Alan Corry Finn Executive Director of Nursing / Director of Primary Care & Older People’s Services Nursing Revalidation for Specialist Practice & Advanced Roles Conference 9 th June 2015 Pilot Site Update: Improving the Quality of Nursing Appraisal to meet Revalidation

Presentation Overview Northern Ireland Health & Social Care Context Profile of Western Health & Social Care Trust – Trust Vision – Key Facts – Governance for Nursing and Midwifery – Where do they work – What do they do Specialist & Advanced Nursing and Midwifery Roles in the Trust NMC Pilot – Journey So Far – What they said – Where to next

Health and Social Care in Northern Ireland (NI) Northern Ireland receives a block grant, which the NI Executive then distributes among the various government programmes. The Minister for Health, Social Services and Public Safety then makes an allocation to the Health and Social Care Board which is primarily based on the regional capitation formula. The Department of Health, Social Services and Public Safety receive an allocation of over £3.8billion each year which accounts for almost 45% of total public expenditure

519,000 In-patient or Day Case Admissions 709,000 Treatments at A&E Departments 1.5million Outpatient Attendances

Within NI on a typical day: - 28,000 people see a family doctor or practice nurse; 20,000 people visit a community pharmacy where around 84,186 prescription items are dispensed 2,800 new courses of dental treatment are started 8,500 people are provided with intensive support in their own homes 12,000 people are receiving a nursing home or residential care package 7,000 people received a meals service care package 24,000 people received a Home Help care package, and 2,400 children are looked after in some form of care. These services are provided to the entire population on the same basic principles of equal access and generally without regard to ability to pay.

Profile of Western HSC Trust Circa 300,000 population Circa 12,500 staff Budget circa £500million Geography of 2,000 sq. miles 17% NI Land Mass Rural / Urban Hospital / Community Changing Functions of Hospitals and Community Services

Trust Vision Our Aim: - “to provide high quality patient and client focused care through well trained staff with high morale”.

Key Facts 13/14 58,703 attendances at Altnagelvin’s A&E Department 30,042 attendances at the South West Acute Hospital 17,537 attendances at the Urgent Care & Treatment Centre at TCH. 349,415 face to face AHP Services contacts with clients 201,851 District Nursing Services contacts with clients 3,948 births at Altnagelvin and the SWAH Hospitals 241 patients referred to the Telemonitoring System.

2,596 compliments and 495 formal complaints (in additional 15 Children Order complaints). 217 business cases supported amounting to £1.661m 296,010 visitors to the Trust website Library Service – 24,862 visits from staff and students – 4,109 books and articles issued, supplied and renewed. – 97 induction information skills training sessions delivered to 977 staff and students – 110 detailed literature searches to support patient care, education and research.

Approximately 3,000 staff - all programmes of care Skill Mix 78:22 Registered / Non-Registered Millions of Patient Contacts

Governance for Nurses & Midwives Executive Director of Nursing 3 Assistant Directors 25 Professional Lead Nursing Staff Trust Nursing & Midwifery Governance Committee Role Design and Development Scope of Practice and Policy Development Fitness to Practise

Where do they work? 2 Acute Hospitals 1 Learning Disability Hospital 2 Psychiatric Hospitals 2 Rehab and Palliative Care Hospitals 19 Health Centres & Clinics 9 Children’s Homes 5 Residential Care Homes 27 Day Centres 200 Foster Homes 6 Ambulance Bases 6 Adult Training Centres 12 Administration Offices 1000’s of people’s homes …

What do they do? Pre-conception advice and support Antenatal care Intrapartum care Postnatal care Paediatric Nursing School Nursing Specialist Public Health support and advice Adult Nursing Hospital Care Mental Health Nursing

Addiction Services Therapists Community Care – District Nursing Treatment Room Nursing Learning Disability Nursing Nursing Older People Intermediate Care / Day Hospitals / Clinical Intervention Services Rehabilitation

Occupational Health Palliative Care Bereavement Care Specialist Nurses Consultant Nurse Care Management Residential Care Planning Services Planning New Builds Others

Specialist and Advanced Nursing & Midwifery Roles Impetus for development European Working Time Directive Nursing pushing the boundaries to meet patient need Evolutionary not revolutionary Need to demystify the roles and clear lines of accountability to nursing

Line management understanding – leadership and supervision can be weak Absence of workforce plan including succession planning Line managers need to assume responsibility for appraisal of specialist nurses Specialist & Advanced Nurses need to come out from under the medical professional and align with nursing Courageous conversations - high challenge with high support

Organisation challenge – protected time Clear job planning Still needing to be grown Avoid it being a tick box exercise Safe and effective high quality care – excellence in professional standards Continuous improvement

151 employed in the Western HSC Trust 146 WTE Single handed to teams of up to 13 staff ED/Diabetes/Oncology/Paediatrics specialties have largest number of staff

Regional Development of Job Planning Guidance for Clinical Nurse Specialist Roles ongoing Regional template devised Job plans for Specialist Nurses working in Acute Services in first instance Workforce activity

Challenges exist! Require a regional agreement on the data that needs to be collected to identify the contribution of Specialist & Advanced Nursing staff Lack of dedicated admin support Systems to capture nurse led clinics as nursing - not as part of medical

NMC Pilot – The Journey so far 124 staff signed up for the pilot. All attended workshops and information sessions Completed a personal profile of their readiness against the NMC requirements 111 felt the need to attend workshops on writing a reflective piece 75 % were able to completed in the time frame agreed

The NMC Pilot - What they said Video at this point

The NMC Pilot - Where to Next Organisational readiness – lack of central repository containing all staff data Scoping all wards, teams and departments Approx. 900 staff need to revalidate in 2016/2017/ staff have not got a nursing line manager 60% currently have appraisal

Supervision is moveable feast from % of staff Reflective writing skills need to be developed Skilling up champions with master classes

I attribute my success to this - I never gave or took any excuse.” Florence Nightingale

Thank you for the opportunity to share today Any Questions?