Supporting experienced hospital nurses to move into community matron roles

Report of a study to examine the key knowledge and support required by nurses, experienced in the management of patients with long term conditions, to work in primary care contexts in undertaking community matron roles. Commissioned by the Department of Health (England) 200

An evaluation of the role of the Admiral Nurse : a systematic evidence synthesis to inform service delivery and research

Two thirds of people with dementia live in the community and receive support from family members. There is a great deal of evidence to suggest that caring for a person with dementia impacts on the health and wellbeing of family carers. Despite this the provision of funded support for family carers is often limited or inadequate. Admiral Nurses, developed in the 1990s, were specifically designed by the charity for dementia (now Dementia UK) to support the family carers of people with dementia. Admiral Nurses are mental health nurses specialising in the care of people with dementia. They are mainly employed by local providers of care for people with dementia but dementia UK is involved in setting up new posts and providing ongoing practice development. There are currently around 100 Admiral Nurses employed in England. In addition the charity has a national helpline provided by experienced Admiral Nurses. The evidence synthesis presented here was commissioned by Dementia UK in order to establish what is currently known about the scope, nature and effectiveness of Admiral Nurse

The district nursing and community matron services workforce: A scoping review in South London for the South London Nursing Network

This report presents both an overview of the issues influencing district nursing and community matron workforces and also a scoping of key issues in respect of workforce development in district nursing and community matron services in South Londo

The Guy's and St Thomas' NHS Foundation Trust Neighbourhood Nursing Team Test and Learn project of an adapted Buurtzorg model : An early view

This report provides the early view evaluation of a Test and Learn pilot of an adapted Buurtzorg model undertaken in Guy's and St. Thomas' NHS Foundation Trust (GSTT) adult community services in Inner London

The development of advanced clinical practitioners in NHS organisations providing acute, community and emergency services in London : an evaluative interview study

Internationally health care systems are developing advanced clinical practitioners (ACPs), such as nurse practitioners, to address growing health care needs, shortages of doctors and financial constraints. At present in the United Kingdom there is no state regulation for such roles in nursing, midwifery, allied health professionals or health scientists, either for the level of education or clinical competency. In England, Health Education England (HEE) which is responsible for workforce planning and training is supporting the development of ACP roles in all types of professional groups (nurses, midwives, allied health professionals and health scientists). The London HEE team commissioned an evaluative study concerned with factors influencing the development of ACPs. The evaluation questions addressed were: 1. What has influenced the development of ACP roles? 2. To what extent are NHS acute, community and emergency services employing and deploying ACPs? 3. What are the factors influencing the success or otherwise in introducing and sustaining ACPs in the workforce? 4. Is there documentary or published evidence of the value, or otherwise, of ACP roles and of patient perceptions of ACP roles. This monograph reports on a qualitative exploration in 2019 of the views of senior NHS managers and clinicians in a range of health care organisations in London

Models of inter professional working for older people living at home: a survey and review of the local strategies of English health and social care statutory organisations.

BACKGROUND: Most services provided by health and social care organisations for older people living at home rely on interprofessional working (IPW). Although there is research investigating what supports and inhibits how professionals work together, less is known about how different service models deliver care to older people and how effectiveness is measured. The aim of this study was to describe how IPW for older people living at home is delivered, enacted and evaluated in England. METHOD: An online survey of health and social care managers across England directly involved in providing services to older people, and a review of local strategies for older people services produced by primary care organisations and local government adult services organisations in England. RESULTS: The online survey achieved a 31% response rate and search strategies identified 50 local strategies that addressed IPW for older people living at home across health and social care organisations. IPW definitions varied, but there was an internal consistency of language informed by budgeting and organisation specific definitions of IPW. Community Services for Older People, Intermediate Care and Re-enablement (rehabilitation) Teams were the services most frequently identified as involving IPW. Other IPW services identified were problem or disease specific and reflected issues highlighted in local strategies. There was limited agreement about what interventions or strategies supported the process of IPW. Older people and their carers were not reported to be involved in the evaluation of the services they received and it was unclear how organisations and managers judged the effectiveness of IPW, particularly for services that had an open-ended commitment to the care of older people. CONCLUSION: Health and social care organisations and their managers recognise the value and importance of IPW. There is a theoretical literature on what supports IPW and what it can achieve. The need for precision may not be so necessary for the terms used to describe IPW. However, there is a need for shared identification of both user/patient outcomes that arise from IPW and greater understanding of what kind of model of IPW achieves what kind of outcomes for older people living at home

Adult nurse turnover and retention : South London project report

This project was commissioned by Health Education South London (HESL) in response to the workforce planning process for 2014/15 indicating an unprecedented increase in demand for adult nurses in NHS Trusts. The focus of the project was to identify issues and interventions to improve retention of adult nurses and reduce the rate of leaving jobs (turnover). During 2015 the work of the project has included: a systematic literature review to examine evidence of determinants, costs and interventions of adult nurse turnover; analysis of adult nurse workforce data to identify trends and rates in sub-groups of nurses and by characteristics of their employment context; interviews with senior nurse and human resource managers across South London for views and examples of initiatives to reduce turnover; interviews with adult nurses and nurse managers managers as to their views on the issues and initiatives that might help retain nurses. The evidence from each element is presented and then synthesised

Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: a systematic review of literature

Background Safe and timely access to effective and appropriate medication through primary care settings is a major concern for all countries addressing both acute and chronic disease burdens. Legislation for nurses and other professionals allied to medicine to prescribe exists in a minority of countries, with more considering introducing legislation. Although there is variation in the range of medicines permitted to be prescribed, questions remain as to the contribution prescribing by nurses and professionals allied to medicine makes to the care of patients in primary care and what is the evidence on which clinicians, commissioners of services and policy makers can consider this innovation. Methods An integrative review of literature on non-medical prescribing in primary care was undertaken guided by dimensions of health care quality: effectiveness, acceptability, efficiency and access. Results 19 papers of 17 empirical studies were identified which provided evidence of patient outcome of non medical prescribing in primary care settings. The majority were undertaken in the UK with only one each from the USA, Canada, Botswana and Zimbabwe. Only two studies investigated clinical outcomes of non-medical prescribing. Seven papers reported on qualitative designs and four of these had fewer than ten participants. Most studies reported that non medical prescribing was widely accepted and viewed positively by patients and professionals. Conclusions Primary health care is the setting where timely access to safe and appropriate medicines is most critical for the well-being of any population. The gradual growth over time of legislative authority and in the numbers of non-medical prescribers, particularly nurses, in some countries suggests that the acceptability of non-medical prescribing is based on the perceived value to the health care system as a whole. Our review suggests that there are substantial gaps in the knowledge base to help evidence based policy making in this arena. We suggest that future studies of non-medical prescribing in primary care focus on the broad range of patient and health service outcomes and include economic dimensions

Addressing incontinence for people with dementia living at home: a documentary analysis of local English community nursing service continence policies and clinical guidance

Aim and objectives.  To establish whether the problems and issues experienced by people with dementia living at home and their carers were addressed in the clinical guidance for continence management for community nursing services in England. Background.  Internationally, the numbers of people with dementia are rising. Managing incontinence is a significant issue as the presence of incontinence is one of the triggers for people with dementia to move their residence to a care home. People with dementia living at home and their family carers report difficulties in accessing knowledgeable professionals and acceptable continence products. Design.  A review by documentary analysis of clinical policies and guidance from a sample of community nursing services in all Strategic Health Authority regions of England. Methods.  A sample of clinical policy and guidance documents for continence assessment and management from up to four community nursing services in each of the ten Strategic Health Authority regions in England was sought. Documentary analysis was undertaken on the relevance of the documents identified for people with dementia living at home. Findings.  Ninety-eight documents from 38 local community nursing services spread across ten Strategic Health Authority areas were obtained and analysed. Only in the documents of three services were nurses offered detailed guidance about the management of incontinence for people with dementia at home. In the documentation of only one service were people with dementia identified as a special case which warranted the provision of additional continence products. Conclusion.  Clinical guidance on continence assessment and management for community nurses in many parts of England does not address the specific needs of people with dementia living at home or their carers. Relevance for clinical practice.  Nurses working in community settings and those providing clinical leadership in continence care should review their clinical guidance and policies to ensure relevance for people with dementia living at home and their family carers