2. The aim of this session is to
âŚAnalyse key NHS and Nursing Policy in relation to
supporting care provision for people living with long
term conditions
âŚAddress LO 4 "Analyse the role of the professional
nurse in promoting self care and management of adults
with long term conditions"
âŚ
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 60âs 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 = ÂŁ124.7
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 â 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 1980âs
9. Consequences of this ideology for
patients with LTCs
⌠Individual Responsibility
⌠Shift from âtreatingâ to âliving withâ
⌠New normal
⌠Responsibility for self-care
⌠Use of wider resources â 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
âŚPrevention
âŚEmpowering Patients
âŚEfficiency
âŚNew Models of Care (House of Care)
âŚIn 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
⌠â˘Championing health promotion
⌠â˘Social movement for health
⌠â˘Leading and shaping care especially
young people and children
Actions
⌠â˘Promote culturally appropriate systems of
prevention for sustainable change
⌠â˘Enable people to take responsibilities for
their behaviours
⌠â˘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 â 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 â ensuring culture,
difference and vulnerability is respected
⌠Listen and respond to actual needs
⌠Curiosity to unwarranted variation
⌠Adapt care to âplaceâ 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 â 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
⌠â˘Effectively manage resources to reduce
waste
⌠â˘Understand local systems
⌠â˘Act as an agent of change
⌠â˘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 â 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
âŚAre designed to equip the nurse with the skills
required to survive/shape a modern health care
service underpinned by neo liberalism ideology
âŚTherefore 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 â 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/