Innovations in Nursing Conference

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Innovations in Nursing Conference

• Sally Bassett
• Nursing Advisor Department of Health

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Changing public expectations

• not a passive victim of illness
• A decision maker
• A care manager
• A co-producer of health
• An evaluator of quality
• An active citizen, voter taxpayer
• (Source The Autonomous Patient Angela Coulter)

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Demographics

• Ageing population - gt 65 doubled since 1930s
• Changing pattern of disease
• Changing health priorities
• Less emphasis on acute care
• Changing workforce

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Changing health needs

• Focus on public health
• 17.5 million people with one or more long term
  conditions
• Co-morbidity is common
• Poly pharmacy is common
• Many people have complex needs
• Poor anticipatory care people are admitted to
  hospital, there are gaps in provision, people are
  having a poorer quality of life

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Putting the person at the centre

• Huge cultural shift to develop a system that is
  patient led and professionally supported
• Choice and information are central
• Patients voices are truly heard
• Independent inspection driving up quality

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Policy context
New white paper
The NHS Improvement plan
Agenda for change
Liberating the Talents
Workforce Demographic lifestyle changes
Person Centred Care
New GMS Contract
Building On The Best
Practice Based Commissioning
Long Term Conditions
Choosing Health
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Nursing constants

• Caring
• Co-ordinating
• Teaching
• Developing programmes of care
• Technical
• Concern for those who are ill and those who are
  currently well
• Special responsibility for the frail and
  vulnerable

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New roles new opportunities

• Community Matrons
• Nurse Entrepreneurs
• Nurse Partners
• Nurse led organisations providing general medical
  services
• Nurse led organisations focussed on specific
  disease pathways and long term conditions
• Nurses forming limited companies and enterprises

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(No Transcript)
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Inverting the triangle
S p e c a I l s t s
Level one self care/self management 70-80
Level 2 Specialist disease management 15-20
Level 3 5
Community matrons
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Who is the community matron?

• An experienced nurse who provides advanced
  nursing care and case management to people with
  multiple complex long term conditions
• Reducing fragmentation of care
• Undertaking nursing, medical and social care
  assessment to initiates interventions to improve
  quality of life, maintain well being and manage
  the acute execrations of chronic illness e,g IV
  hydration and antibiotic therapy,

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Case management competences frameworkfor the
care of people with long term conditions
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Competences management framework
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Competences management framework
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Issues to consider

• Ensure that you are developing roles in
  accordance with the patient pathway and
  commission accordingly.
• How will specialist nurses and community matrons
  work in partnership together to provide
  personalised care?
• How will the operational systems be developed to
  support the delivery of personalised care?
• How can the case management framework be used by
  others?
• How will patient choice be offered and provided?
• How will information be shared to inform the
  provision of personalised care?
• Is there a clear view on how to maximise the
  contribution of specialists in an integrated way?
• What will the rest of the workforce need to look
  like to support the implementation of the LTC
  framework
• How will self case management be promoted,
  sytamitised and consistently provided to people
  with LTC

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Reflection points

• Are you involved in developing this agenda?
• Are you working without walls are all the key
  stakeholders engaged?
• Do you know the criteria for the VHIUs
• Have you made contact with your local Community
  Matrons?
• Do you know how will you contribute to the
  commissioning of services at all levels?