Julie Perrin Louise Ramsden Nurse Consultant Leadership Fellow Emergency Care ST6 Neonatology 21st April 2016

What is Advanced Practice? ‘An advanced clinical practitioner is a professional who has acquired the expert knowledge base, complex decision making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or the country in which s/he is credentialed to practice.’ HEE YH January 2015 Discuss difference between AP and specialist practitioner. ‘Next patient through the door’. This will be role of faculty to clarify. Involves working with many different specialities and many different professional roles.

Faculty for Non Medical AP Sub regional – Barnsley, Doncaster, Rotherham and Sheffield Roles including SHU and UoS Provide - Standardisation and consistency Quality Assurance, role development training standards and supervision Professional support Jo Stubbs and I started regional group in response to lack of national direction. Faculty, who is on it, provide standardisation and support for development of AP roles across the Trust and sub regionally. Focus is to develop workforce of the future.

Workforce of the future 2013 funding from HEYH of £3.5m for 2 year programme 54 trainee ANPs including 9 Trust Trainees (Assessment Units) Supervision from a range of clinicians Regional forum in development Past and future workforce Paramedics, pharmacists, ANPs ‘Give it a go’ week on MAUs as part of the team. Getting the right people for the role, talk about the recruitment process.

Challenges Limited nursing pool Impact on organisation Retention Work-life balance Pay NHS/business model NHS as a training facility

Physician’s Associates ‘a new healthcare professional who, while not a doctor, works to the medical model, with the attitudes, skills and knowledge base to deliver holistic care and treatment within the general medical and/or general practice team under defined levels of supervision’ Competence and Curriculum Framework for the Physician Assistant 2012 Discuss potentially bringing 15 across from USA. Will fall under Faculty remit

Physician’s Associates will work… Under physician supervision (which may vary over time) Within their scope of practice and competence as agreed with their supervisor As dependent practitioners in a relationship between doctor and PA based on mutual trust and respect

PAs are coming! 4 courses in Yorkshire! 14 current courses Sheffield Hallam University University of Leeds University of Sheffield – Sept 2016 Hull York Medical School – Sept 2016 4 courses in Yorkshire! 14 current courses 9 starting soon 7 courses in development

PA training Postgraduate 2 year course Bio-science graduates National competence framework National exam 2 courses in Sheffield Clinical placements at STH

Challenges New model Integration into the team (incl. pay) Regulation Restriction to their scope of practice Prescribing Requesting radiology

Collaborative working Aim is for multi professional team delivering high levels of patient care Possibility for educational integration Consideration of multi professional portfolio Faculty role and support networks Evaluation of roles and impact on patient care Inform national agenda Education both internal to STH and in partnership with SHU. Want Sheffield to be a beacon for Advanced Practice.

With the imagery on this slide, I wanted to illustrate that we are working in challenging but exhilarating conditions. At STH we have invested in our workforce of trainee and Advanced Practitioners to ensure that the patients and their families receive an excellent service from the Trust. I want Sheffield to be a beacon of excellence for Advanced Practice and believe we are on our way to achieving this.