An Update on the National Practitioner Programme Jackie Younger

1. An Update on the National Practitioner Programme Jackie Younger National Practitioner Programme Lead

2. Which Practitioner Programmes Have Moved Where and For How Long? • New Ways of Working in Surgery (NWWS) • North West London HA (18 months) • SCPs • Endoscopy practitioner • Assistant theatre practitioner • Perioperative Specialist Practitioner (PSP) • North West London HA (24 months) • Emergency Care Practitioners • SfH with the career framework team (24 months)

3. Which Practitioner Programmes Have Moved Where and For How Long? • New Ways of Working in Critical Care • North West London HA (12 months) • Assistant critical care practitioners • Advanced critical care practitioners • Anaesthesia Practitioners • Shrops & Staffs HA (18 months) • Medical Care Practitioners • South West London HA (24 months)

4. The Role of National Practitioner Lead • Ensure links continue between NPP streams of work • Identify & tackle common issues • Retain links to DH policy and HRD teams • Retain links to other teams e.g. skills for health • Ensure links to SHAs and all other key stakeholders • Communication strategy

5. The journey towards mainstream

6. Surgical Care Practitioner • Pre, intra & post operative role • Diagnostic and surgical intervention • Started Feb 2003 • Now 54 trainees in 32 organisations • 3 training centres • Definitive curriculum framework to be published within two weeks • Assess initial demand

7. SCP Priorities • Commission national training centres • Continue to monitor progress & outcomes • Quality and standards processes • External evaluation • Mainstream

8. Perioperative Specialist Practitioner • Pre & Post operative role (ward / clinic only) • WTD pilot from April 2003 • 5 sites – 12 trainees • One training centre – Imperial College • Success converted to commercial programme • WDDs pay for places

9. PSP Priorities • Now into 3rd cohort • Monitor outcomes Cohorts 1, 2 and 3 • Feedback to other WDDs / advertise places • Continue to monitor demand • Curriculum framework developments from SCP work – interchange between roles • Masters level accreditation now optional • Mainstream

10. Assistant Theatre Practitioner • Led by NSC WDD across – NSC, Essex, NRL, B&H • Nurses and ODPs – advance their roles • So HCAs have to advance their roles • Scoping existing developments

11. ATP Priorities • Share scoping work • Report potential of the roles • Link with wider stakeholder group • Testing SfH competences – sites selected • Recommend national transferable developments

12. Endoscopy • Small pilot in April 2003 • Who can be trained to do flexible sigmoidoscopy? • 3 trainees – nurse, physiologist, PA • Colonoscopy waiting down from 20 – 6 months • National HRM awards runner up - 2004

13. Endoscopy Continued • 8 new sites commenced in September 04 • Monitor outcomes and progress • Report potential of the role • Monitor year 2 • Impact on bowel screening ? • Demand and ? more training centres

14. Endoscopy Priorities • Now career framework for endoscopy • 3 year – step on step off training in Hull • Foundation – diploma – degree • Monitor year 1 trainees - outcomes • Recruit for 2006 • Promote programme widely • Mainstream

15. NWW in Critical Care • Assistant critical care practitioners • Senior & advanced practitioners • Scope existing roles • Developing R & R strategies • 8 development sites

16. CC Priorities • Develop a career framework in critical care • Map roles nationally • Map national competences and training opportunities • Look at care pathways • Mainstream

17. New Ways of Working in Anaesthesia To develop an advanced practitioner role within the anaesthetic team that will: • maintain patient safety • have transparency to the public, with particular reference to responsibility, delegation and the referral of patients • be supported by appropriate transferable education and training • with medically qualified anaesthetic staff in a supervised capacity as part of the team

18. Anaesthesia Practitioner • Started with 5 sites exploring & testing overseas practitioners & development of a redesigned role • Commenced phase 2 October 2005 with 8 cluster networks involving 25 sites • Developed a national learning programme

19. Anaesthesia Practitioner • Exploring career pathway with different entry levels including graduates • Identify demand • Record how the programme will influence • Doctors training in the future & WTD Compliance • Theatre Utilisation • Role and Career Pathways of ODPs and Perioperative Nurses and others

20. Examples of Work • Pre operative assessment • Insertion of lines • Transfers to recovery / critical care • Assist with induction and reversal • Maintain anaesthesia • Post operative pain management

21. AP Priorities • Start phase 3 and monitor the training programme delivery through all phases • Promote the programme • Monitor outcomes • Explore workforce issues for whole theatre team • External evaluation • Mainstream

22. Medical Care Practitioners • Increasing capacity in primary and secondary care through widening the source of healthcare professionals • Recruitment – science graduates, armed forces etc • Medical model supporting physicians but working in a multi-professional team • Level of decision making based upon competence

23. Medical Care Practitioners • Learning from global best practice e.g. US Physician Assistants • Two pilot SHAs – North East London and South West London working in primary and secondary care • Curriculum developed in partnership with Royal College of Physicians, Royal College of General Practitioners and Skills for Health.

24. MCP Priorities • Consultation complete • Analyse results • Wider stakeholder links • Monitor potential and outcomes • Identify training centres • Mainstream

25. Emergency Care Practitioners • Nurses & Paramedics • Road side → A & E • Reduced transfers to A & E • Meeting 4 hour trolley waits • Assistant Practitioner Roles ?

26. ECPs Priorities Monitor consistency of delivery National curriculum framework Mainstream

27. National Practitioner Programme • Holds the ring: • NWL / SASHA / SWL / SfH / RCN & others • Links to other stakeholders and SHAs • NPP implementation group • Common practical issues • Regulation • Communications Strategy

28. Regulation Issues • ? Significantly different (SCP & AP) • ? Patient safety issues (ECP) • ? Direct entrants (MCP & AP) • Distributed regulation • Papers sent into the Foster review • Recommendations made to Ministers • Their views awaited • Then consultation

29. Wider Issues • Local delivery plans – Workforce response • MMC • WTD • Changes to HAs and PCTs • Better healthcare closer to home • There is room for all practitioners

30. Jackie YoungerNational Practitioner Programme Leadjackie.younger@nwlondon.nhs.uk07789 653360