1. Working Towards an Integrated Model of Nursing Appendix 6 Northern Health and Social Care Trust

2. The need for change Although managed as a single entity acute and community nursing services remain fragmented with historical and cultural barriers to best practice Inflexibility within the workforce due to historical boundaries of acute/community and across community localities Continued growth in numbers of technology dependent children and children with complex health needs Acute nursing interventions requiring a dedicated skill set now being delivered regularly in children’s own homes- ‘hospital at home service’ Consequently CCN teams have increased with a high ratio of non skilled workforce delivering care Increase in skill mix resulting in changing roles/responsibilities of CCN caseload holders

3. The vision for paediatric nursing services The right care in the right place at the right time An integrated paediatric nursing workforce One skill set across acute and community settings Greater flexibility to respond to the needs of the service More efficiently manage capacity and demand Greater flexibility of the workforce to move across boundaries and packages in response to the fluidity of care packages

4. Integrated model of nursing Composition of the children’s directorate promotes the development of one paediatric nursing skill set working across acute and community settings Nursing workforce will move between hospital and community settings and gain experience across acute, ambulatory and community facilities Re admission of children with complex health needs-packages of care will follow children into hospital Change will be incremental Rotation of staff will form part of continuous professional development Introduction of trust wide rotational posts Opportunity to pilot on Coleriane site