Role of Community Matrons in shifts in settings of care


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Role of Community Matrons in shifts in settings of care

  1. 1. Role of Community Matrons and Practice Nurses in shifts in settings of care
  2. 2. Political Context……………… <ul><li>1991 - GP Fund Holding - give GPs a financial incentive to manage costs and to apply some competitive pressure to hospital providers </li></ul><ul><li>2006 - The White Paper ‘Our Health, Our Care, Our Say: a new direction for community services’ </li></ul><ul><li>2005 - Commissioning a Patient Led NHS - develop commissioning throughout the whole NHS system </li></ul><ul><li>2005 - Practice Based Commissioning - enables GPs and other front line clinicians to redesign services that better meet the needs of their patients. </li></ul><ul><li>2010 - Equity and excellence: Liberating the NHS - Government's long-term vision for the future of the NHS. </li></ul><ul><li>2011 - Liberating the NHS: Legislative Framework and Next Steps - setting out with clarity and direction why and how we need to deliver long-lasting reform in the NHS.' </li></ul>
  3. 3. What are the changes that are expected? <ul><li>Focus on outcomes, not targets </li></ul><ul><li>Wider involvement in clinical commissioning </li></ul><ul><li>Stronger accountability </li></ul><ul><li>Implementation of a new model of care </li></ul><ul><li>Preventing ill health </li></ul><ul><li>Supporting self-care </li></ul><ul><li>Enhancing primary care </li></ul><ul><li>Providing care in people’s homes and the community </li></ul><ul><li>Increasing co-ordination between primary care teams and specialists and between health and social care </li></ul>
  4. 4. <ul><li>These changes require a significant ‘shift’ in the way care is delivered, away from what is often a ‘one size fits all’ approach, frequently delivered in a specialist setting, to a community based, responsive, adaptable, flexible service </li></ul><ul><li>Shift in resources away from acute hospitals to providing care in and closer to people’s homes.. </li></ul><ul><li>Understand how to deliver the shift and how to accelerate this change across the NHS. </li></ul><ul><li>Comprehensive approach that improves the co-ordination of services for patients and promotes integration in the delivery of care. </li></ul>
  5. 5. Challenges <ul><li>Financial Pressures and using resources more efficiently </li></ul><ul><li>Organisational complexity and culture </li></ul><ul><li>Absence of a single electronic medical record </li></ul><ul><li>Divisions between GPs and specialists </li></ul><ul><li>Meeting the needs of an ageing population in which chronic medical conditions are increasingly prevalent. </li></ul><ul><li>Implementing a new model of care in which clinicians work together </li></ul><ul><li>Changing mindsets and behaviour across the whole system. </li></ul>
  6. 6. Where is Care Delivered? <ul><li>Home </li></ul><ul><li>Secondary Care </li></ul><ul><li>Street </li></ul><ul><li>Churches </li></ul><ul><li>Practices </li></ul><ul><li>Community Settings </li></ul><ul><li>Shops </li></ul><ul><li>Markets </li></ul><ul><li>And many more.................. </li></ul>
  7. 7. However the NHS Reforms expects a shift from.............
  8. 8. How can Community Matrons & Practice Nurses contribute? <ul><li>Participating in the development of a whole systems approach </li></ul><ul><li>Sharing and applying knowledge </li></ul><ul><li>Adoption of best practice. </li></ul><ul><li>Maximising the knowledge and skills of the workforce </li></ul><ul><li>Developing and working in a culture that facilitates sharing of learning and experience </li></ul><ul><li>Participating in ongoing service redesign and transformation </li></ul>
  9. 9. Working Together - Benefits <ul><li>Knowledge and experience held by staff, service users and carers is the most valuable </li></ul><ul><li>There are assets available </li></ul><ul><li>Ability to provide high quality, personalised care </li></ul><ul><li>Re-use and sharing and making best use of existing capability in the current climate of financial constraint </li></ul><ul><li>Using evidence to make shared decisions on care </li></ul><ul><li>Work together as a network to support joint working and learning </li></ul>
  10. 10. New Model of Care Should Focus on.. <ul><li>Prevention of ill health </li></ul><ul><li>Supported self-care </li></ul><ul><li>Enhanced primary care </li></ul><ul><li>Co-ordination of care </li></ul><ul><li>High-quality, safe specialist care </li></ul><ul><li>Consistent standards of care </li></ul>
  11. 11. Core ingredients of integrated care <ul><li>Defined populations that enable health care teams to develop a relationship </li></ul><ul><li>Encourage the management of ill-health in primary care settings </li></ul><ul><li>Shared accountability and the Use of data to improve quality </li></ul><ul><li>Information technology that supports the delivery of integrated care </li></ul><ul><li>Use of clinical decision support systems, </li></ul><ul><li>Use of guidelines to promote best practice, support care co-ordination across care pathways, and reduce unwarranted variations or gaps in care </li></ul>
  12. 12. Core ingredients of integrated care (cont’d) <ul><li>Effective leadership at all levels with a focus on continuous quality improvement </li></ul><ul><li>A collaborative culture that emphasises team working and the delivery of highly co-ordinated and patient-centred care </li></ul><ul><li>Multi-specialty groups of health and social care professionals in which, for example, generalists work alongside specialists to deliver integrated care </li></ul><ul><li>Patient engagement in taking decisions about their own care and support in enabling them to self-care </li></ul>
  13. 13. Opportunities <ul><li>Shared learning events </li></ul><ul><li>Use of Case Studies </li></ul><ul><li>Sharing similar goals and values </li></ul><ul><li>Network of influencers and innovators </li></ul><ul><li>Share good practice through lessons from practical experience, case studies and discussion </li></ul><ul><li>Contribute to developing guidelines and a possible resources bank </li></ul>
  14. 14. Final Thought...................... <ul><li>Doing more of the same won’t work. </li></ul><ul><li>Increasing demand, greater </li></ul><ul><li>complexity and rising </li></ul><ul><li>expectations mean that the </li></ul><ul><li>current situation is not sustainable </li></ul>