1. Adam Williams MSc BSc (HONS) NIP RNA Head of Nursing
Quality
Patient Outcome
Spend
Improving care quality through Non-Medical Prescribing in the Out of Hours and Out of Hospital setting.
Adam Williams MSc BSc (HONS) NIP RNA Head of Nursing

2. Content Overview of what Mastercall provides
Out of Hours, Walk in Centre and Community-based IV service
Non-medical prescribing structure
Benefits for patients
Benefits for clinicians
Benefits for commissioners
How does NMP improve patient experience?
How do we measure performance of non-medical prescribers?
Conclusion

3. non-medical prescribing
Mastercall and NMPs
Social Enterprise
Out of Hours across Stockport and Trafford
Community-based IV Therapy Service
Pathfinder/Alternative To Transfer service
Walk in Centre in Trafford
Home visiting service
Frontline clinician in A&E service
120 nurses and paramedics
200 sessional GPs
Mastercall could not
function without
non-medical prescribing

4. Non-medical prescribing structure
Nurse practitioners, advanced nurse practitioners can use either PGD or are independent prescribers
Paramedics as emergency care practitioners can issue drugs from a PGD
We have approximately drugs on our PGDs from antibiotics, pain relief and many others
Prescribing is electronic wherever possible
Prescribing of intravenous antibiotics in the community under consultant microbiology guidance

5. Benefits of NMP to patients
Care closer to home – IV service/OOH
Reduced delay in definitive treatment
‘One stop shop’ for a patients
Avoids hospital admission/attendance
No disruption to usual therapies
Improves access to treatments for patients with long term conditions

6. Benefits of non-medical prescribing to commissioners
Supports the Right Care/Commissioning for Value agenda
Supports the NHS Outcome Domains framework
Positive experiences of care
Enhancing life for patients with long term conditions
Helping people recover from periods of ill health
Treating patients safely and avoiding harm
6/27/2018

7. Benefits of NMP for clinicians
Maximise staff wellbeing and learning
Improve patient experience
PATIENT
OUTCOMES
Increase value and efficiency
Greater autonomy and freedom in job role
Job satisfaction increased
Enables independent management of patients
Enhances care by enabling timely access and management of conditions
Avoids hospital admission
Releasing time to care
NHS Improving Quality
6/27/2018

8. Top 5 conditions NMPs prescribed for 2014/15
In 2014/15 – 22,000 prescriptions issued by non-medical prescribers

9. Top 10 Drugs Prescribed by NMPs at Mastercall
Prescribing is audited by a quality panel
Feedback in writing to clinicians
Incidences of inappropriate prescribing is flagged
Non-compliant clinicians may have higher audit
Driver for quality

10. Community Managed IV Therapy Service (COMMIT)
Nurse led service under a medical director
11,000 bed days saved July 2013 – April 2013
Approximate savings circa £2.5+ saving vs inpatient stay
NMP has been vital to the success of the service
Very high patient satisfaction based on detailed patient survey
Complex patients – brain and liver abscesses, spinal infections, sepsis, and post-op complications
I am the main carer for my disabled wife and recently used the service for a skin infection.
Previously I had to be admitted to hospital, which meant my wife needed carers who she didn’t know.
This service enabled me to remain at home and did not disrupt my wife’s care.
Patient feedback, 2014

11. How does NMP improve patient experience?
PATIENT A
Long term conditions
PATIENT B
Positive experience of care
PATIENT C
Care closer to home

12. How do we train our staff for NMP?
Bespoke, unique 6 month degree-level minor illness course validated by Liverpool John Moores University
Support staff to undertake the V300 in near future
Regular teaching sessions from clinical experts
Regular audit and feedback on performance
Measured against local prescribing guidance and policy
Clinicians asked to provide written feedback on prescribing decisions as part of development and learning

13. The future? The future Paramedics More NMPs
Workforce development to include paramedics
Increase non-medical prescriber led services and care provision
Measure NMP vs GP
Recent co-amoxiclav audits – 100% compliance from NMP
More NMPs
Paramedics
The future

14. Thanks for listening… Any questions?