(c) Dewing & Reid 2003 Achieving the expert practice function as a consultant healthcare practitioner Network for Consultant Nurses & Consultant Healthcare Practitioners RCN London - 29 May 2003

(c) Dewing & Reid 2003 Sharing the Dewing & Reid Model for clinical practice Jan Dewing Consultant Nurse Milton Keynes PCT & General NHS Trust Brigid Reid Consultant Nurse East Lancashire Hospitals NHS Trust

(c) Dewing & Reid 2003 Core skills and qualities of the consultant role Be able to apply the practice of the discipline Have leadership & strategic vision Be able to use research and evaluation approaches that focus on day to day issues in practice Facilitate systematic practice development Create a learning culture Provide consultancy throughout the organisation and relevant partners

(c) Dewing & Reid 2003 Practicing as an ‘expert’ Defining practice Strategic intent –What, where, why, with whom? Access and authority as an insider-outsider Awareness of competency Levels of competency Assessing impact of competency –patients, teams, organisation, profession

(c) Dewing & Reid 2003 Beware the ‘lone ranger’ and ‘magic wands’ The dangers of isolated action in and on practice Resisting quick fixes, visible ‘busyness’ and ‘business’ Not working regularly to provide a service or part of a service that another member of the team would ordinarily do –working regularly as part of the ward team –routinely running clinics –having a regular case load

(c) Dewing & Reid 2003 In the beginning… An awareness of the practice culture Effective assessment of the practice culture –‘how things are done around here’ To map practice development within teams as they see it To create ‘presence’ and ‘credibility’ to underpin the establishment of transformation leadership and facilitation

(c) Dewing & Reid 2003 Ways to realise clinical practice Opportunistic but planned interventions Working a session/shift with express intent of achieving goals Focusing on specific elements in practice in ‘real time’ with a clear purpose, shared with others Facilitation of practice within the practice setting

(c) Dewing & Reid 2003 Sustaining practice Less and less ad-hoc interventions More proactive facilitation of care/therapy initiated by others Less direct input with patients/clients More group and work based learning facilitation Moving on

(c) Dewing & Reid 2003 What impact are we having? Patient Care –creating cultures that are patient centred and evidence based –moment to moment experience for patients remains variable Teams –taking responsibility for owning and developing their own effective culture Organisations –clinical governance agenda realised in practice –Consultant practice tests espoused versus lived values

(c) Dewing & Reid 2003 Critique the model Omissions or under emphasis? How to evaluate the model? Potential misuse of the model? Clarity for sharing with aspiring consultant practitioners? How to enable organisations understand and support?

(c) Dewing & Reid 2003 Feedback