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