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

2. 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

3. 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

4. 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

5. 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.

6. 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

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

8. 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

9. 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?

10. 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?

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

12. Thank you
Further information;