Nail Care

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Developing Implementing a new role A
Partnership Development Marion Rogerson
(Former NHS Commissioner)
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Other Stakeholders
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A Head of Steam

• NHS podiatry had discharged 4,000 people who
  needed routine nail cutting 3 years earlier
• This grey lobby were vociferous in their
  lobbying contacted health, social care, local
  politicians and the media
• Lobbying groups wanted a free service or at
  least a very uniform pricing structure
• Social Care wanted the political issue off
  their backs and offered 25,000 over three
  years to fund nail cutting (didnt renew the
  budget 3 years later )
• A Director of Strategy (Commissioning) offered
  125,000 to bring nail cutting back into the NHS
  ......... BUT
• The Head of Podiatry had had the CEOs support to
  discharge 4,000 people in order to re-profile the
  service and allow for growth in need and wasnt
  going to take nail cutting back

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A new role with new responsibilities

• Development Challenges were
• Defining what the role would (and wouldnt) do
• Having time to reflect in a busy world / thinking
  outside the box other industries / models
• Creating a service that was sustainable (50k
  max budget in to the future with growing need)
• Creating a contract of (quality)standards
  (Lawyers)
• Implementation Challenges
• Helping others to understand the model eg
  Pharmacies and GP practices
• Introducing the new training and role and
  trusting we had done the right thing!

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Securing an Education Provider

• Finding someone to design and deliver the
  education and training for the role
• Vested interests can cause barriers learned
  that individuals can make things happen (you just
  have to find them!)
• Quid pro quo we offered creation of the Nail
  Care logo as a project for students at the local
  college. The Head of Art and Design gave us a way
  into Hair and Beauty
• Little profit so ......Find individuals who
  understand or who have a passion. How many of you
  have had to cut a relatives toenails? How many of
  you wanted to?

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Recruiting to the course

• Avoid calamity and complaint early on
• Tried to get a variety of mature people on the
  first course
• Home visits, day centres, walk in service
• About sustainability and not relying on training
  people from one background or type of employer
• Learned a lot from the first course
• Subsequent courses required attendees (or their
  employers) to pay half the fee
• We changed the order subjects were taught
• People wanting to attend the course had to
  complete a questionnaire e.g. Do you like feet?
  (youd be amazed)

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Supporting Nail Carers and their clients

• Seizing opportunities to develop the service -
  Non NHS but a health related role investing
  time and effort in addressing the queries and
  concerns of Nail Carers
• Used funding to support with CPD help line
  contract of standards (for Birmingham Nail
  Carers) web site (25k then 50k)
• Independent Nail Carers ( we never could set that
  uniform pricing structure)
• Nail Carers in domiciliary care
• Nail Carers in social care
• Nail Carers in day centres
• Nail Carers in pharmacy/GP services
• Insurance
• Marketing 2 for the price of one introduce a
  friend and get a free nail cut! NB No
  legislation or regulations apply! Common sense
  makes sense!
• Developing the customer base trust,
  familiarity, quality service at the right price

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What have we achieved?

• Helped to keep people comfortable and mobile
• Helped to prevent trips and falls
• Given some isolated clients a new lease of life
  ly isolated

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Working with Skills for Health

• We knew we had a model that worked and we wanted
  to enable our good practice to spread
• Saw education as key
• SfH supported us with their expertise to
• Develop the Transferable Role Template for Nail
  Care
• Engage with potential Awarding Organisations
• Develop the Accredited qualification with 3 AOs
• Evaluate the Nail Care role and look at future
  impact

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Judging Success

• Informally keeping in touch, CPD, Nail Carer
  of the Year award, no complaints, clients keep
  coming (and paying)
• Quantitative - waiting times for routine NHS
  Podiatry have fallen from almost 2 years down to
  just a few weeks
• Over 120 nail carers have been trained to date
  (estimate that 100 are active)
• Estimated 5,000 clients
• Value of the business estimated at 250,000 per
  annum
• Lots of room for growth.
• Potentially lots of wider health benefits
  (although these are difficult to measure)
• Qualitative lots of quality areas
• Visiting a Nail Carer is an opportunity for a
  meaningful social interaction, really important
  for people who are more socially isolated
• The role is a flexible employment opportunity
  allowed some people to transform their life and
  their careers

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Following Birminghams success there is huge
potential for growth and spread across the UKIf
we can replicate a similar level of coverage
across the UK the value of the Nail Care business
could easily exceed 10million per annum........
And ................. Help to ensure that those
who cant cut their own toe nails keep active and
healthy and avoid disability!
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Skills for Health Evaluation Videos

• New nail carer role benefits South Birmingham
  etc... 
• http//vimeo.com/88043092
•  Nail Care, a new career
• http//vimeo.com/88043091
• NHS supports creation of new role...
• http//vimeo.com/88043089
• Working with Skills for Health...
• http//vimeo.com/88043088