this over their own developmental needs.”
Converting yearly time
allocations into a weekly timetable
Reduced clinical capacity
Keeping job plans ‘live’, up to
date & accurate
Perceived as a paper exercise
Challenges
“I feel the job plan is a great concept however a job plan on paper doesn't transfer into reality.”
“I am currently on a 6 month secondment in the community and my job has changed but my job plan hasn’t been updated.”
“The number of patients being seen will reduce and the list of patients waiting to see us will increasingly grow. Hope that this will improve services in the long run so be worth it though.”
Supports equity across common roles
Captures the broad contribution that AHP’s make
Supports professional registration requirements
Protects time for personal development of staff & service improvement activities
Gives clarity of clinical hours available and associated activity
Informs realistic staffing establishment requirements & skill mix
Identifies key differences between bands / roles & demonstrates USP’s
Supports clear expectations & accountability
Provides a common language
Benefits
Postgraduate study with training allocation in working hours
Duplication of responsibilities in Team Leader job share
Sharing of good practice between services - ‘askadietitian’ email
Inconsistent time allocations for the same task - MSK referral triage
Admin demands clinical specialist clinician service – Urogynae PT
Clinically facing hours out-stripped by meetings – Rehab Hospital Clinical Lead
Unclear expectations of activity quota in DCC hours – community SLT clinics
Enabling quality improvement via regular dedicated time - Podiatry plantar fasciitis
groups & one-stop nail surgery
Real-life Examples
Rolling out trials of ‘working to plan’ within services
Proposed job plans included within recruitment documents
Continued perseverance and priority given to embedding job
planning fully into the culture of the department
Creating the Therapies vision & underpinning priorities with linked
quality improvement projects in each service
ICS bid for capital funds to invest in e-job planning
Where are we now?
Team Job Plan Timetables
Job Plan Database
Dietetics Bands Headcount WTE WTE Hours Clinical care hours Expected weekly Contacts (G) Contacts in plan (P) CHtC (G) CHtC (P) % DCC hrs
Acute 7 (TL) 1 0.91 34.00 19 24.32 15 0.78 1.27 56%
7 (CS) Renal 2 1.00 37.50 27 34.56 35 0.78 0.77 72%
7 (CS) CF 1 0.60 22.50 14 17.92 16 0.78 0.88 62%
6 3 2.85 106.88 83.6 107.01 95 0.78 0.88 78%
6 Cat 1 1.00 37.50 15.5 19.84 21 0.78 0.74 41%
5 1 1.00 37.50 33 42.24 36 0.78 0.92 88%
4 1 1.00 37.50 33 42.24 36 0.78 0.92 88%
3 2 1.39 52.13 47.5 60.80 49 0.78 0.97 91%
Totals: 12 9.75 365.5 272.60 348.93 303.00 75%
“Gradual process to implement culture change in department. Needs to become
meaningful to staff & they need to see an end result. They need to set out
realistic times for CPD opportunities / projects and allow those to be booked in &
reviewed at appraisal to prove they are using the time allowed and evidencing it.
If we utilise them effectively we will start to get more meaningful reports on
capacity and demand in order to form the basis of business cases moving
forward but also to outline the service we can realistically provide. Provides more
transparency across the board.”
Band 7 Clinical Lead Physiotherapist
Culture Change
Interactive process
Consistent language, methodology & approach
Don’t over-complicate
Leadership
Harness ‘champions’ in each area
Allow plenty of time
Job planning code
Identify the value job planning will bring to your organisation & the individuals working within it; sell the vision. Far more than just a piece of paper!
Key Messages
Thankyou for listening.
Any questions?
Overcoming the challenges of recruitment and retention via a
collaborative approach
Angie Abbott
Head of Podiatry and Orthotics
Torbay and South Devon NHS Foundation Trust
Regional Podiatry Manager Forum Chair
The Situation
• Dwindling applicants for BSc Hons podiatry programme.
• History of poor application rates compared to other Allied Health Professions
• September 2016 tuition fees introduced and bursaries withdrawn
• 2016-17 UCAS applications down 5% for UK students
• 2017-18 Students studying podiatry down 12% in UK
• Aging workforce profile
• Vacancies across South West
Nationally recognised as small vital AHP profession
• Couldn’t wait for National work streams
• Pace important
• Forum in place
• Required a Collaborative approach
Birth of stakeholder group March 2018
• Presented case for change
Collaborative and collective approach
• HEE
• Managers
• Education providers
• Commissioners
• Organisational workforce teams
• Apprentice leads
Round table discussion
World café x 3 questions
Good practice and where its happening
Gaps and local priorities
National work streams
Barriers
Solutions
Presentations
• Education providers
• Workforce Analysis and data
• Heads of professions
• Education and training teams
• Apprentice leads
• HEE
Key work-streams
• Attracting people to profession
• Influence and impact
• Retention and leadership and educational development
• Future direction and leadership
Action plan
• Attracting people to podiatry • Retention/leadership and educational
development • Influence and impact
• Models of care shared portalhttps://modelsofcare.co.uk/collaborationspace/146
Attracting people to Podiatry
• Future supply options
• Integrated Degree Apprenticeship standard released Feb
2018
• Band 4 Assistant practitioner FdSc
• Virtual reality – day in the life of
• Story book
• Careers fairs
• Paid work experience pilot
• Return to practice
Retention/leadership and educational development • Trust level escalation • Research and innovation • 15s 30m.co.uk an quality Improvement initiative
#LetsQItogether with #15s30m • Preceptorship national programme of work- Carrie
Biddle HEE, Katie Collins COP
• FIKA/ staff wellbeing • Mentorship, rotational schemes and shared
learning.
Influence and Impact
• Workforce plans
• Risk registers
• CCG engagement
• Private providers
Our first story book Grandad Gerald’s Poorly Toe
Achievements to date
• Expansion of FdSc Assistant practitioner distance learning under apprenticeship
• Development of course content for BSc Hons podiatry apprenticeship course. Blended learning.
• Paid work experience
• VR day in the life of
Next Steps
• Support for managers and staff for next phase of the journey.
Thank you for listening
Questions?
Non-Medical Prescribing Sally Jarmain
Clinical Fellow
Non-Medical Prescribing in the UK
@NHS_HealthEdEng
1990 2000 2010 2020
Community
nurse
prescribers
under
careplan
Community
nurse
prescribers
under
formulary
Supplementary
radiographer,
podiatrist,
physiotherapist
prescribers
Independent
nurse and
pharmacist
prescribers
Independent
therapeutic
radiographer and
supplementary
dietitian
prescribers
Independent
podiatrist and
physiotherapist
prescribers
Independent
paramedic
prescribers
AHP Medicines Project
@NHS_HealthEdEng
In 2009, the Department of Health commissioned the Allied Health
Professionals Prescribing and Supply Mechanisms Scoping Project Report.
Phase 1
Independent prescribing by Physiotherapists and
Podiatrists.
The amendments to legislation were laid in 2013.
Development of statutory public consultation
8 week public consultation
CHM – consideration & recommendations
Changes to legislation
Approval of training programmes as needed
Preliminary work to identify case of need • Scoping project
• Business cases
• Non-Medical Prescribing Board
AHP Medicines Project
@NHS_HealthEdEng
.
Phase 2
Commenced in 2013.
• Use of exemptions by orthoptists
• Supplementary prescribing by advanced dietitians
• Independent prescribing by advanced paramedics
• Independent prescribing by advanced radiographers
(therapeutic and diagnostic)
Chief Professions Officers’ Medicines
Mechanisms Programme
• In 2015 NHS England commissioned the Chief Professions
Officers’ Scoping Project
• Aimed to identify potential for expansion of the
use of medicines mechanisms to further
professions
• The resultant report (2017) recommended
a number of healthcare professions to be
considered for extension of medicines
responsibilities
CPOMM Workplan
Lists Project
• Amendment of the list of controlled drugs that can be prescribed by:
• Physiotherapist independent prescribers
• Podiatrist independent prescribers
• Amendment of the list of medicines that paramedics can supply/administer under exemptions
Exemptions Project
• Use of exemptions by:
• Dental therapists
• Dental hygienists
PGD Project
• Use of Patient Group Directions by:
• Biomedical scientists
• Clinical scientists
• Operating department practitioners
AHP Medicines Project
• Independent prescribing from a specified list of controlled drugs by:
• Paramedics
CPOMM Programme
Controlled Drugs
Physiotherapist Independent Prescribers
Current:
Morphine
Fentanyl
Oral Diazepam
Dihydrocodeine
Lorazepam
Oxycodone
Temazepam
Proposed additions:
Codeine
Tramadol
Pregabalin
Gabapentin
Controlled Drugs
Podiatrist Independent Prescribers
Current:
Diazepam
Dihydrocodeine
Lorazepam
Temazepam
Proposed additions:
Morphine
Tramadol
Pregabalin
Gabapentin
Controlled Drugs
Paramedic Independent Prescribers
Current:
Proposed additions:
Morphine
Diazepam
Midazolam
Lorazepam
Codeine
Controlled drugs changes
Eight week consultation on
proposals
Presentation of proposals and report
of consultation findings to CHM and
ACMD
CHM makes recommendations to Ministers regarding
changes to the Human Medicines
regulations
The ACMD makes recommendations to Ministers regarding
changes to the Misuse of Drugs
regulations
Number of NMPs in the UK
Supplementary
Prescribers
Independent
Prescribers
Nurse 39904* 40941
Pharmacist 308 9000
Physiotherapist 118 1017
Podiatrist 71 376
Paramedic - 194
Diagnostic Radiographer 24 -
Therapeutic Radiographer 123
Dietitian 89 -
*Community Nurse Practitioner Prescribers
What does the future look like?
• Dietitian Independent Prescribers
• Psychologists
• Physician’s Associates
• Advanced Practice
• Generalist versus Specialist
What can you do?
Support each other
Share what you are doing
Talk to your professional body
Be creative and curious!
@jarmain_sally
07805 848283
Contact details
@NHS_HealthEdEng
