1. Sue Clarke MSc, PGCE, BSc (Hons), RN Project Lead: Non-Medical Community Workforce Development Project

2. Action On Community Education and Training Transforming the Out of Hospital Non-Medical Workforce “AvOCET is important to me because it closes the gap between acute and out of hospital services” South of England Nursing Workforce Summit 02 nd July 2015

3. AvOCET Partners

4. What is AvOCET Non-Medical Out of Hospital Workforce Development Project Puts the patient at the centre and listens to the providers of services and helps them define the skills, knowledge and values of their workforce. Recognises that new and transformed services require workforce to work and think in different ways Challenges professional and organisational boundaries Puts working in teams ahead of individuals

5. Before AvOCET So - - Providers of out of hospital services had little influence on education providers to supply the staff they needed to cope with the increasing complexity and demand now and in the near future Education commissioning was dominated by secondary care: influencing curricula and providing placements Newly qualified staff not fit for purpose for out of hospital workforce Hospital centric view of care, little Public Health involvement Expensive and waste of valuable clinical time retraining to work in the community Few first posts in community and general practice so recruitment an issue Community and general practice not seen as dynamic, innovative, progressive Lack of skilled staff to deal with policy move to treat and care for more people in the community

6. Practice Nurses Specialist Practitioner (nurse or AHP) Physicians Associate Support Workforce Associate Practitioner Apprenticeships Community Up Skilling Volunteers and Carer Education Integrated Development Care Coordinator Student Nurses AHPs RTP

7. Practice Nurses Specialist Practitioner Primary Care Learning Network Support Workforce Community Up Skilling Care Coordinator Student Nurses AHPs RTP Successes - - - so far Community (wider workforce) Up Skilling Programmes To demystify patient pathways AvOCET will pilot across health and social care workforce (working together, learning together) A ‘Foundations of Integrated Care’ course An ‘Integrated Front Line Leadership’ course From July 2015, a carers hub will offer vital support, information and development for carers Just starting a piece of work to look at system wide approach to a learning and development solution to the recognition of deteriorating physical health in mental health patients In collaboration with voluntary sector, developed an induction and development framework for a new volunteer sign poster role. Return on Investment Financial savings from use of non-medical workforce for aspects of GP role  Band 8 ANP potential savings £31,255 per ANP per year  Band 7 PA potential savings £38,000 per PA per year Recruitment Retention Workforce pipeline Reduce locum / agency costs Students = improved quality Care Coordinator (non clinical) Designed a development framework for care coordinator role Developed and added a new integrated care module – “context of service provision” to existing Health and Social Care Foundation Degree in Southampton Solent University. Shared via Hampshire County Council across Hampshire vanguard sites Primary Care Learning Network (PCLN) Eleven surgeries working together as a PCLN Collaborating with community care, social care, and voluntary sector Produced a scalable framework to develop primary care to provide practice placements for pre-registration student nurses Increased nurse mentors by 11 (and still going) Met university quality requirements for practice placements Student Nurses, Allied Health Professionals, Return to Nursing Cohort of Post Graduate Diploma pre-registration student nurses undertaking a pilot 50% Out of Hospital facing placement plan Primary care placements ‘wellness’ focussed Exploring role of clinical specialist physiotherapist (respiratory) in primary care Using HEE Return to Nursing process for primary care Specialist Practitioners Post Graduate Diploma Advanced Nurse Practitioner (ANP) programme for practice nurses Three trainee advanced nurse practitioners now in place Physicians Associate (PA) role in Primary Care Developing role of primary care pharmacist Practice Nurses Employed 1st newly qualified practice nurse in our PCLN Created preceptorship process for new practice nurses Practice nurse representation on local primary care transformation project Accredited CPD for practice nurses Support Workforce Developed ‘common competences’ shared by health and social care support workers necessary to effectively assist frail people to live independently, live well and remain out of hospital Using apprenticeship route to upskill primary care HCAs December 2015 will be collaborating with local community Trust to develop assistant practitioners in primary care

9. Challenges Articulating the vision 18 months ago – preparing for the future Getting buy in from stakeholders Temptation to maintain the status quo – “we just need more of the same” Maintaining the enthusiasm (and budget) when the initial gloss wore off Mind-set – coproduction, collaboration – it is not us and them (especially when the going gets tough) but us! Being bold, adventurous and taking risks…

10. Just remember, diamonds are made under pressure! Stay Calm, and say - - - “bring it on”! Any Questions?