This document discusses the future of primary care and the paradigm shift in the role of nurses to promote self-care and management of long-term conditions. It outlines key NHS policies that emphasize prevention, empowering patients, new models of integrated care, and reducing inpatient admissions. The role of nurses is shifting towards coordinating care, educating patients on self-management, and working in partnership with individuals, families, and communities. Ten commitments are presented to equip nurses with the necessary skills and approaches to support this changing healthcare environment and paradigm shift in the nursing role.
Introduction and definition of healthcare
Concepts and values in healthcare
Efficiency-driven approaches
Problems and proposed solutions
Healthcare and population health
Investing in Health
Equity-driven approaches
Primary health care
Conclusion
Beginning in 2014 and continuing through 2017, Native American Health Center’s SBHCs incorporated social determinants of health questions into screening tools used with students. This presentation will provide an update on implementing these screening questions, specifically the challenges and strategies to responding effectively when students identify a need. The importance of leveraging internal resources, partnering with community agencies and building connections with school staff will be addressed in relation to specific identified needs. Models of clinic staff role expansion and internal capacity building, along with other challenges and adaptations will be shared as tools for helping participants plan for and engage in incorporating screening and evaluations of these important health indicators into their practices.
Introduction and definition of healthcare
Concepts and values in healthcare
Efficiency-driven approaches
Problems and proposed solutions
Healthcare and population health
Investing in Health
Equity-driven approaches
Primary health care
Conclusion
Beginning in 2014 and continuing through 2017, Native American Health Center’s SBHCs incorporated social determinants of health questions into screening tools used with students. This presentation will provide an update on implementing these screening questions, specifically the challenges and strategies to responding effectively when students identify a need. The importance of leveraging internal resources, partnering with community agencies and building connections with school staff will be addressed in relation to specific identified needs. Models of clinic staff role expansion and internal capacity building, along with other challenges and adaptations will be shared as tools for helping participants plan for and engage in incorporating screening and evaluations of these important health indicators into their practices.
This presentation offers critical insight on the social determinants of health and public policy.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
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This presentation offers critical insight on the social determinants of health and public policy.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Program among these measures are the NATIONAL HEALTH PROGRAMS, which have been launched by the central government of control/ eradication of communicable diseases, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health. Introduction
Barriers and facilitators for regular physical exercise among adult females n...Dr. Anees Alyafei
What stimulates and prevents females from regular physical exercise. Updated Comprehensive narrative review.
https://www.researchgate.net/publication/341220204_Citation_AlYafei_A_Albaker_W_2020_Barriers_and_Facilitators_for_Regular_Physical_Exercise_among_Adult_Females_Narrative_Review_2020
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2. The aim of this session is to
◦Analyse key NHS and Nursing Policy in relation to
supporting care provision for people living with long
term conditions
◦Address LO 4 "Analyse the role of the professional
nurse in promoting self care and management of adults
with long term conditions"
◦
3. By the end of the session
◦ List core Health Policy that is shaping the care of patients with long term conditions
◦ Define paradigm shift
◦ List the models of care being introduced in order to support patients with long term conditions
◦ Reflect upon the role of the nurse and list the skills required to coordinate care for patients with
long term conditions
Content mapped with the Module LO 4 and can be used to underpin and inform discussion
related to the role of the nurse
4. Reminder from yesterday
◦ 15 Million people have a long term condition
◦ 58% of over 60’s have a long term condition (increased in lower socio-
economic groups)
◦ 50% of all GP appointments
◦ 64% of all Outpatient appointments
◦ 70% all in patient bed days
◦ £7 of every £10 of total health and social care budget is spent on
patients with a long term condition. NHS Budget 2017/18 = £124.7
billion
5. First complete the following
Reflection (5mins)
◦ Reflect upon the NHS and highlight 3 areas
that concern you from each of the
following perspectives:
◦ One as a member of the public
◦ Two as a student nurse
◦ Three as an advocate for a patient who has
co morbitities and living on their own
Consider
◦ Political climate
◦ Media reports
◦ Experience
When construction your responses
6. Look at your responses
Consider
◦ The responses from each perspective
◦ Do they differ?
◦ Is there a common area across each of the
perspectives
◦ Your sources
◦ What do you conclude from your
responses?
Self Assessment
Using a scale 1-10 1 being none
5 being good 10 being excellent
◦ Your knowledge
◦ Your understanding
◦ Your confidence on the topic
◦ Conclude innate or informed or both
7. Did you think of the following
◦ Increasing demand, ageing population
◦ New Treatments
◦ Increased pressure
- 3 million avoidable A&E attendances - reduce 2000 – 3000 beds (146
-200 000 less admissions)
◦ Increased General Practice (7 day/week)
◦ Focus on frailty
◦ Integrated services and Funding (Accountable Care Systems)
◦ Technology and Innovation
8. Political Climate: Neo Liberalism
◦ Based upon
◦ Economic liberalisation
◦ Privatisation
◦ Fiscal Austerity
◦ Deregulation
◦ Free Trade
◦ Individual responsibility rather than state managed
◦ Underpinned UK government strategy since 1980’s
9. Consequences of this ideology for
patients with LTCs
◦ Individual Responsibility
◦ Shift from “treating” to “living with”
◦ New normal
◦ Responsibility for self-care
◦ Use of wider resources – community, digital
◦ Is this driving a paradigm shift in nursing?
10. Ideology underpinning policy shaping
care services
◦ Examples of Policy Documents
◦ Current Core Policy Driver is Five Year Forward View, available at
https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf
◦ What is a paradigm shift according
to https://dictionary.cambridge.org/dictionary/english/paradigm-shift
◦ "It is a time when the usual and acceptable way of doing and thinking about something changes
completely" so is nursing undergoing a paradigm shift and what is driving this shift?
11. Care built on these Principles
◦Prevention
◦Empowering Patients
◦Efficiency
◦New Models of Care (House of Care)
◦In patient care as a last resort
12. Commitment 1 -We will promote a culture where improving the
population health is a core component of the practice of all nursing,
midwifery and care staff
Drivers
◦ All our Health
◦ Five Year Forward View
◦ Public Health Outcome Framework
Action
◦ Act as a role model in adopting a healthy
lifestyle
◦ Share information about healthy choices
◦ Support people to make informed choices
◦ Be open and willing to change in response
to evidence/research
13. Commitment 2 -We will increase the visibility of nursing and midwifery
leadership and input in prevention
Aims
◦ •Championing health promotion
◦ •Social movement for health
◦ •Leading and shaping care especially
young people and children
Actions
◦ •Promote culturally appropriate systems of
prevention for sustainable change
◦ •Enable people to take responsibilities for
their behaviours
◦ •Make every contact count
Design and implement prevention
programmes
14. Commitment 3 - We will work with individuals, families and communities to
equip them to make informed choices and support them to manage their own
health
Context
◦ Poor health of older population
◦ Making every contact count
◦ Working with communities
Actions
◦ Encourage and engage individuals to make
healthy choices
◦ Co-design personalised care plans
◦ Work with communities – harness
voluntary sector
◦ Share skills of self- management, self-
esteem, social contact and build networks
for resilience
15. Commitment 4 -We will focus on individuals experiencing high value care
Ideology
◦ No decision about me without me
◦ Putting people first
◦ Care planning
◦ User voices
Actions
◦ Individuals influence all aspects of co-
ordinated care – ensuring culture,
difference and vulnerability is respected
◦ Listen and respond to actual needs
◦ Curiosity to unwarranted variation
◦ Adapt care to “place” based care
16. Commitment 5 -We will work in partnership with individuals, their
families, carers and others important to them
Approaches
◦ Asset based care
◦ Integrated Services – including volunteers
◦ Personalised care, community partnerships,
equality, valuing carers, volunteering and
social action
Action
◦ Co-design plans to provide care in the right
time, in the right place to agreed outcomes
◦ Build trusting relationships
◦ Co-ordinate care
◦ Coach individuals and families for care to
be delivered in a way that works for them
17. Commitment 6 -We will actively respond to what matters most to our
staff and colleagues
Aims
◦ What matters to you?
◦ Mental Health First aiders
◦ Work environment
◦ Right staff support systems
◦ Staff engagement
Actions
◦ Sharing learning
◦ Listen to our colleagues to ensure we
deliver outcomes
◦ Listen and create opportunities for new
ways of working
◦ Seek feedback on the quality of services
18. Commitment 7 -We will lead and drive research to evidence the impact
of what we do
Aims/Targets/Goals
◦ Celebrating success
◦ Building competency and capability to
identify unwarranted variation
◦ Use metric to improve productivity
◦ Share findings
Actions
◦ •Effectively manage resources to reduce
waste
◦ •Understand local systems
◦ •Act as an agent of change
◦ •Listen to individuals to deliver measurable
care
19. Commitment 8 -We will have the right education, training and development to
enhance our skills, knowledge and understanding
Aims and Goals
◦ Revalidation
◦ Shape of Care Review
◦ Career progression
◦ Clinical academic careers
◦ Working across settings
Actions
◦ Value of reflection and learning from
experience
◦ Seeking constructive feedback
◦ Team and action learning
◦ Acquiring right skills, knowledge and
behaviours to measure our impact
20. Commitment 9 -We will have the right staff in the right places at the
right time
Aims/Targets
◦ Carter Review
◦ Working across organisational boundaries
◦ Recruitment and retention
◦ Evidence behind workforce decisions – local
context
◦ E-learning package to monitor and support
development
Actions
◦ Engage in development and training
◦ Facilitate new ways of working
◦ Flexible patterns of work
◦ Workplace as a beacon of excellence
21. Commitment 10 -We will champion the use of technology and
informatics to improve practice, address unwarranted variations and
enhance outcomes.
Goals
◦ Technology literate workforce
◦ Technology to reduce variation
◦ Leading as early adopters
◦ Empowering for self management
◦ Technology to manage workforce
Actions
◦ Embrace technology and informatics
◦ Understand benefits to increase time to
care
◦ Technology for co-ordination
◦ Dissemination and tool to reach hard to
reach groups
22. These 10 commitments
◦Are designed to equip the nurse with the skills
required to survive/shape a modern health care
service underpinned by neo liberalism ideology
◦Therefore and final thought if and when the political
climate changes from the current neo liberalism
ideology, would this result in a further paradigm shift
for nursing?
23. References
◦ JaneCummings – Supported Self Care commentary, available at
https://www.england.nhs.uk/2017/01/jane-cummings-29/
◦ Five Year Forward View, available at https://www.england.nhs.uk/wp-
content/uploads/2014/10/5yfv-web.pdf
◦ Leading Care, Adding Value, available at https://www.england.nhs.uk/wp-
content/uploads/2016/05/nursing-framework.pdf
◦ Next Steps on the NHS Five Year Forward View available at https://nhs.engand.nhs
◦ Nuffield Institute, available at http://www.nuffieldtrust.org.uk/
◦ NHS England Self Care, available at https://www.england.nhs.uk/ourwork/patient-
participation/self-care/