2.2 develop the team - nursing - louise brady
TRANSCRIPT
‘The healix of change’
Louise Brady
Practice Nurse Donneybrook M/C
Clinical Lead Practice Nursing NHS Manchester CCG’s
GPN Advisor NHS Alliance Executive
Heather Henry, Co- Chair, New NHS Alliance and Queen’s Nurse, Zoe Starmer Practice Nurse Champion North Manchester CCG, & Louise Kay, Lead for Practice Nursing, Tameside & Glossop CCG
Representing GMHSC Practice Nurse Collaborative & Beyond!
The Perfect Storm
1/3rd to retire by 2020 Indemnity costs rising 10 fold Variation in qualifications Variation in terms and conditions Variable training placements 23% have more than one job
Opportunity or Threat?
2015 survey of 3032 nurses concluded
Queen’s Nursing Institute
Opportunities for New Care models
GM Practice Nurse Collaborative
• New Curriculum ‘Healix’
• Co- design, Co- production & Health Creation
In equal partnership with local people
• Nurturing & Developing the workforce
• Interdisciplinary Learning
• Realising time in Practice
• Improving Health Outcomes
A Magical Experience!!
What did I learn as a nurse?
• The foundation for peer support is spontaneous , it’s natural and it occurs with ease, when there is mutual agreement of ‘what is helpful’
• Less correcting, and more Connecting!
• 147 RTC evidence base for peer 2 peer ( Nesta)
• Nursing as a whole offers communities a rich architecture of care, knowledge & skill base to tap into to
• Combine that knowledge & support with the abundance of local knowledge & skill that exists within our communities, & we have a rich tapestry of care.
Impact
Respiratory: Practice nurses instrumental in gathering together Integrated Breathe easy Group April 2016
Potential outcomes
Applying Kent findings: 42% reduction in unplanned GP visits. 57% reduction in unplanned hospital admissions
Heart failure: Co-design PN developing information in partnership with Patients to drive up quality of accessible information ‘health literacy’ – tested against information standard Published & peer reviewed.
Impact
• Health inequalities are estimated to account for over £5.5bn annually in healthcare costs to the NHS in England each year
• Enabling ‘at risk groups’ to become more health literate has potential for social & economic impact and savings to the NHS.
• Only 30% of GP surgeries have information that is accessible to people with learning disabilities.
• North Manchester Peer group: 500 members Learning disabilities Aim: 2 support a 10% increase in LD Care. PN Key to connect with communities
Outcomes: Diabetes Prevention in Practice Shared Medical appointments
• Nurse Led by Nicola Milne Practice nurse: with17 Patients
• Total weight loss 52kg waist circumference 53cm
• Reduction in BP, lipids, fasting glucose
• Post prandial glucose level dropped by 1.7mmols from a baseline of 8.2mmols to 6.5mmols.
• At 1 yr follow up: average weight increase 0.8kg but 3kg below mean weight at start of programme.
• Increased wellbeing scores, patient experience & peer support. Published & peer reviewed.
Moving towards Group Consultations
•A more efficient, rewarding and person centered way to improve outcomes , at individual & population level
•Also known as shared medical appointments (SMA’s)
Clinical consultations that take place in a supported group setting that have a strong evidence base .
•One of the High impact Actions outlined in GP Forward View
Alison Manson
Group Consultations Programme Lead, The ELC Programme
What group consults are not..
• Health education
• Self management support
• Self help groups
• Behavioral medicine programmes
• Group therapy sessions
• Expert patient programme
The aim & ambition
• Alternative way of seeing patients more patients 1:1 in less time
• Consultation model that also delivers peer support
• A way of supporting a group of people who have a similar condition ( 10 -15)
• 1.5 – 2 hour session with clinician present for around 45 mins
Why adopt Group Consultations?
• Potential to transform primary care
• Improve clinical outcomes, patient and clinicians experience
• Help cut time pressures and clinic backlogs
• Bring joy back to primary care
• A good fit with what patients tell us matters to them!
City Wide Group •Shared learning •Partnership work •Vertical & horizontal integration •Potential to transform primary care •Improved clinical outcomes, patient and clinicians experience time •Bring joy back to primary care!!!!
