Sue Clarke MSc, PGCE, BSc (Hons), RNProject Lead: Non-Medical Community

Workforce Development Project

AvOCETAction On Community Education and Training

Transforming the Out of Hospital Non-Medical Workforce

“AvOCET is important to me because it closes the gap between acute and out of hospital services”

South of England Nursing Workforce Summit 02nd July 2015

AvOCET Partners

What is AvOCET

Non-Medical Out of Hospital Workforce Development ProjectPuts the patient at the centre and listens to the providers of services and helps them define the skills, knowledge and values of their workforce.Recognises that new and transformed services require workforce to work and think in different waysChallenges professional and organisational boundariesPuts working in teams ahead of individuals

Before AvOCET

So - -

Providers of out of hospital services had little influence on education providers to supply the staff they needed to cope with the increasing complexity and

demand now and in the near future

Education commissioning was dominated by secondary care: influencing curricula and providing placements

Newly qualified staff not fit for purpose for out of hospital workforce

Hospital centric view of care, little Public Health involvement

Expensive and waste of valuable clinical time retraining to work in the community

Few first posts in community and general practice so recruitment an issue

Community and general practice not seen as dynamic, innovative, progressive

Lack of skilled staff to deal with policy move to treat and care for more people in the community

Practice Nurses

Specialist Practitioner (nurse or AHP)

Physicians Associate

Support Workforce Associate Practitioner

Apprenticeships

Community Up Skilling Volunteers and Carer Education

Integrated Development

Care Coordinator

Student NursesAHPsRTP

Practice Nurses

Specialist Practitioner

Primary Care Learning Network

Support Workforce

Care Coordinator

Student NursesAHPsRTP

Successes - - - so far

Community (wider workforce) Up Skilling Programmes

To demystify patient pathways AvOCET will pilot across health and social care workforce (working together, learning together)• A ‘Foundations of Integrated Care’ course• An ‘Integrated Front Line Leadership’ course

From July 2015, a carers hub will offer vital support, information and development for carers

Just starting a piece of work to look at system wide approach to a learning and development solution to the recognition of deteriorating physical health in mental health patients

In collaboration with voluntary sector, developed an induction and development framework for a new volunteer sign poster role.

Return on Investment

• Financial savings from use of non-medical workforce for aspects of GP role Band 8 ANP potential savings £31,255 per ANP

per year Band 7 PA potential savings £38,000 per PA per

year• Recruitment• Retention• Workforce pipeline • Reduce locum / agency costs• Students = improved quality

Care Coordinator(non clinical)

Designed a development framework for care coordinator role

Developed and added a new integrated care module – “context of service provision” to existing Health and Social Care Foundation Degree in Southampton Solent University.

Shared via Hampshire County Council across Hampshire vanguard sites

Primary Care Learning Network (PCLN)

Eleven surgeries working together as a PCLN

Collaborating with community care, social care, and voluntary sector

Produced a scalable framework to develop primary care to provide practice placements for pre-registration student nurses

Increased nurse mentors by 11 (and still going)

Met university quality requirements for practice placements

Student Nurses, Allied Health Professionals, Return to Nursing

Cohort of Post Graduate Diploma pre-registration student nurses undertaking a pilot 50% Out of Hospital facing placement plan

Primary care placements ‘wellness’ focussed

Exploring role of clinical specialist physiotherapist (respiratory) in primary care

Using HEE Return to Nursing process for primary care

Specialist Practitioners

Post Graduate Diploma Advanced Nurse Practitioner (ANP) programme for practice nurses

Three trainee advanced nurse practitioners now in place

Physicians Associate (PA) role in Primary Care

Developing role of primary care pharmacist

Practice Nurses

Employed 1st newly qualified practice nurse in our PCLN

Created preceptorship process for new practice nurses

Practice nurse representation on local primary care transformation project Accredited CPD for practice nurses

Support Workforce

Developed ‘common competences’ shared by health and social care support workers necessary to effectively assist frail people to live independently, live well and remain out of hospital

Using apprenticeship route to upskill primary care HCAs

December 2015 will be collaborating with local community Trust to develop assistant practitioners in primary care

ChallengesArticulating the vision 18 months ago – preparing for the futureGetting buy in from stakeholdersTemptation to maintain the status quo – “we just need more of the same”Maintaining the enthusiasm (and budget) when the initial gloss wore offMind-set – coproduction, collaboration – it is not us and them (especially when the going gets tough) but us!Being bold, adventurous and taking risks…

Just remember, diamonds are made under pressure!Stay Calm, and say - - - “bring it on”!

Any Questions?