"Making an impact:Lessons learned from Advanced Practitioners in the North West"

Sarah Jackson MSc RNLDAdvanced Practitioner in Autism & Physical Health

We think things are working but is there a better way of doing it?

National Rationale: Autism• National Autistic Society ‘I Exist’ Campaign 2008• Autism Act 2009• Autism Strategy• Statutory guidance 2010• NICE autism in adults

Local Rationale: Autism• Lack of autism diagnosticians / long waiting lists• Diagnostic assessments done in isolation• Only one diagnostic tool used• Non user-friendly autism reports• Therefore autism not recognised• Longer stay within services!

Autism Progress• Joint lead of autism multi-disciplinary team• Autism consultancy role• Trained autism diagnostician• Developed autism care pathway• Developed autism training framework• Involved in autism research

National Rationale: Health• Death by indifference and counting (Mencap, 2012)• People with LD have poorer health outcomes and face serious health inequalities (DoH,

2011)• No Health without Mental Health (DoH, 2011)• Health Inequalities & People with Learning Disabilities in the UK: 2010. The Public Health

Learning Disabilities Observatory. (Emerson, 2010)• How people with learning disabilities die. Learning Disabilities Observatory (Glover and Ayub,

2010)• Six lives: the provision of public services to people with learning disabilities (Parliamentary

and Health Services Ombudsman, 2009)• Healthcare for All. The findings of the Independent Inquiry into health inequalities of people

with learning disabilities (Michael, 2008)• Human Rights based Approach to Healthcare (DH, 2008)• Mencap’s report Death by Indifference (2007)• Valuing People’s Oral Health (DoH) A good practice guide for improving the oral health of

disabled children and adults (2007)• Closing the gap – a report from the Disability Rights Commission (DRC, 2006)• Choosing Better Oral Health (DoH) An Oral Health plan for England (2005)

Physical Health Progress

• Different roles for each advanced practitioner• Sam, Lucy and Sarah complete annual / admission / discharge

physical examinations, saving £3.12 per physical health check and approximately £686.40 per year

• Sarah and Sam have completed the Non-Medical Prescribing qualification

• Sam can prescribe olive oil drops and has completed ear irrigation course, reducing the need for GP appointments

• Sam, Lucy and Sarah to prescribe Vitamin D according to National guidance, reducing the need for Medical prescribing

• Respiratory disease management in primary care, cardiovascular disease in primary care, diabetes in primary care courses

• Develop prescribing portfolio in line with service need and knowledge / skills

ConclusionAs an advanced practitioner in the current climate, the

reality check is that you have to constantly prove your worth. Throughout our time as trainee and advanced practitioners, our roles have constantly evolved with the needs of our organisation.

We still don’t have a finalised job description!

But we know that we need to meet contemporary health agendas, current policies and respond to patient need.