integrated nurse led respiratory service sandy walmsley rgn, msc lead respiratory nurse specialist...
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Integrated Nurse Led Respiratory Service
Sandy Walmsley RGN, MScLead Respiratory Nurse Specialist –Solihull Care Trust
Co Respiratory Clinical Lead – West Midlands SHA
Session Overview
Background
Current service
Future projects/developments
Reflections
How did it all start?Offered job in September 2005
Remit was to initiate Pulmonary Rehabilitation in Community
Funding also available for full time physiotherapist
If at first you don’t succeed……
Physiotherapist who was originally appointed declined the offer
After much discussion a Service level Agreement (SLA) was agreed with local Acute Trust
Friends need to be made!
GPs
Practice Nurses
Consultants
Commissioners
Professional Executive Committee (PEC)
Patients
Progress…….
Referrals started to come in from GPs, Practice Nurses & consultants
Nurse led clinics initiated to assess patients for PR
Community PR successfully initiated
But………..
More staff were needed to help manage referrals
What happened next?
Presentation of business case to PEC
Agreed to appointAnother nurseOccupational therapistAdmin assistant
Community Pulmonary Rehab expanded
Additional site identified
Maintenance classes commenced at both sites
Local Breathe Easy group “born” out of rehab classes
Admission figures from Pulmonary Rehabilitation
But quality was needed too
Further presentation to PEC to request yet more funding
Funding for provision for COPD diploma for1 practice nurse and1 GP from every surgery
Further funding awarded from SHA with proviso that training be offered to hospital nurses too.
Integration, integration, integration!
After lengthy discussions with consultants & physiologists
Business case submitted for 2 blood gas analysers
Pathway developed for integrated oxygen assessment pathway
Post discharge oxygen pathway
Rationalising oxygen use to improve patient safety and to reduce waste
The IMPRESS step-by-step guide
Partnership working
One GP consortia decided to address COPD with LES.
Agreed to fund further staff for teamBand 7 nurse2 HCAs
Early supported discharge to be initiated
Integrated discharge planning with acute care
Early Supported Discharge Figures & Trends
NHS
.........where to now?
The White Paper
• This represents a significant shift in focus for the NHS – moving away from monitoring the processes of care to monitoring the results of the care and treatment provided to patients
• Sets out the Government’s strategy for the NHS
Transforming Community Services
Integrating with acute care
Preparations have already started
Meetings with acute & community teams
Reviewing current pathways with all stakeholders
Current Projects
Working closely with Smoking Cessation Services to identify “Missing Millions”
One of 6 National End of Life projects. Working with Specialist Palliative Care Team
We CAN do it!!Draft consultation document & NICE Guidelines
foundation for quality care
Collect your data & benchmark with similar PCTs to use as rationale for service improvement and delivery
Contact SHA Leads for help & support
Showcase your service
Identify “friends” and share best practice
Together we will get the whole picture
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