RepsDirect No 145 - 22nd July 2002

• Head of Health Sabbatical
• National Association of Theatre Nurses
• Health Professions Council
• Pathology Services
• Early Implementers
• Changing Workforce Programme
• Whitehall College Courses
• Latex Allergy

Next step forward for NATN

The National Association of Theatre Nurses has concluded a partnership agreement with amicus-MSF which will provide indemnity insurance and workplace representation to NATN members. The arrangement concludes a three month series of negotiations and Melanie van Limborgh , Acting Chairman of NATN, and Roger Spiller, Head of Health for amicus-MSF, will exchange the articles of association in London on Wednesday 24 July.

Ms van Limborgh commented: "NATN is a rapidly expanding organisation and it is vital that we meet our members' expectations in the service that we provide. This partnership builds on the professional support we already offer and gives a solid platform upon which NATN can continue to grow.

"The NATN negotiating team led by our Professional Officer, John Beesley and Treasurer, Marion Taylor, have concluded an agreement which allows NATN to maintain its traditional independence yet seizes many of the opportunities offered by a trade union."

Roger Spiller comment on behalf of amicus-MSF: "I warmly welcome this new partnership with the National Association of Theatre Nurses which further reinforces amicus-MSF's position as the premier union for healthcare professionals. NATN members will benefit from retaining membership of their own professional organisation while at the same time enjoying all the benefits of belonging to the UK's second largest trade union. Benefits of this dual membership being not only the support of NATN as the professional body for Theatre Nurses but also full trade union support and backing including Professional Indemnity Insurance cover, provided by amicus-MSF"

Copies of the consultation document are available from Colin Adkins in the Health Section Office. Colin.Adkins@amicus-m.org

Members and OACs are asked to send in comments on the issue of the proposed fee level and other issues raised in the consultation documents by Friday 23rd August 2002 in order that these may form part of a submission from Amicus MSF. Comments are also welcome from members and OACs who have aspirations to be registered with the HPC in the not too distant future. These should be sent to Colin Adkins.

SUMMARY PROGRESS REPORT ON 13 PILOT SITES -MAY 2002

This is the collection of summaries from the Changing Workforce Programme (CWP) pilot reports, for the end of May 2002.

Introduction
Pilot Progress Report
Diabetes

The pilot is progressing well. Design teams have been set up, are currently engaged in the final scoping of the new roles, and are beginning the small scale tests. During this process more new and amended roles are beginning to fall out, as the potential impact of the roles on the rest of the service is realised. The roles currently under development include:

a community diabetes educator, who will deliver a series of weekly education sessions in a community centre, targeted at specific patient groups and according to their specific education needs;

diabetes care technicians, who will carry out the basic technical and slightly more advanced aspects of the annual review, according to the level of competence of the technician (2 grades);

extended role diabetes practitioners: these roles will extend the scope of practice for diabetes specialist nurses, dietitians, podiatrists and pharmacists involved in diabetes care, enabling a more seamless service for patients with fewer hand-offs and delays. This will result in increased depth of some roles, with staff taking on more responsibility and developing greater expertise, as well as working across the traditional uni-disciplinary boundaries (e.g. dieticians and DSNs taking on aspects of each other's roles). It also involves redesign of the roles at all the levels within the service.

a diabetes co-ordinator, who will bring together information about diabetes, including new research, best practice and information about education and training, and be a central point of contact for patients and staff, which will help to co-ordinate the service.

As the work progresses, more people are becoming involved in the pilot, seizing the opportunity to test out new ways of working within their own sphere, e.g. the paediatric DSN and specialist paediatric dietician are coming into the pilot to test out new ways of sharing their work. In addition, new ideas for roles continue to emerge, such as a diabetes runner to make contact with all patients with diabetes admitted to hospital, and ensure and co-ordinate contact with the specialist diabetes team, during admission and after discharge home. Initial scoping of some of these new ideas goes on in tandem with the other work, where there is overlap or strong connections. Additional themes will continue to be explored throughout the life of the pilot. In Peterborough it was decided to provide regular updates for local trust newsletters and community papers to keep everyone informed of the progress of the pilot.

Mental Health

This month has seen a continued emphasis on the testing of roles, with some implementation occurring in 2 projects across the Mental Health pilot site. Roll out work is commencing within the pharmacy project, with a proposal to develop the specialist mental health clinical pharmacist role, and the dispenser role in North Cumbria. A lot of work is being done around providing baseline measures prior to any implementation of roles. Work was undertaken this month on the pre-piloting of the STR worker by the Changing Workforce Programme Mental Health pilot team, and Health and Social Care organisations. The pilot is continually receiving information on emerging new themes, and has in place a mechanism to review and organise these.

Primary Care

The area serviced by the Mendip PCT encompasses West Mendip, Shepton Mallet and East Mendip, and lies in the North East of Somerset. It is a rural area covering 300 square miles, and includes the towns of Street, Glastonbury, Wells, Shepton Mallet and Frome. The Mendip PCT provides community health services to a population of approximately 108,000. There are 16 general practices and four community hospitals in Frome, Shepton Mallet, Wells and Butleigh.

The fundamental aim of the pilot is to explore the implementation of new ways of working in primary care, with the aim of improving the experience of healthcare for both patients and staff. Five themes have been developed in discussion with management and staff in the Trust, and key stakeholders: recruitment and retention, intermediate care, therapists, public health and practitioners with a special interest.

Scientists (cancer)

The pilot for Cancer Scientists and Technical staff currently has three main themes: pathology, medical physics and oncological pharmacy. It is addressing the potential for solving service problems and labour shortages by developing new ways of working, and creating new roles. Developments since last month's report include the following:

Histopatholgy: testing is continuing on new ways of working for the biomedical scientists at UBHT (Bristol), and is expected to last approximately six months. The development of the MLA role, at Salisbury Health Care Trust, is awaiting NVQ2 accreditation. The MLAs and their assessors have been briefed on the NVQ level 2 requirements. Following successful completion of the NVQ2 it is anticipated that development work on a proposed NVQ3, aimed at supporting the extended role of the MLA, will commence. Discussions are underway at Southmead Hospital to investigate the potential of developing a new role for MLAs within the digital camera recording of cut ups and sections.

Oncological Pharmacy: the network pharmacist group continue to work on new roles / new ways of working around the following: network pharmacist (this could be developed into the consultant role below), patient information support role and preparation unit accredited support staff.

The following are also being considered but are subject to delay: consultant / specialist pharmacist (delayed by prescribing rights for pharmacist) and checking technician (requires MCA approval).

Medical Physics: work continues on new ways of working. A survey has been developed which is due to be sent to other radiotherapy centres around the country in early June. The survey will identify work undertaken by different staff groups within Medical Physics departments.

Senior House Officer & equivalent roles

The pilot is progressing well within the key clinical areas. Radiology has been identified as an ongoing project outwith the timescale of the pilot. Input from the Changing Workforce Programme has facilitated identification of appropriate training bodies to support role extension, and the Directorate has set up a group to take their project forward, looking at recruitment, retention and training issues.

The pharmacy team is developing an exciting new role, which combines learning from the initially separate areas tested. The broadened scope of practice will reduce handoffs, save SHO time, and provide improved medicine management. The pharmacists involved have showed much enthusiasm in view of the potential of the new role as an excellent recruitment initiative.

The obstetric group is ready to appoint a new obstetric technician, and the training needs of the service have been identified. A presentation to the midwifery team was well received despite initial concerns.

A visit to the Central Middlesex Hospital with the night nurse practitioner from UHL was extremely useful, and provided excellent contacts for support and information exchange. The UHL night nurse practitioner is planning a return visit to work alongside a CMH practitioner for comparative data.

Contact with the Audit Department at UHL has provided support and advice regarding progress measures. Further work in support of the services involved in the pilot is anticipated. Job descriptions, person specifications and training packages are being collated from each of the key clinical areas. Staff at each Steering Group meeting are giving presentations of new roles within each Directorate. The musculo skeletal service presented their new roles to the meeting in May. The urology service will present their new roles in July.

Allied Health Professionals