INAUGURAL NI AHP CONFERENCE 2013:

1. INAUGURAL NI AHP CONFERENCE2013: “AHP’s – Transforming Your Care” Wednesday, 23 October, Lagan Valley Island, Lisburn

2. Introduction • Clinical Site Specialist Radiographers • Expert knowledge • Integral member of medical team • Completion of accredited course and Designated Medical Practitioner in clinical setting

3. Partnerships Transforming Your Care Non Medical Prescribing

4. Non medical prescribing- Aims • To improve patient care without compromising safety • Promote shared decision making • Improving patient experience • Reducing delays • Improving the use of medicines • increasing patient access • convenience and choice • Better use of staff skills mix • Change in traditional roles • Continuity of care

5. Single Competency Framework- NPC 2012: 3 Domains Governance Framework Domain A: The Consultation • Competency 1: Knowledge • Competency 2: Options • Competency 3: Shared decision making Domain B: Prescribing Effectively • Competency 4: Safe • Competency 5: Professional • Competency 6: Always Improving Domain C: Prescribing in Context • Competency 7: The Health Care System • Competency 8: Information • Competency 9: Self and Others

6. Transforming Your Care Strategic Themes: • Promoting good Health decisions • Preventing ill health • Enabling people to live healthily and independently for as long as possible • Achieving better outcomes when ill health does occur

7. 1. Promoting good health decisions Good health decisions mean different things to different people. Cancer patients treatment is complex and often multi modality, our job is to maintain health during and post treatment to ensure best potential outcome and quality of life. • Generic prescribing • Antibiotic prescribing • Opiates with laxatives • Steroids with gastric protection • Bone density management with aromatase inhibitors • Appropriate onward referral • Smoking cessation • Obesity/ Dietary management • Exercise • Screening programs

8. 2. Preventing Ill Health in the First Place We conduct regular review during and post treatment there by managing treatment related toxicity by anticipating acute and late side effects of treatment and prescribing appropriately. Management can also be non pharmacological • Vaginal Stenosis • Respiratory rehabilitation Contact details

9. 3. Achieving better outcomes when ill health does occur Establish a relationship with patients, care givers based on trust and mutual respect. Recognising patients as partners in shared decision making, thus improving concordance and compliance • Demystify medicines • Empower patients • Listening to patients • Over come the language barrier • Equality and diversity • Timely access to medication

10. 2012 AHP Strategy Improving Health and Well Being through Positive partnerships • Promoting Person- centred Practice and Care • Delivering safe and effective practice and care • Maximising resources for success • Supporting and developing the AHP workforce

11. 4. Enabling People to live healthy and Independently for as long as possible • Holistic Approach • Integrated care partnerships • Referral within the AHP team • Use of electronic care record (ECR)

12. Self Directed Aftercare

13. Audit- PPI •  25 patients- outcome • Patients reported: • Happy with the concept of NMP • More time needed with prescriber to understand the medicines they were taking • Wanting to help themselves and to avail of non- medicinal interventions were possible • Liking the move away from the medical Dr model • Liking the link with there key worker and being seen by someone who was there from the start of their cancer journey it gave them confidence

14. Audit of Safety and Compliance with BHSCT Non- Medical Compliance Random sample of 40 patients in June- September 2013. There were 15 prescriptions • 100% compliance of prescribers responsibility with regards to registration- BHSCT, HPC • 100% compliance with prescribing appropriateness • 0% minor violations with CMP care pathway • 0% major violations with MHRA • Identified two areas for change • Identified suitable additions to core formulary • Patients requiring prescriptions- no Clinician signature on review protocol

15. Are we Prescribing Effectively and Transforming Care? • We have a framework which allows to safely prescribe within our limitation to ensure patient safety is not compromised • Ensure prescribing practice is consistent with scope of practice, organisational, professional and regulatory standards, guidance and codes of conduct • Participate in review, audit practice, PPI to ensure the development of prescribing practice is appropriate to optimise patient outcomes