This document describes care navigation services in West Wakefield, UK. It provides details on the care navigation model, including definitions, staff involved, services available, guidelines and results from 2016-2017. Over 25,000 patients were signposted away from GP appointments to alternative services, with high acceptance and satisfaction rates. This significantly freed up GP time, estimated to be over 700 hours in one example practice. Online training and consultancy is available to help implement successful care navigation programs.
يكون التعلّم "ذا معنى" عندما يقوم الطالب من خلاله بإثارة أسئلة، فيعثر على مصادر معلومات، يعالج المعلومات ويخلق معرفةً جديدة ذات صلة بعالمه الشخصي وبالحياة. في العصر التكنولوجي خلال القرن ال- 21 يعتبر الهدف من التعلّم "ذي المعنى" تطوير القدرة على التفكير وعلى الابتكار والتعلّم الذاتي وتشجيع التنمية الشخصية والتدخل الاجتماعي.
برنامج شهادة كامبردج الدولية في تقنية المعلومات يمثل معياراً دولياً لقياس مهارات استخدام الحاسب,ويمكن للمتدربين على هذا البرنامج الحصول على شهادة معتمدة وموثقة ومعترف بها عالمياً ومحلياً في مجال استخدامات الحاسب . ومنهاج البرنامج مبني على اساس علمي ومعتمد من هيئة امتحانات كامبردج الدولية وهي من أضخم الهيئات المزودة للمؤهلات الدولية في العالم .
وقد صمم البرنامج ليغطي المهارات الاساسية في استخدام الحاسب وتطبيقاته وينقسم إلى سبعة وحدات تدريبيه بالاضافة إلى اختبارات تفاعليه عالميه معتمدة تقيس المهارات المكتسبة لدى المتدرب يتم إجرائها لكل وحدة تدريبية .
يكون التعلّم "ذا معنى" عندما يقوم الطالب من خلاله بإثارة أسئلة، فيعثر على مصادر معلومات، يعالج المعلومات ويخلق معرفةً جديدة ذات صلة بعالمه الشخصي وبالحياة. في العصر التكنولوجي خلال القرن ال- 21 يعتبر الهدف من التعلّم "ذي المعنى" تطوير القدرة على التفكير وعلى الابتكار والتعلّم الذاتي وتشجيع التنمية الشخصية والتدخل الاجتماعي.
برنامج شهادة كامبردج الدولية في تقنية المعلومات يمثل معياراً دولياً لقياس مهارات استخدام الحاسب,ويمكن للمتدربين على هذا البرنامج الحصول على شهادة معتمدة وموثقة ومعترف بها عالمياً ومحلياً في مجال استخدامات الحاسب . ومنهاج البرنامج مبني على اساس علمي ومعتمد من هيئة امتحانات كامبردج الدولية وهي من أضخم الهيئات المزودة للمؤهلات الدولية في العالم .
وقد صمم البرنامج ليغطي المهارات الاساسية في استخدام الحاسب وتطبيقاته وينقسم إلى سبعة وحدات تدريبيه بالاضافة إلى اختبارات تفاعليه عالميه معتمدة تقيس المهارات المكتسبة لدى المتدرب يتم إجرائها لكل وحدة تدريبية .
اثارة التحفيز والدافعية لدى الطلاب للتعلم
حقيبة اثارة التحفيز والدافعية لدى المتعلمين
لا شك ان المعلم هو الاساس وله الدور الاكبر في اثارة الدافعية هي واحدة من استراتيجيات التعلـم والتعليم التــــي يمارسها المعلم في الغرفة الصفية بل ربما تكون هي من اهم هذه الاستراتيجيات واصعبها تطبيقا ، فالطلبة ياتون الى المؤسسة التعليمية بمستويات مختلفة من الدافعية ( مرتفعة ، متوسطه، ومنخفضة) ولا يوجد هناك وصفة سحرية لاثارة دافعية الطلبة للتعلم، لذلك فاثارة دافعية الطلبة بحاجة لمهارة وفن من قبل المعلم
المحتويات الفنية للحقيبة التدريبية:
فيديو تدريبي.
نشاط تدريبى
مفهوم الدافعية
أهمية الدافعية فى التعليم
نشاط تدريبى
أنواع الدافعية
وظائف الدوافع
نشاط تدريبى
فيديو تدريبي.
استخدام الدوافع فى التعليم الصفى
العلاقة بين الدوافع والعادات
الدوافع والتحفيز
نشاط تدريبى
مظاهر وأسباب تدنى الدافعية للتعلم
وظيفة الدوافع فى عملية التعلم
قصة تدريبية
تفسير الاتجاهات النفسية فى تفسير الدافعية للتعليم
فيديو تدريبي.
توظيف الدافعية داخل الفصل الدراسى
نشاط تدريبى
أسباب مشكلة انخفاض الدافعية للتعليم عند الطلاب
نشاط تدريبى
فيديو تدريبي.
حلول مقترحة لعلاج مشكلة تدنى الدافعية للتعليم
دور المعلم فى اثارة وتحفيز دافعية الطلاب للتعلم
نشاط تدريبى
دور الاسرة فى اثارة وتحفيز دافعية الطلاب للتعلم
العوامل المثيرة للتفاعل الصفى والدافعية
نشاط تدريبى
فيديو تدريبي.
انواع التفاعل الصفى
التقويم وزيادة الدافعية للتعليم
نشاط تدريبى
العلاقة بين التحفيز والتعليم
حالة عملية
مدة الحقيبة التدريبية:-
عدد الأيام:
يوم تدريبى
عددالجلسات:
جلستان
عدد الساعات:
4 ساعات
أهم خداماتنا فى مجالات الحقائب التدريبية:
حقائب تدريبية, حقائب تدريبية تعليمية,حقائب تدريبية اسرية,حقائب تدريبية عن تطوير الذات
حقائب تدريبية خاصة بمجال الاطفال , حقائب تدريبية عن الموارد بشرية
حقائب تدريبية تسويق ومبيعات,حقائب تدريبية عن الادارة,حقائب تدريبية عن القيادة
Internal audit ARABIC course PART II Jamal Nassar 2013 v3 المراجعة الداخلي...Jamal Nassar
كورس باللغة العربية عن خطوات المراجعة الداخلية واساسياتها... يعنى بهذا الكورس المبتدئين والاشخاص الذين ليس لهم خلفيه في هذا المجال.
اعداد وتحضير جمال نصار الهمداني
مدرب متخصص في الاستراتيجية وادارة الاعمال
وكذلك يقدم دورات في الادارة والتواصل عبر الثقافات مع شركة بروكفيلد العالمية حاليا مقيم في ماليزيا
للمزيد
www.JamalNassar.com Email: tojamalnassar@gmail.com
This is an internal Audit mostly in Arabic.
التعليم المتمايز : هو فلسفة في التدريس موجهة إلى مساعدة المعلم على تطويع خطة وسيناريو الموقف التعليمي تبعا للاختلافات الموجودة بين الطلاب في الاهتمامات وأنماط وتفضيلات التعلم والخلفيات المعرفية، وبما يكفل للجميع تحقيق أكبر قدر ممكن من نواتج التعلم المستهدفة.
جوانب الاختلافات بين الطلاب في فصول التعليم المتمايز . تعريف التعليم المتمايز . المبدأ الرئيسي للتعليم المتمايز . الأبعاد الأساسية للتعليم المتمايز . الأهداف الأساسية للتعليم المتمايز. طريقة قياس التمايز بين الطلاب في تفضيلات التعلم . أفضل الاستراتيجيات التدريسية القادرة على تفعيل التعليم المتمايز. من إعداد د. حسين محمد أحمد عبد الباسط . كلية التربية بقنا – جامعة جنوب الوادي
شهد التعليم في القرن الحادي والعشرين تحولًا جذريًا في أساليب التدريس وأنماط التعليم ومجالاته، وقد أتى هذا التطور استجابةً لجملةٍ من التحديات التي واجهته؛ تمثلت في تطور تقنيات التعليم وزيادة الإقبال عليه والانفجار المعرفي الهائل. ومن هنا؛ أصبح التعليم مطالبًا أكثر من أي وقتٍ مضى بالعمل على الاستثمار البشري بأقصى طاقةٍ ممكنة، وذلك بتطوير مهارات الطلاب ليكونوا قادرين على التعامل مع كافة المستجدات والمتغيرات التي يشهدها العصر.
ولعل أهم ما يشغل التربويين هو كيفية إعداد المعلم باعتباره الركيزة الأساسية لتطوير التعليم. ولما للمعلم من تأثير كبير في جودة مخرجات العملية التعليمية، فإن إحداث أي تغيير تربوي أو تحديث في المناهج وطرائق التدريس لا يمكن أن يتم دون وجود معلمٍ كفء مؤهل.
إذن؛ فالتطوير المهني المستمر ضرورة عصرية، تُمكّن المعلمين من إعداد جيل مستعد لمتطلبات التطور في عصر التكنولوجيا والانفتاح على الثقافات.
Active signposting. Training reception staff and providing tailored information about services, to connect patients with the most appropriate source of help and advice. Featuring West Wakefield's approach. David Cowan. Social Prescribing & Care Navigation Lead , West Wakefield Health & Wellbeing.
اثارة التحفيز والدافعية لدى الطلاب للتعلم
حقيبة اثارة التحفيز والدافعية لدى المتعلمين
لا شك ان المعلم هو الاساس وله الدور الاكبر في اثارة الدافعية هي واحدة من استراتيجيات التعلـم والتعليم التــــي يمارسها المعلم في الغرفة الصفية بل ربما تكون هي من اهم هذه الاستراتيجيات واصعبها تطبيقا ، فالطلبة ياتون الى المؤسسة التعليمية بمستويات مختلفة من الدافعية ( مرتفعة ، متوسطه، ومنخفضة) ولا يوجد هناك وصفة سحرية لاثارة دافعية الطلبة للتعلم، لذلك فاثارة دافعية الطلبة بحاجة لمهارة وفن من قبل المعلم
المحتويات الفنية للحقيبة التدريبية:
فيديو تدريبي.
نشاط تدريبى
مفهوم الدافعية
أهمية الدافعية فى التعليم
نشاط تدريبى
أنواع الدافعية
وظائف الدوافع
نشاط تدريبى
فيديو تدريبي.
استخدام الدوافع فى التعليم الصفى
العلاقة بين الدوافع والعادات
الدوافع والتحفيز
نشاط تدريبى
مظاهر وأسباب تدنى الدافعية للتعلم
وظيفة الدوافع فى عملية التعلم
قصة تدريبية
تفسير الاتجاهات النفسية فى تفسير الدافعية للتعليم
فيديو تدريبي.
توظيف الدافعية داخل الفصل الدراسى
نشاط تدريبى
أسباب مشكلة انخفاض الدافعية للتعليم عند الطلاب
نشاط تدريبى
فيديو تدريبي.
حلول مقترحة لعلاج مشكلة تدنى الدافعية للتعليم
دور المعلم فى اثارة وتحفيز دافعية الطلاب للتعلم
نشاط تدريبى
دور الاسرة فى اثارة وتحفيز دافعية الطلاب للتعلم
العوامل المثيرة للتفاعل الصفى والدافعية
نشاط تدريبى
فيديو تدريبي.
انواع التفاعل الصفى
التقويم وزيادة الدافعية للتعليم
نشاط تدريبى
العلاقة بين التحفيز والتعليم
حالة عملية
مدة الحقيبة التدريبية:-
عدد الأيام:
يوم تدريبى
عددالجلسات:
جلستان
عدد الساعات:
4 ساعات
أهم خداماتنا فى مجالات الحقائب التدريبية:
حقائب تدريبية, حقائب تدريبية تعليمية,حقائب تدريبية اسرية,حقائب تدريبية عن تطوير الذات
حقائب تدريبية خاصة بمجال الاطفال , حقائب تدريبية عن الموارد بشرية
حقائب تدريبية تسويق ومبيعات,حقائب تدريبية عن الادارة,حقائب تدريبية عن القيادة
Internal audit ARABIC course PART II Jamal Nassar 2013 v3 المراجعة الداخلي...Jamal Nassar
كورس باللغة العربية عن خطوات المراجعة الداخلية واساسياتها... يعنى بهذا الكورس المبتدئين والاشخاص الذين ليس لهم خلفيه في هذا المجال.
اعداد وتحضير جمال نصار الهمداني
مدرب متخصص في الاستراتيجية وادارة الاعمال
وكذلك يقدم دورات في الادارة والتواصل عبر الثقافات مع شركة بروكفيلد العالمية حاليا مقيم في ماليزيا
للمزيد
www.JamalNassar.com Email: tojamalnassar@gmail.com
This is an internal Audit mostly in Arabic.
التعليم المتمايز : هو فلسفة في التدريس موجهة إلى مساعدة المعلم على تطويع خطة وسيناريو الموقف التعليمي تبعا للاختلافات الموجودة بين الطلاب في الاهتمامات وأنماط وتفضيلات التعلم والخلفيات المعرفية، وبما يكفل للجميع تحقيق أكبر قدر ممكن من نواتج التعلم المستهدفة.
جوانب الاختلافات بين الطلاب في فصول التعليم المتمايز . تعريف التعليم المتمايز . المبدأ الرئيسي للتعليم المتمايز . الأبعاد الأساسية للتعليم المتمايز . الأهداف الأساسية للتعليم المتمايز. طريقة قياس التمايز بين الطلاب في تفضيلات التعلم . أفضل الاستراتيجيات التدريسية القادرة على تفعيل التعليم المتمايز. من إعداد د. حسين محمد أحمد عبد الباسط . كلية التربية بقنا – جامعة جنوب الوادي
شهد التعليم في القرن الحادي والعشرين تحولًا جذريًا في أساليب التدريس وأنماط التعليم ومجالاته، وقد أتى هذا التطور استجابةً لجملةٍ من التحديات التي واجهته؛ تمثلت في تطور تقنيات التعليم وزيادة الإقبال عليه والانفجار المعرفي الهائل. ومن هنا؛ أصبح التعليم مطالبًا أكثر من أي وقتٍ مضى بالعمل على الاستثمار البشري بأقصى طاقةٍ ممكنة، وذلك بتطوير مهارات الطلاب ليكونوا قادرين على التعامل مع كافة المستجدات والمتغيرات التي يشهدها العصر.
ولعل أهم ما يشغل التربويين هو كيفية إعداد المعلم باعتباره الركيزة الأساسية لتطوير التعليم. ولما للمعلم من تأثير كبير في جودة مخرجات العملية التعليمية، فإن إحداث أي تغيير تربوي أو تحديث في المناهج وطرائق التدريس لا يمكن أن يتم دون وجود معلمٍ كفء مؤهل.
إذن؛ فالتطوير المهني المستمر ضرورة عصرية، تُمكّن المعلمين من إعداد جيل مستعد لمتطلبات التطور في عصر التكنولوجيا والانفتاح على الثقافات.
Active signposting. Training reception staff and providing tailored information about services, to connect patients with the most appropriate source of help and advice. Featuring West Wakefield's approach. David Cowan. Social Prescribing & Care Navigation Lead , West Wakefield Health & Wellbeing.
Transforming clinical phamacy into a seven day serviceNHS England
This webinar gives an example of how the role Pharmacy services are improving patient care and flow across seven days a week.
Richard Cattell from NHS Improvement gave a national overview and weekend benchmarking information and Steve Brown, the regional lead from NHS Improvement & England gave some background information on the Carter Report.
Iain Davidson from Royal Cornwall NHS Trust and David Heller from Surrey and Sussex Healthcare NHS Trust describe the development of their respective weekend Pharmacy services and how this has improved patient care and flow
3.4 - Workforce and developing multi-disciplinary teams in primary careNHS England
The importance of the workforce needs in Beds, Luton and Milton Keynes, what does it mean to the people on the ground and how are they going to be affected. How will it improve their working lives?
Making Seven Day Services a reality, pop up uni, 2 pm, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
General Practice Transformation Champions: Care Navigation
1.
2. West Wakefield Health & Wellbeing
Care Navigation
David Cowan
Care Navigation Programme Manager
Twitter: @HealthyDaveC
David.cowan@westwakefield.org.uk
Twitter: @ConexusHealthUK
LinkedIn: West Wakefield Health & Wellbeing Ltd
Website: http://www.Conexus-Healthcare.org
3. Wakefield District
Wakefield District
• 37 Practices
• 369,000 Patients
West Wakefield
• 6 Practices
• 64,000 Patients
Networks 3, 5 and 6
• 18 Practices
• 162,000 Patients
4. Care Navigation Definition
“A person-centred approach that uses signposting and
information to help primary care patients and their carers
move through the health and social care system as
smoothly as possible to ensure that unmet needs are met”
5. Decreasing number of GPs
‘In March 2017 there were 33,423 FTE GPs (excluding
locums), which is a reduction of 890 (2.59%) on March 2016.’
Increasing number of patients
‘The 513,000 or 0.8% rise in the number of people living in
Britain in the year to June 2015 was similar to the annual
average increase over the last decade.’
Increasing number of Allied Health Professionals
‘There were 5,027 more qualified allied health professionals
(FTE) in March 2017 compared to March 2010 (8.51%).’
Why do Care Navigation?
NHS
Confed
Guardian
NHS
Digital
6. • GP forward view 2016 widening workforce.
• Care Navigators will be pivotal to navigate to the
extended primary care team and local services
• Patient’s receive the right care, by the right
professional, at the right time.
• This means one visit, not two for the patient.
• Improved job satisfaction for frontline staff.
• The Care Navigators now receive thanks from patients
https://youtu.be/OOWUWnJVmRk
Why do Care Navigation?
7. Extended Primary Care Team
• Care Navigators
• Physio First
• Pharmacists in General Practice
• Advanced Nurse Practitioners
• Paramedics
• Social Prescribing
• GP Extended Hours Services
• Mental Health Workers
• Health Champions
10. Best Practice Guidelines
• Practices have call recording facilities.
• To be backed up by the use of the clinical system template.
• Useful phrases:
• “If your condition worsens, please come back to us”
• “If the service we have given you information on, does not meet
your needs, please come back to us”
• Supplying patients with detailed information.
• Via leaflets, electronic information, etc.
11. Our Work in Focus: Care Navigation
2016/17 Results
• 25, 582 signposts away from GP appointments.
• 92% accepted signposts.
• 97% of patients surveyed were happy to see the
healthcare professional they were signposted to.
• 277 trained Care Navigators across Wakefield.
Feedback
“I'm happy as long as I get to see someone who is
best suited to help me.”
“It frees up the GP to see someone more needy,
you are able to see the best person to help you.
Makes the system more efficient.”
“Yes. Saves GP time. Target the problem.”
What are the results?
13363
2542
984
192 13
0
2000
4000
6000
8000
10000
12000
14000
16000
Internal Navigations Accepted
Pharmacist in GP
Nurse Practitioner
Physio First
Minor Illness Clinic
Practice Nurse
0
500
1000
1500
2000
2500
April
May
June
July
August
September
October
November
December
January
February
March
2016 2017
Accepted / Rejected Navigations Per Month
Accepted Navigation Rejected Navigation
12. 2016/17 Signposts
Services / Clinicians Accepted Signposts
Blood pressure monitoring 15
CASH Clinic 93
Community Pharmacy Service 1997
Counselling Service 7
Dental Service 11
District Nurse 300
Health Care Assistant 350
Health Trainer 5
IAPT 2
Midwife 3
Minor ailments clinic 218
Nurse Practitioner 2871
Nurse telephone triage 138
Optician 148
Pharmacist in GP 14812
Physio First 1091
Practice Nurse 242
Smoking cessation service 27
Social prescribing service 21
Social Services 5
Voluntary support service for carers 8
Warfarin Monitoring 5
Grand Total 22369
13. GP Time Saved Table
Service / Clinicians GP Time Saved (In Minutes)
Nurse telephone triage 5
Health & Wellbeing Development Worker 10
Blood Pressure Monitoring 5
Warfarin monitoring 0
CASH Clinic 10
Counselling service 10
Dental Service 10
District Nurse 5
Health care assistant 5
Health Trainer 10
IAPT 10
Midwife 10
Minor ailments clinic 10
Nurse practitioner 5
Optician 10
Pharmacist in GP 7.5
Community Pharmacy Service 10
Physio First 10
Practice Nurse 5
Smoking Cessation Service 10
Social prescribing service 10
Social Services 10
Voluntary support service for carers 10
14. GP Time Saved
• Pharmacist in GP
• Prescribing Support Services (PSS) study suggested that for every 100 minutes of
pharmacist time, 75 minutes of GP time was saved.
• Therefore, for every Pharmacist navigation we have accredited 7.5 minutes of GP
time saved.
• Advanced Nurse Practitioner
• Nurse Practitioner can effectively deal with all GP problems with the exception of
Fit notes and termination of pregnancy.
• Some patients who are referred to Nurse Practitioner could potentially see a GP
for 10 mins or 5 mins through telephone call.
• Therefore, for every ANP navigation we have accredited 5 minutes of GP time
saved.
• Physio First
• Patients would normally be seen by a GP for minor MSK problems.
• Now they are seen in a longer consultation by the physiotherapist.
• Very few patients are referred back to the GP after using Physio First.
• Therefore, each Physio First navigation is 10 minutes of GP time saved.
15. GP Time Saved
• Community Pharmacy Service
• Patient rings for minor illness, is then normally given a face to face assessment by
a GP or NP.
• Care Navigation directs them to a more appropriate resource.
• Patients could potentially have come to see a GP for an eye problem.
• Therefore, each above navigation is 10 minutes of GP time saved.
• Optician
• Through Care Navigation we are diverting patients to a more specialised clinician
through the pears scheme.
• This means they are seen within 48 hours by their regular optician, who provides
acute eye care in the community.
• Therefore, each above navigation is 10 minutes of GP time saved.
• Dentist
• Patient's should not be seen for dental problems in GP practice, but they can
present quite frequently.
• If they had not been asked the nature of their problem, these patients could have
seen a GP and their time would have been wasted.
• Therefore each dental problem care navigation is 10 minutes of GP time saved.
16. Practice Worked Example
• Care Navigation at a practice with a list size of 12,500 patients in 2016/17
• 5819 signposts per year = 743 GP hours saved
(based on the ‘GP Time Saved Table’)
• Typical GP at this practice works 8 appointment sessions of 3 hours
• 24 GP Consultation Hours per week
• 24 x 46 working weeks = 1,104 GP Consultation hours per year
• This Practice has 7 x WTE GPs
• 7 x 1,104 GP hours = Total of 7,245 GP hours per year
• 743 / 7,728 = 9.61% GP Consultation Hours Saved
17. The West Wakefield Model
Accredited
Online
Training for
Receptionists
Virtual Support &
E-Consultancy
Face to Face
Consultancy
18. Timeline
GP Stakeholder
engagement
Task and Finish
Group
Provider
Engagement
Event – Phase 1
‘Go Live’
Designing local
model
Accredited
Online Training
For Receptionists
Evaluation &
Rolling
Programme
3 Months
20. Covers the following topics;
• What is care navigation?
• Understanding the role of the care navigator
• Understanding how to undertake care navigation
• Understanding other health professionals we can work with for
effective care navigation
Outline of Accredited Online
Learning
22. Care Navigation Consultancy
• Lessons learned from delivering this model in Wakefield
& other elements of extending primary care
• Multiple packages to suit differing requirements
• Health Education England recommends ongoing support
from peers and mentors, as well as training resources about
local services (HEE Competency Framework, 2016).
• Business Intelligence Support
• Promoted by NHSE as best practice amongst the
Vanguards
23. Our Successes
Proud to have won a GP Award
and Yorkshire & Humber AHSN
award for our adoption &
spread of our model of care
across 10% of England
Care Navigation Learning Centre:
Over 3000 Learners had successfully completed the course
97.21% understood what Care Navigation was on completion
96.63% knew how to Care Navigate a patient
93.90% felt the training is clear and accessible
24. DAVID COWAN
CARE NAVIGATION PROGRAMME MANAGER
TWITTER: @HEALTHYDAVEC
DAVID.COWAN@WESTWAKEFIELD.ORG.UK
TWITTER: @CONEXUSHEALTHUK
LINKEDIN: WEST WAKEFIELD HEALTH & WELLBEING LTD
WEBSITE: HTTP://WWW.CONEXUS-HEALTHCARE.ORG
Any Questions?
Editor's Notes
Intros
The Journey, the spread
PMCF
Vanguard Year 1
Vanguard Year 2
Care Navigation didn’t have a set definition when the journey started, we’ve developed a model locally that works for our patients and practices.
The context: Numbers of FTE GPs in 2017 declined by 2.59%, as we know the trend has been declining for some time, however there are workforce plans to increase numbers of GPs by but the demand is far too great right now, with an increasing population year on year, especially in the more complex older generation. We now have numerous initiatives to help us get more alternative health professionals in general practice, such as Pharmacists, Physio & Paramedics.
Link back to the Quadruple aim. Lower Cost, Improved Patient Experience & outcomes, Improved Staff Experience.
Video to be used if required.
Care Navigation pivotal to extended the primary care team, acts as a gateway to these new clinicians
Example of one of our access criteria.
Allows Care Navigators to safely navigate patients to a service or clinician. This is something that we help with when spreading to other districts.
The receptionist can use the list of access criteria and print off a patient information leaflet too.
Further down the access information is explanations on what the services do, so if patients ask they have this as a reference.
There is also lists of local services their information such as opening times, addresses and contact details
Results
21,621 Signpost away from GP appointments
92% accepted signposts
97% of patients surveyed were happy to see the health care professional they were signposted to
277 Trained Care Navigators
New improved SystmOne template & signpost criteria
81.5% of patients feel it is appropriate for Receptionists to Care Navigate
Feedback
‘I'm happy as long as I get to see someone who is best suited to help me’
‘It frees up the GP to see someone more needy, you are able to see the best person to help you. Makes the system more efficient’
‘Yes. Saves GP time. Target the problem.’
‘Yes I do. Could put some peoples mind at rest. Can be stressful seeing a doctor’
‘Yes - helpful. GPs have got a lot on their plate.’
‘I think so. See someone who is the best person to see.’
These are the numbers of navigations going out to services and clinicians in the Wakefield district
This is the amount of GP time saved we allocate to each signpost a receptionist makes. This was developed locally with GPs, details to follow.
The Receptionists will be trained to the essential level via our online learning. They will not be expert at a social prescribing level for example.
This is the contents of our online learning package, which will take from 30 minutes to 2 hours to complete.
We facilitate the shared learning locally in terms of peer to peer support amongst experienced practice staff; secretaries, administrators practice managers often once worked on the reception booking appointments for patients. The practiced staff know the patients and are able to peer to peer support each other about what could work in practice. We facilitate the shared learning with guest speakers talking about phase one go live services, demonstration of locally developed clinical templates and our extensive experience of implementation through the hard earned lessons of implementing in Wakefield. These type of events are sighted by HEE as a key factor for success in care navigation programmes.