Primary/Community Nursing Integration Amanda Waite, Lead Nurse Manager Mid Hampshire Healthcare Tina Bishop, Primary Care Adviser.

Primary Care - General Practice Nursing Employed by GPs to care for patients who can attend the practice Health Promotion, Screening, Immunisations, Long term condition management, Wound care, etc. etc. Role variation and scope across practices Variation in Skills expertise and competence Plethora of titles; Nurse Practitioner, Advanced Nurse Practitioner, Practice Nurse, Treatment Room Nurse, Health care Assistant, Nursing Associate

Primary Care - Community Nursing Employed by Community trusts to care for House bound patients or work in Community clinics Demarcation across roles not always in the patients best interest Restricted service level agreements and lack of flexibility

Integrating Health and Social Care Health service are faced with reduced funds alongside increasing population who are living longer with complex care needs Development of approach to care by alignment of services to meet the needs of patients Unlocking different ways of working New Care Models

New Care Models are a key element of NHS England 5 Year Forward Plan Many different Models Vanguards, Integrated Care Pioneers, Primary Care Home, GP Federation networks to name but a few All aim to redesign an area of practice or service delivery at a local level.

How can we influence change and develop new models of working? Think skills and competencies rather than role definition Map patient journey or service pathway Where are the gaps and overlaps? Focus on small steps to change The big picture can be too daunting Identify and engage interested parties Colleagues, CCG Commissioners, Service leads and providers, PRG

Possibilities? Post operative Leg ulcer care Care Diabetes COPD Health promotion

How Could it look? Nursing in Primary Care Both teams visit at home Joint visits with Community/Practice Nurse experience Joint practice/location clinics Develop new knowledge and skills Holistic approach to care – one visit right skills Less Bureaucracy Enhances Student experience or New preceptorship programme Multi-professional collaboration Don’t forget the Tertiary sector

Challenges Staff engagement, time, purpose Who pays? What about indemnity? Tradition and history –always done it this way Not in service level agreement, what are the risk?

How to Mitigate Challenges. Communication is Key Be clear on aims and objectives Focus and drive, engage key clinicians Start small Keep focus on Patient Care Funding opportunities, CCG project funding, sponsorship, what else is out there?

Continual Assessment and Evaluation Keeping talking How are we doing? Is it working? Can we improve anything? Share success Spread the word

Thank you Further information; https://www.rcn.org.uk/employment-and-pay/integrated-care-in-england/new-models-of-care