Multiprofessional Learning; Do we know what we need ? Dr David Eadington, April 2016 Change is inevitable… … Progress is optional

Transformation drivers 1 Transformation drivers 1. Patient experience and safety; Francis (x2), Bewick, Kirkup, Greenaway (SoT) reports. 2. Financial constraint 3. Improving quality of care

Don Berwick’s Top 10 Tips Put patient at the centre Stop restructuring Strengthen local health systems Reinvest in primary care Don’t trust market forces Avoid supply driven care Develop integrated quality process Heal professions/managers/Govt divide Train workforce for future, not past Aim for Health (not Sickness)

Changing patients/service/workforce Nurse specialists/consultants - prescribing, monitoring LTCs Nurse practitioners surgery, endoscopy, anaesthetics Midwives, pharmacists, psychologists, chiropractors Physician assistants/associates Crisis team/Liaison services

Questions 1. Who in your department ‘shares’ role(s). 2 Questions 1. Who in your department ‘shares’ role(s) ? 2. One workforce – how many units of training ? 3. What makes doctors ‘different/special’ ? Physician Assistant MB ChB

Professionalism Status

Consultant Trainee ANPs CSWs EM nurses Speaking to relatives, bad news Running Trauma Team Difficult IV access ECGs, treating ACS Responding to complaints Airways Managing patient flow Capacity, mental health team OFTEN SOMETIMES RARELY NEVER

8 7 6 5 4 3 2 1 1995 2016 Consultant 3 8 Registrar 1 5 Core/Foundation Dialysis nurse ~20 ~50 Transplant nurse Low clearance nurse 2 Anaemia nurse Vascular access nurse 8 7 6 5 4 3 2 1

Where ? Workplace, increasing shared understanding of roles and learning needs for different staff groups   Classroom, new forms of co-learning. Increasing use of team simulation scenarios an early example. LETB/CCGs, facilitator for piloting new ways of working, and sharing innovative practice

Purpose of a multiprofessional school Augment learning for all students, without detracting from any existing learning experience . Potential risks to the quality of PGMDE ?   Production of a more effective future health workforce. Clear statements from policy planners Political support, health and social care, vision fragmented ‘Transformation Footprints’ will target funding towards meeting patient needs by planning for Place rather than Institution. Changes in the learning programmes (local) must remain consistent with separate curriculum requirements (national, multiple regulators).

What opportunities does the MPS create ? “If you change the way you look at things, the things you look at change” Better mutual support and trust across learner groups. Sharing of problems may improve morale (??) More effective development of alternative workforce solutions New development opportunities for faculty and HEIs Spreading of good practice and innovation More coordinated approach to learning from patient safety incidents Greater clarity over future workforce needs

What are the barriers to progress ?   What are the barriers to progress ? “If you want to make enemies, try to change something” Professional differences – leadership of the School Regulator attitudes More complex planning, including HEIs Reorientation of the faculty New approach to Quality – already begun New financial models and budgets