1. National Practitioner Programme An Update on the National Practitioner Programme Jackie Younger National Practitioner Programme Lead

2. National Practitioner Programme Which Practitioner Programmes Have Moved Where and For How Long? New Ways of Working in Surgery (NWWS) –North West London HA (18 months) –SCPs –Endoscopy practitioner –Assistant theatre practitioner Perioperative Specialist Practitioner (PSP) –North West London HA (24 months) Emergency Care Practitioners –SfH with the career framework team (24 months)

3. National Practitioner Programme Which Practitioner Programmes Have Moved Where and For How Long? New Ways of Working in Critical Care –North West London HA (12 months) –Assistant critical care practitioners –Advanced critical care practitioners Anaesthesia Practitioners –Shrops & Staffs HA (18 months) Medical Care Practitioners –South West London HA (24 months)

4. National Practitioner Programme The Role of National Practitioner Lead Ensure links continue between NPP streams of work Identify & tackle common issues Retain links to DH policy and HRD teams Retain links to other teams e.g. skills for health Ensure links to SHAs and all other key stakeholders Communication strategy

5. National Practitioner Programme The journey towards mainstream

6. National Practitioner Programme Surgical Care Practitioner Pre, intra & post operative role Diagnostic and surgical intervention Started Feb 2003 Now 54 trainees in 32 organisations 3 training centres Definitive curriculum framework to be published within two weeks Assess initial demand

7. National Practitioner Programme SCP Priorities Commission national training centres Continue to monitor progress & outcomes Quality and standards processes External evaluation Mainstream

8. National Practitioner Programme Perioperative Specialist Practitioner Pre & Post operative role (ward / clinic only) WTD pilot from April 2003 5 sites – 12 trainees One training centre – Imperial College Success converted to commercial programme WDDs pay for places

9. National Practitioner Programme PSP Priorities Now into 3 rd cohort Monitor outcomes Cohorts 1, 2 and 3 Feedback to other WDDs / advertise places Continue to monitor demand Curriculum framework developments from SCP work – interchange between roles Masters level accreditation now optional Mainstream

10. National Practitioner Programme Assistant Theatre Practitioner Led by NSC WDD across – NSC, Essex, NRL, B&H Nurses and ODPs – advance their roles So HCAs have to advance their roles Scoping existing developments

11. National Practitioner Programme ATP Priorities Share scoping work Report potential of the roles Link with wider stakeholder group Testing SfH competences – sites selected Recommend national transferable developments

12. National Practitioner Programme Endoscopy Small pilot in April 2003 Who can be trained to do flexible sigmoidoscopy? 3 trainees – nurse, physiologist, PA Colonoscopy waiting down from 20 – 6 months National HRM awards runner up - 2004

13. National Practitioner Programme Endoscopy Continued 8 new sites commenced in September 04 Monitor outcomes and progress Report potential of the role Monitor year 2 Impact on bowel screening ? Demand and ? more training centres

14. National Practitioner Programme Endoscopy Priorities Now career framework for endoscopy 3 year – step on step off training in Hull Foundation – diploma – degree Monitor year 1 trainees - outcomes Recruit for 2006 Promote programme widely Mainstream

15. National Practitioner Programme NWW in Critical Care Assistant critical care practitioners Senior & advanced practitioners Scope existing roles Developing R & R strategies 8 development sites

16. National Practitioner Programme CC Priorities Develop a career framework in critical care Map roles nationally Map national competences and training opportunities Look at care pathways Mainstream

17. National Practitioner Programme New Ways of Working in Anaesthesia To develop an advanced practitioner role within the anaesthetic team that will: maintain patient safety have transparency to the public, with particular reference to responsibility, delegation and the referral of patients be supported by appropriate transferable education and training with medically qualified anaesthetic staff in a supervised capacity as part of the team

18. National Practitioner Programme Anaesthesia Practitioner Started with 5 sites exploring & testing overseas practitioners & development of a redesigned role Commenced phase 2 October 2005 with 8 cluster networks involving 25 sites Developed a national learning programme

19. National Practitioner Programme Anaesthesia Practitioner Exploring career pathway with different entry levels including graduates Identify demand Record how the programme will influence –Doctors training in the future & WTD Compliance –Theatre Utilisation –Role and Career Pathways of ODPs and Perioperative Nurses and others

20. National Practitioner Programme Examples of Work Pre operative assessment Insertion of lines Transfers to recovery / critical care Assist with induction and reversal Maintain anaesthesia Post operative pain management

21. National Practitioner Programme AP Priorities Start phase 3 and monitor the training programme delivery through all phases Promote the programme Monitor outcomes Explore workforce issues for whole theatre team External evaluation Mainstream

22. National Practitioner Programme Medical Care Practitioners Increasing capacity in primary and secondary care through widening the source of healthcare professionals Recruitment – science graduates, armed forces etc Medical model supporting physicians but working in a multi-professional team Level of decision making based upon competence

23. National Practitioner Programme Medical Care Practitioners Learning from global best practice e.g. US Physician Assistants Two pilot SHAs – North East London and South West London working in primary and secondary care Curriculum developed in partnership with Royal College of Physicians, Royal College of General Practitioners and Skills for Health.

24. National Practitioner Programme MCP Priorities Consultation complete Analyse results Wider stakeholder links Monitor potential and outcomes Identify training centres Mainstream

25. National Practitioner Programme Emergency Care Practitioners Nurses & Paramedics Road side → A & E Reduced transfers to A & E Meeting 4 hour trolley waits Assistant Practitioner Roles ?

26. National Practitioner Programme ECPs Priorities Monitor consistency of delivery National curriculum framework Mainstream

27. National Practitioner Programme Holds the ring: NWL / SASHA / SWL / SfH / RCN & others Links to other stakeholders and SHAs NPP implementation group Common practical issues Regulation Communications Strategy

28. National Practitioner Programme Regulation Issues ? Significantly different (SCP & AP) ? Patient safety issues (ECP) ? Direct entrants (MCP & AP) Distributed regulation Papers sent into the Foster review Recommendations made to Ministers Their views awaited Then consultation

29. National Practitioner Programme Wider Issues Local delivery plans – Workforce response MMC WTD Changes to HAs and PCTs Better healthcare closer to home There is room for all practitioners

30. National Practitioner Programme Jackie Younger National Practitioner Programme Lead jackie.younger@nwlondon.nhs.uk 07789 653360 jackie.younger@nwlondon.nhs.uk