1. North Manchester District Nursing Improvement Programme

2.  Growing demand for services  Increased acuity of patients  Largely re-active care  Little recent modernisation in the service Challenges

3. Pump Priming to achieve efficiencies – not new recurrent resources  Increased treatment room capacity/Better access for patients and referrers  Workforce re-design  Leadership & Team development  Strategic planning to manage future demand  Productivity, performance management and IT District Nursing Improvement Programme

4.  Lack of Capacity  Impacted by annual leave & sickness  Lack of clarity about what is managed in treatment room  Difficult to get through to some health centres to book  District Nurses home visiting for mobile patients Treatment Room

5.  Changes went Live 7 th April  New model – 4 hubs linked to DN teams.  Skill mixed with Clinic Support Workers  Single booking number 0161-778-2233 ( Option 2)  New Patient form Treatment room

6.  Ancoats/ Newton Heath  Cheetham  Cornerstones  Hapurhey ( & Charlestown Road) 4 Hubs

7.  Currently am & pm until 4pm  Saturdays at Ancoats  Later appointments from the Summer  Accommodation Issues particularly Harpurhey area still not resolved. 6 day service

8.  Patient form Wound care, removal of sutures & stitches, injections ( eg Clexane, not vitamin B12), Self Care training, line flushes, catheter / continence. Not routine primary care  Ear Care What do Treatment rooms do ?

9. Ear Care Services

10. Treatment Room Availability

11. Treatment Rooms

12.  Phlebotomy for patients who are housebound with urgent medical need for phlebotomy Eg: full blood count required post admission, follow up for patient with hyperkalamia, U&E when titrating up ace or changing diuretics Not - Annual - cholesterols, U and E’s for ace and diuretics,TFT Routine hba1c for Diabetics Home Phlebotomy – coming end of summer

13.  Capped activity levels with an indicative practice allocation. Per 2,000 patients - 28 a year * ( one patient a fortnight) Home Based Phlebotomy

14.  Home IV therapy  Palliative Care Hub  NMINC - self care  Productive Community Services Developments

15.  Sharing of knowledge & Skills  Increased integrated working (NMINC)  Joint Training where appropriate  Inter Professional communication Working Together

16. Questions ?