An Update on the National Practitioner Programme

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• An Update on the National Practitioner Programme
• Jackie Younger
• National Practitioner Programme Lead

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Which Practitioner Programmes Have Moved Where
and For How Long?

• New Ways of Working in Surgery (NWWS)
• North West London HA (18 months)
• SCPs
• Endoscopy practitioner
• Assistant theatre practitioner
• Perioperative Specialist Practitioner (PSP)
• North West London HA (24 months)
• Emergency Care Practitioners
• SfH with the career framework team (24 months)

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Which Practitioner Programmes Have Moved Where
and For How Long?

• New Ways of Working in Critical Care
• North West London HA (12 months)
• Assistant critical care practitioners
• Advanced critical care practitioners
• Anaesthesia Practitioners
• Shrops Staffs HA (18 months)
• Medical Care Practitioners
• South West London HA (24 months)

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The Role of National Practitioner Lead

• Ensure links continue between NPP streams of work
• Identify tackle common issues
• Retain links to DH policy and HRD teams
• Retain links to other teams e.g. skills for
  health
• Ensure links to SHAs and all other key
  stakeholders
• Communication strategy

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The journey towards mainstream
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Surgical Care Practitioner

• Pre, intra post operative role
• Diagnostic and surgical intervention
• Started Feb 2003
• Now 54 trainees in 32 organisations
• 3 training centres
• Definitive curriculum framework to be published
  within two weeks
• Assess initial demand

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SCP Priorities

• Commission national training centres
• Continue to monitor progress outcomes
• Quality and standards processes
• External evaluation
• Mainstream

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Perioperative Specialist Practitioner

• Pre Post operative role (ward / clinic only)
• WTD pilot from April 2003
• 5 sites 12 trainees
• One training centre Imperial College
• Success converted to commercial programme
• WDDs pay for places

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PSP Priorities

• Now into 3rd cohort
• Monitor outcomes Cohorts 1, 2 and 3
• Feedback to other WDDs / advertise places
• Continue to monitor demand
• Curriculum framework developments from SCP work
• interchange between roles
• Masters level accreditation now optional
• Mainstream

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Assistant Theatre Practitioner

• Led by NSC WDD across NSC, Essex, NRL, BH
• Nurses and ODPs advance their roles
• So HCAs have to advance their roles
• Scoping existing developments

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ATP Priorities

• Share scoping work
• Report potential of the roles
• Link with wider stakeholder group
• Testing SfH competences sites selected
• Recommend national transferable developments

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Endoscopy

• Small pilot in April 2003
• Who can be trained to do flexible sigmoidoscopy?
• 3 trainees nurse, physiologist, PA
• Colonoscopy waiting down from 20 6 months
• National HRM awards runner up - 2004

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Endoscopy Continued

• 8 new sites commenced in September 04
• Monitor outcomes and progress
• Report potential of the role
• Monitor year 2
• Impact on bowel screening ?
• Demand and ? more training centres

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Endoscopy Priorities

• Now career framework for endoscopy
• 3 year step on step off training in Hull
• Foundation diploma degree
• Monitor year 1 trainees - outcomes
• Recruit for 2006
• Promote programme widely
• Mainstream

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NWW in Critical Care

• Assistant critical care practitioners
• Senior advanced practitioners
• Scope existing roles
• Developing R R strategies
• 8 development sites

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CC Priorities

• Develop a career framework in critical care
• Map roles nationally
• Map national competences and training
  opportunities
• Look at care pathways
• Mainstream

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New Ways of Working in Anaesthesia

• To develop an advanced practitioner role within
  the anaesthetic team that will
• maintain patient safety
• have transparency to the public, with particular
  reference to responsibility, delegation and the
  referral of patients
• be supported by appropriate transferable
  education and training
• with medically qualified anaesthetic staff in a
  supervised capacity as part of the team

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Anaesthesia Practitioner

• Started with 5 sites exploring testing overseas
  practitioners development of a redesigned role
• Commenced phase 2 October 2005 with 8 cluster
  networks involving 25 sites
• Developed a national learning programme

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Anaesthesia Practitioner

• Exploring career pathway with different entry
  levels including graduates
• Identify demand
• Record how the programme will influence
• Doctors training in the future WTD Compliance
• Theatre Utilisation
• Role and Career Pathways of ODPs and
  Perioperative Nurses and others

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Examples of Work

• Pre operative assessment
• Insertion of lines
• Transfers to recovery / critical care
• Assist with induction and reversal
• Maintain anaesthesia
• Post operative pain management

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AP Priorities

• Start phase 3 and monitor the training programme
  delivery through all phases
• Promote the programme
• Monitor outcomes
• Explore workforce issues for whole theatre team
• External evaluation
• Mainstream

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Medical Care Practitioners

• Increasing capacity in primary and secondary care
  through widening the source of healthcare
  professionals
• Recruitment science graduates, armed forces etc
  
• Medical model supporting physicians but working
  in a multi-professional team
• Level of decision making based upon competence

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Medical Care Practitioners

• Learning from global best practice e.g. US
  Physician Assistants
• Two pilot SHAs North East London and South West
  London working in primary and secondary care
• Curriculum developed in partnership with Royal
  College of Physicians, Royal College of General
  Practitioners and Skills for Health.

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MCP Priorities

• Consultation complete
• Analyse results
• Wider stakeholder links
• Monitor potential and outcomes
• Identify training centres
• Mainstream

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Emergency Care Practitioners

• Nurses Paramedics
• Road side ? A E
• Reduced transfers to A E
• Meeting 4 hour trolley waits
• Assistant Practitioner Roles ?

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ECPs Priorities

• Monitor consistency of delivery
• National curriculum framework
• Mainstream

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National Practitioner Programme

• Holds the ring
• NWL / SASHA / SWL / SfH / RCN others
• Links to other stakeholders and SHAs
• NPP implementation group
• Common practical issues
• Regulation
• Communications Strategy

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Regulation Issues

• ? Significantly different (SCP AP)
• ? Patient safety issues (ECP)
• ? Direct entrants (MCP AP)
• Distributed regulation
• Papers sent into the Foster review
• Recommendations made to Ministers
• Their views awaited
• Then consultation

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Wider Issues

• Local delivery plans Workforce response
• MMC
• WTD
• Changes to HAs and PCTs
• Better healthcare closer to home
• There is room for all practitioners

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Jackie YoungerNational Practitioner Programme
Leadjackie.younger_at_nwlondon.nhs.uk07789
653360