1. Nurses working in partnerships to improve out-of-hours care Pamela Bradbury Nursing Officer Primary Care Department of Health Wilma Ayris NE Out of Hours Project

2. Why the need for change? The world is changing and nursing needs to continue to change too. Successes already include: NHS Direct, walk-in centres, PMS, NwSI, CDM As lead professionals we need to accept the challenge of nGMS and OoH and embrace the future

3. Policy Initiatives and Opportunities 24/48 access - PMDU Carson review - Out-of-Hours services Chronic disease management - Evercare Choice - Improving the patient experience Shifting the Balance of Power Agenda for Change - Fair reward

4. Toolkit content so far.. Liberating the Talents Freedom to Practise New roles and new ways of working Nurse prescribing National PGD templates NHSU First contact care programme

5. New ways of working out-of- hours Review existing nursing care out-of- hours -district nursing, rapid response teams -palliative care, mental health services, wics Nurses working as first point of contact Identify the role of support workers Create flexible posts - NHS Direct etc Ensure adequate clinical support

6. NE Out of Hours Project Develop and implement a patient focussed whole systems approach to the provision of Out of Hours services which brings together all aspects of health, social care and support to provide fully integrated service provision

7. The Framework

8. Response to patient need Responsive to patient need Holistic approach Greater emphasis on admission avoidance Management of chronic disease in the home setting Opportunity to provide real choice for patients in out of hours services

9. Opportunities for nursing Nursing practice as a whole Collaboration between all branches of the profession Prevalence of nursing skills Development opportunity for Health Care Assistants Contribution to quality of healthcare in the local community

10. The Challenge Real opportunity for nursing to lead the provision of patient focussed care out of hours to provide improved and more fully responsive services to patients in their local health community