Chief Allied Health Professions Officer’s Conference 2016 Workshop 2: Primary care – Chair Mark Radford National Advanced Clinical Practitioner Programme. Professor Mark Radford Chief Nursing Officer, University Hospitals Coventry and Warwickshire NHS Trust.

1. Advanced Clinical Practice
Innovation and engagement
June 2016
Professor Mark Radford
Chief Nursing Officer
University Hospitals Coventry and Warwickshire NHS Trust
& Associate Director of Nursing , NHS Improvement

2. Vision – to enable a
skilled and knowledgeable
Advanced Practice
workforce to be used
effectively to enhance the
capacity of the existing
health workforce to
ensure a quality service
for patients, now and in
the futureAcademic
Framework
Curriculum
diversity
Competence
diversity
Academic
and
Professional
uncertainty
of ACP
Role Diversity
Deployment
challenges
Regulation
and
management

3. What matters to patients ?
• Accessibility
• Convenience
• Time spent
• Decision making/Diagnosis
• Gateway knowledge to specialist
• Navigation
• Caring
• Continuity

4. State
•Legislation
•Policy
Corporate
•Business model
•Productivity and
Performance
•Finance
•Governance (Policy and
Procedure)
Profession
•Licensing
•Regulation
•Educational
requirements
•Knowledge and
Expertise
Macro
Division of
Labour
Radford, 2012 . PhD

5. The Division of labour
Radford, 2012 . PhD

6. Band 2
Band 3
Band 5 -
RN
Band 6
Band 8 ACP
Junior Doc
Unwarranted variation in scope and
competence

7. Skills/knowledge adaption
Adaptive
medical
Redundant
Medical
Clinical
knowledge
Professional
medical
Technical
Medical
Nursing
Care
Examples include cannulation,
venepuncture and catheterisation
Examples include PIC, CVP,
arterial lines, ultrasound
scanning.
history taking, examination, diagnosis
and ordering tests and investigations
such as radiology tests
conducting assessments on junior
doctors, conducting audit on the
medical process or outcomes.
Clinically, giving diagnosis,
prognosis and referral
Radford, 2012 . PhD

8. What stops it ?
State
•Legislation
•Policy
Corporate
•Business model
•Productivity and
Performance
•Finance
•Governance (Policy and
Procedure)
Profession
•Licensing
•Regulation
•Educational requirements
•Knowledge and Expertise
Macro
Division of
Labour
A lot !
Very Little
Very Little
Radford, 2012 . PhD

9. Working to the top of your license
The Institute of Medicine in 2010
• Each care team member works within a different scope of
practice, so that a Advanced Practitioner can do more than an
RN, an RN can do more than a HCA, and so on.
• The idea of operating at the top of your license means
practicing to the full extent of your education and training,
instead of spending time doing something that could be
effectively done by someone else.

10. Band 2
Band 3
Band 5 -
RN
Band 6
Band 8 ACP
Doc
What's possible
What you do now
Training
& Ed
Training
& Ed
Training
& Ed

11. ACP Program HEE(WM)
https://www.hee.nhs.uk/sites/default/files/documents/ACP%20Fr
amework%20for%20the%20WM.PDF

12. ACP Program HEE(WM)

13. Vision – to enable a
skilled and knowledgeable
Advanced Practice
workforce to be used
effectively to enhance the
capacity of the existing
health workforce to
ensure a quality service
for patients, now and in
the futureAcademic
Framework
Curriculum
diversity
Competence
diversity
Academic
and
Professional
uncertainty
of ACP
Role Diversity
Deployment
challenges
Regulation
and
management

14. • Curriculum and
Competence
• Consensus across all HEI’s
• Clear outlined model and
framework
• Defined 80% core curriculum
• Covers Primary, Secondary ,
(Nurse, Midwife and AHP)
MH and LD
• 20% local academic and
speciality variation

15. • ACP Deployment model in
HEE (WM)
• Agreed model & definition
• Alignment of educational
and professional
educational standards
• Nomenclature and grading
harmonisation
• 15/16 - 200 Student ACP’s
in training

16. UHCW – Advanced Practice teams
• Acute Med
• General Med
• Gynaecology
• Trauma
• Cardiac surgery
• Cardiology
• Gerontology
• Anaesthesia
• ED
• Neonatology

17. Chief Nursing Officer
University Hospitals Coventry & Warwickshire NHS Trust
Clifford Bridge Road
Coventry
CV2 2DX
Tel: 024 7696 4000