1. ADVANCED CLINICAL PRACTITIONERS Imperial Experience
Mary Dawood
Consultant Nurse

2. The London Scene
Fair to say London lags behind much of the country in establishing ACP roles
Need has not been so stark or perhaps acknowledged
Varying levels and different models emerging but little consensus about the way forward

3. National Picture NHS recruitment crisis 2016
Ian Cumming, chief executive of Health Education England, said there would be a shortfall in nurses until at least 2020.
Figures in December 2015, showed the NHS in England, Wales and Northern Ireland had more than 23,443 vacant nursing posts and 6,207 vacancies for doctors.
That equates to a vacancy rate of 7% for doctors and 10% for nurses compared with an average vacancy rate of 2.7% for the general economy as assessed by the Office for National Statistics.

5. London’s context

6. NWL

7. Imperial Programme Demonstrating the need in NWLondon
Unable to fill middle grade posts
Bid to HENWL
Funding from HENWL
Course Fees
Ring Fenced Time for learning
Backfill
Consultant Nurse to oversee the project

8. Understandable Response
We don’t have enough nurses ,why are we taking on doctors roles ?
We need our Band 7,s shift leading
We can’t backfill Band 7 posts

9. Progress to date 6 ACP’s in training completing first year
2 in their second year
3 more starting this September
Slowly gaining acceptance
Increasing interest from PAMS ,(physio and paramedics
A long way to go to credentialing
Some surprising results

10. Challenges for Programme Leaders
Communicating the need to colleagues
Gaining acceptance
Lack of coherence
Managing Expectations
Dealing with the convoluted processes of NHS finance
Identifying the right people for the role

11. Challenges for students
Masters level expectations
Sufficient development time allotted / achieved
Increasing responsibility
Individual pace of learning / styles / needs
Socialisation into the role

12. Socialisation into the role

13. Socialisation Confidence Legitimacy Indemnity Patients Expectations
Gaining trust of colleagues
Acceptance

14. Issues for the Medics Shortage of Consultants to supervise
Lack of understanding of commitment needed
Difficulty in benchmarking
Scepticism/ dismissive attitude about programme from some Consultant colleagues

15. Which Master’s programme?
Finding the right programme, most are generic with variable approaches to the practical component Liaising with HEI,s ensuring the programmes delivered are fit for purpose Developing a working relationship with the HEI

16. Programme example
Programme and module learning outcomes mapped to existing advanced nursing standards
Part-time, one day a week attendance at HEI
2 day Induction and pre-course workbooks
For Postgraduate Diploma complete six 20 credit modules
Module delivery – face to face & blended learning
Prescribed sequence of compulsory modules

17. Tips for setting up a programme
The multidisciplinary team must have a shared goal
Detailed business case
Make sure the programme is adequately funded and endorsed by the Trust both medical and nursing, over estimate rather than underestimate
Consider indemnity issues and the need for clinical supervision
Have a different uniform
Ensure Admin support for the programme

18. Choosing Applicants
Test for tenacity at the outset, this is a tough programme
Match your students to the needs of the service
As far as possible ensure you have a champion for the duration of the programme i.e appoint a Consultant nurse to oversee the programme
Allocate dedicated consultant time in terms of PA to the programme

19. Summary Becoming an ACP is not for the fainthearted Tough Programme
Needs commitment from all stakeholders as well as students
Is not a substitute for doctors
Not a cheap alternative
Is a satisfying career pathway for clinically focused professionals