Develop the team - nursing. Developing nursing roles in primary care. Reviewing a wide range of initiatives including from Manchester, Gateshead and Hanwell. Louise Brady, Clinical & Strategic Development Lead Practice Nursing , Manchester CCGs.

1. ‘The healix of change’
Louise Brady
Practice Nurse Donneybrook M/C
Clinical Lead Practice Nursing NHS Manchester
CCG’s
GPN Advisor NHS Alliance Executive

2. Heather Henry, Co- Chair, New NHS
Alliance and Queen’s Nurse,
Zoe Starmer Practice Nurse
Champion North Manchester CCG, &
Louise Kay, Lead for Practice
Nursing, Tameside & Glossop CCG
Representing
GMHSC Practice
Nurse
Collaborative &
Beyond!

3. The Perfect Storm
1/3rd to retire by 2020
Indemnity costs rising 10 fold
Variation in qualifications
Variation in terms and
conditions
Variable training placements
23% have more than one job
Opportunity
or Threat?
2015 survey of 3032 nurses concluded
Queen’s Nursing Institute

4. Opportunities for New Care
models
GM Practice Nurse Collaborative
• New Curriculum ‘Healix’
• Co- design, Co- production & Health Creation
In equal partnership with local people
• Nurturing & Developing the workforce
• Interdisciplinary Learning
• Realising time in Practice
• Improving Health Outcomes

6. A Magical Experience!!

7. What did I learn as a nurse?
• The foundation for peer support is spontaneous ,
it’s natural and it occurs with ease, when there is
mutual agreement of ‘what is helpful’
• Less correcting, and more Connecting!
• 147 RTC evidence base for peer 2 peer ( Nesta)
• Nursing as a whole offers communities a rich
architecture of care, knowledge & skill base to tap
into to
• Combine that knowledge & support with the
abundance of local knowledge & skill that exists
within our communities, & we have a rich
tapestry of care.

8. Impact
Respiratory: Practice nurses instrumental in gathering
together Integrated Breathe easy Group April 2016
Potential outcomes
Applying Kent findings: 42% reduction in unplanned
GP visits. 57% reduction in unplanned hospital
admissions
Heart failure: Co-design PN developing information in
partnership with Patients to drive up quality of
accessible information ‘health literacy’ – tested
against information standard Published & peer
reviewed.

9. Impact
• Health inequalities are estimated to account for
over £5.5bn annually in healthcare costs to the NHS
in England each year
• Enabling ‘at risk groups’ to become more health
literate has potential for social & economic impact
and savings to the NHS.
• Only 30% of GP surgeries have information that is
accessible to people with learning disabilities.
• North Manchester Peer group: 500 members
Learning disabilities Aim: 2 support a 10% increase
in LD Care. PN Key to connect with communities

10. Outcomes: Diabetes Prevention in Practice Shared
Medical appointments
• Nurse Led by Nicola Milne Practice nurse: with17
Patients
• Total weight loss 52kg waist circumference 53cm
• Reduction in BP, lipids, fasting glucose
• Post prandial glucose level dropped by 1.7mmols
from a baseline of 8.2mmols to 6.5mmols.
• At 1 yr follow up: average weight increase 0.8kg
but 3kg below mean weight at start of
programme.
• Increased wellbeing scores, patient experience &
peer support. Published & peer reviewed.

11. Moving towards Group Consultations
•A more efficient, rewarding and person centered way
to improve outcomes , at individual & population
level
•Also known as shared medical appointments (SMA’s)
Clinical consultations that take place in a supported
group setting that have a strong evidence base .
•One of the High impact Actions outlined in GP
Forward View
Alison Manson
Group Consultations Programme Lead,
The ELC Programme

12. What group consults are not..
• Health education
• Self management support
• Self help groups
• Behavioral medicine programmes
• Group therapy sessions
• Expert patient programme

13. The aim & ambition
• Alternative way of seeing patients more
patients 1:1 in less time
• Consultation model that also delivers peer
support
• A way of supporting a group of people who
have a similar condition ( 10 -15)
• 1.5 – 2 hour session with clinician present
for around 45 mins

14. Why adopt Group Consultations?
• Potential to transform primary care
• Improve clinical outcomes, patient and
clinicians experience
• Help cut time pressures and clinic backlogs
• Bring joy back to primary care
• A good fit with what patients tell us matters to
them!

15. City Wide Group
•Shared learning
•Partnership work
•Vertical &
horizontal
integration
•Potential to
transform primary
care
•Improved clinical
outcomes, patient
and clinicians
experience time
•Bring joy back to
primary care!!!!

16. Thank you for listening
Louise.brady2@nhs.net
Twitter: @louisebrady17