1. Skill mix in clinics – how to improve everyone’s life. Samantha Bower Nurse Specialist – Breast care The Ipswich Hospital NHS Trust

2. Introduction Everyone’s experiences Training and supervision Introducing change Problems encountered Has it made a difference?

3. Patients experiences Waiting times Consultations Information Repeat clinic attendances

4. Doctors experiences Overloaded clinics Inappropriate referrals Low conversion ratio

5. Nurses experience Service improvement Keen to expand practice New challenge

6. Training and supervision 2 years in breast care Undertaken A11 course Attended Radiation Protection study day Performed 100 clinical examination supervised by consultant

7. Nurse Led Breast Clinics (1) Breast pain Family History Recurrent cyst aspiration

8. Nurse Led Breast clinics (2) Consultants refer from GP letters Weekly 20 minute slots SpR also in clinic Consultant cover Letters to GP read by consultant

9. Problems encountered Clinic space Radiology Agreeing protocols Inappropriate referrals

10. Clinical Guideline 5 Non-cyclical Breast Pain

11. Does it make a difference? Patients experience Doctors experience Nurses experience

12. Waiting times 2001

13. Waiting times 2002