Victorian Nurse Practitioner Project

1. Victorian Nurse Practitioner Project Katy Fielding Manager, Nurse Workforce Policy & Programs, Nurse Policy Mental Health NP Collaborative 10 December 2009

2. New capacity for existing health worker –not a new role or a new worker. We want to create environments were all nurses are enabled, encouraged and expected to have responsive, dynamic practice that evolves in response to clients needs. There are opportunities for all divisions and practice levels emerging constantly. NPs are one possible part of a comprehensive workforce strategy What is a NP?

3. The NP is a clinical role. The majority of NP clinical work must be in providing direct services to clients/patients (rather than consultancy, education, support etc). NPs: Autonomous, collaborative practice Manage an episode of care Order a test Vs order the right test, interpret the result and decide on the right treatment Initiating a protocol Vs Differential diagnosis What is a NP?

4. The end of the first decade First 5 years preparing the ground, next 5 sowing the seeds, now….. 450 nationally, >50 in Victoria Over 110 are “emergency” National agreement about education & standards In Victoria, “100%” employment, portability of prescribing authority, partnership between NPC & employer, processes that are compatible with the employers governance structures. NP roles -where are we?

5. The fundamentals are in place in Victoria: Demonstration projects – positive evaluations Legislative framework (DPCS, protected title) EBA – (Grade 6) NBV endorsement process Masters education programs VNPP $ to assist/stimulate in priority areas Health services now need to champion the change where they see the need/value. NP progress in Victoria

6. Phase 4 – Integration & Sustainability Package of VNPP funding in targeted areas for: One off funding for health services to identify & implement a service model (change management) NP Candidate Support Packages NP scholarships Publication grants Collaborative/CoP Victorian Nurse Practitioner Project (VNPP)

7. VNPP currently supports: • Stroke care (9 health services) • Renal care (7 sites) • Palliative care (12 metro sites & 5 regional models) • Oncology (6 services) • Mental health, Alcohol and drug services (10 services) and Sites may have multiple candidates

8. NP Models in Round 4.6 (n=10 services) Austin Health within the Acute Adult Psychiatric Unit Alfred Health within Caulfield Aged Psychiatry Service Eastern Health role to support the ED, psychiatric triage service & CATT Forensicare to provide enhanced specialist services to those in justice system Latrobe Health Service – clients within the emergency department Melbourne Health Emergency CATT role, Youth Mental Health NP & Drug/ Alcohol NP Mercy Healthbetween the Consultation and Partnership (CAP) team and EDs at Western and Werribee Northeast Health - young people's early psychosis group Southern Health - Eating Disorders & Dual Diagnosis NP Western Health- (DASWest) supporting clients across acute care & community services including community withdrawal units.

9. Funding is to support the establishment of a NP model for the service including: role implementation activities ($37,000) appointment of at least one NPC (NPC support package $8,000 and $10,000 for second) First offer was oversubscribed Good quality of applications Second call for applications for MH & AD models and candidates will be in 2010-11 NP Models in Round 4.6

10. Phase 4 Priorities for NP Health Services VNPP Rolling priorities to establish critical mass in key areas NP priorities based on local service planning & workforce data Stroke care – Stroke Care Strategy Renal - Revised Renal Service model MHD - Mental Health Act review Palliative Care & Oncology – Cancer Action Plan

11. Successful sites notified by email by 28 September 2009 Industry Briefing in October 2009. Successful sites commence work by end of October 2009. Processes to appoint first NPC commenced by March 2010. Description of service model by February 2010 – 4 pages! NP Service Model’s 5 year plan by April 2010 – 1 page! Confirmation of NPC appointments & NPC logbook of supervision (log book 6 monthly) Budget acquittal (model dev. Funds) no later than April 2010 Key dates:

12. Differentiate NP from other (advanced) roles Role underpinned by measurable competencies SoP opportunities under MH Act review PBS & MBS access Implementation Guide Cohort of NPs in MH Dialogue with other groups Support for candidacy

13. www.nbv.org.au Guidelines: Scope of nursing & midwifery practice

15. To work together, esp. in some literary, artistic, or scientific undertaking Team up Cooperate Collaborative

16. Informal support network for NPCs and NP (or those interested in becoming a NPC/PN): Support for NP candidates/NPs Support for the supporters Share knowledge, skills and resources Learn & practice leadership skills Identify strategies to build success (individual, organisation and system levels) Advise DH & others (eg clinical networks) on issues impacting on role implementation CoP/Collaboratives Purpose ….of the NPs, by the NPs, for the NPs!

17. Why a collaborative/CoP? • Learning from past – ED models • Long journey • New models – pioneer roles • Single practitioner models • Understanding of role variable • In nursing narratives, validation and authentic conversations are valued

18. If it hadn’t have been for it [emergency collaborative], I wouldn’t be endorsed today! Victorian NP, 2008

19. Oncology Community of Practice Southern Health MH & AD NP Collaborative Austin and NE Health -Wangaratta DH supported NP collaboratives/CoP Stroke care NP Collaborative Leanne Turner – Austin Health (03) 9496 5056 leanne.turner@austin.org.au Renal care NP Collaborative Elizabeth Morley – Bendigo Health (03) 5454 6428 EMorley@bendigohealth.org.au Palliative care NP Collaborative www.pallcare.unimelb.edu.au cpcpa@medstv.unimelb.edu.au Victorian Emergency NP Collaborative Tash Jennings- Alfred Health N.Jennings@alfred.org.au

20. Contacts list Sister sites/networks Preferred ways of connecting (face to face, teleconferences, website, list server, etc) – that reflect membership needs– rural, out of hours Develop guiding principles/values/ways of engaging Learning needs analysis (clinical and other eg change management, NBV processes, oral presentation skills, media skills, etc) Share resources Learn about the system beyond your organisation Social, debrief, celebration and support Work with other Collaboratives/CoP Others….. What might be activities for the collaborative/CoP?

21. Role of Collaborative will change & evolve Value diversity of service provision/organisations – no “one” model for NPs in a specialty NP roles need to improve care and fill gaps in service delivery, not simply add another member to the team Investment for the long term (not projects/pilots) Scope of any/all practitioners is not fixed– dynamic role, change is inevitable Push boundaries - facilitation Vs permission seeking National Registration Scheme Commonwealth/State relations – esp. in health arena Other role redesign initiatives are all around Along the way, remember….

22. NBV NP Information day 12 February 2010 Registration required. Pre-reading: NBV fact sheets (www.nbv.org.au) ***Equivalence assessment by NBV pre June 2010*** mthomas@nbv.org.au Candidates/potential candidates!

23. Nursing in Victoria www.health.vic.gov.au/nursingkaty.fielding@dhs.vic.gov.au

24. NP Implementation guide & resources www.health.vic.gov.au