PM Meeting Powerpoint 1st March

Practice Managers Meeting

1st March 2023

Whakataka te Hau

Karakia Timatanga (opening)

Whakataka te hau ki te uru

Whakataka te hau ki te tonga

Kia mākinakina ki uta

Kia mātaratara ki tai

E hī ake ana te atakura

He tio, he huka, he hau hū

Tīhei mauri ora!

https://www.otago.ac.nz/m aori/world/te-reo-maori/karakia-prayers/

https://www.youtube.com/watch?v=_uQqIGt3H2w

Agenda

1. Welcome and Karakia

2. PHO CEO & Board Updates: Lindsey Webber

3. Practice Manager Items:

• Signatures on Enrolment Forms: Papamoa Pines

• PM Meeting Format – Zoom: Gate Pa

4. Network Services Updates:

• Vensa Utilisation: Phil Back

• Cervical Screening Training Courses 2023: Emma Skellern

• Sterilization Training – EOI: Emma Skellern

• Dermoscopy – Practice Coverage: Laura Penny

5. Nurse Prescribing Update: Donna Hardie

6. Diversifying a GP Workforce - Primary Care Practice Assistant (PCPA): Wendy Horo-Gregory

7. New Practice Staff – PHO Onboarding Process/Document: Laura Penny 8. Open Forum Session

PHO & Board Updates

Lindsey Webber

Practice Manager Items

Signatures on Enrolment Forms

PM Meeting Format – Zoom

Network Services Team Updates

Vensa Utilisation

Network Training

Venepuncture Training – In Progress

Cervical Screening Training Courses 2023

Sterilization Course – EOI

Dermoscopy Training - Stocktake

HR Training Topics - (future sessions)

Nurse Prescribing Update Donna Hardie

Midland Collaborative; Registered Nurse

Prescriber in Community Health (designated RNPCH) Programme

Midland RNPCH: a collaboration of 5 Midland ( Formally) DHBs & 8 Midland PHOs

RNPCH Nurse Leads: Facilitators of the programme & assessors of RNPCH portfolios

Nurse Practitioner-led teaching

Portfolio Assessors – Facilitators, NP & RN prescribers (PG Dip prescribers)

The 3 nurse prescribing models in New Zealand:

Nurse Practitioner:

Authorised prescriber

Authorised prescriber: able to prescribe any prescription medicine

Designated Registered Nurse prescribing in primary health & specialty teams

Designated prescriber: able to prescribe from a schedule of common prescription medicines

Designated Registered Nurse prescribing in community health

Designated prescriber: able to prescribe from a limited schedule of prescription & over the counter medicines

Scope of practice:

Able to independently assess, diagnose and treat a range of conditions for a population group in an area of practice. May work autonomously or within a health care organisation. Consults with health professional colleagues

Additional Qualification

Clinical Master’s degree in nursing.

Scope of Practice

Must work in a collaborative team with an authorised prescriber available for consultation. Able to diagnose and treat common conditions (e.g. asthma, diabetes, hypertension) within a collaborative team.

Additional Qualification

Scope of practice: Must be credentialed on a recertification programme for registered nurse prescribing in community health. Uses clinical pathways/ guidelines to treat a small number of conditions for normally healthy people

Additional Qualification

Post Graduate Diploma in registered nurse prescribing for long term and common conditions

Recertification programme including education, supervision in practice, and credentialing (= to level 7 qualification) not = to a PG qualification

RNPCH: guideline based prescribing

Criteria for RNPCH programme entry:

 A minimum of 3 years clinical experience with at least 1 year in the area of prescribing practice

 Current Annual Practising Certificate

 Compliance with Standing Order requirements/use of Standing Orders/demonstration of assessment using best practice guidelines

(NCNZ 2018)

Midland Programme Components

 Virtual platform x 6 self-directed learning modules: Ko Awatea

 Certificate of successful completion of modules & final quiz

 Virtual teaching: seven 2 ½ hour sessions: facilitated by leads, taught by NP volunteers

 Supervision by Authorised Prescriber during programme (over 6-12 months)

 Completion of RNPCH Portfolio:

• Learning log- 12 hours (min.)supervision

• Case reviews (min.10)

• Case studies (min.2)

• Evidence of meeting x 11 RNPCH competencies, & sign-off by supervisor

 RNPCH Portfolio – assessed by Facilitators & Assessors (NP, Prescribers)

 NCNZ recertification – 3 years

May 2023 Intake.

 May 10th - Pre-course session

 May 17th Module learning begins

 Zoom session completed 28th

June

Thank You – any Q?

Diversifying the GP Workforce

Wendy Horo-Gregory

EXTENDED PRACTICE TEAM

Enhancing the Health Care Home Model of Care – Sustainability Domain

Service Element 6 – The practice develops broader team roles through training with a focus on Te Tiriti o Waitangi and cultural competency to enable GPs, Nurses and other clinicians to consistently work at the top of their scope, and expand their services to patients.

Characteristic 6.4 – Extended Practice Team

AN UNSUSTAINABLE MODEL OF CARE

• An aging population

• An aging workforce

• People living longer with more complex health needs

• Greater demand for more complex health care

• The rising cost of providing health services

• Hospitals are becoming unaffordable given the growing trends

WHAT DID WE DO?

• Literature review and research

• Collective korero with team members

• Nurse educators and leaders – DHB and Tertiary institutes

• Service providers with non-regulated health workers

• Practice Managers

• Nursing Council of New Zealand

BUILDING A BODY OF KNOWLEDGE?

• A body of evidence that showed the value of unregulated health workers in the workplace

• Non regulated health roles already existed in the sector – Community Health Nurses

• WINTEC / Career Force had an NZQA level 4 papers already in place – Curricula Content

• There were nursing/employer considerations – Direction and Delegation

• Socialisation of the proposed role and utilising feedback to inform the development of resources

• It was agreed that resource development should be Network / stakeholder informed for both structure/process

PLANNING THE IMPLEMENTATION?

Resource development included:

• An Education Pathway (Clinical training and Development Workbook)

• A PCPA position description

• A modified Direction and Delegation learning module in collaboration with the Professional Development Unit at Capital and Coast DHB

• A Direction and Delegation of Care Policy

• The planning of a Peer Group to inform ongoing PCPA Development – to roll out once we had sufficient numbers

PRESENTING THE FINDINGS

The HCH Change Team

HCH Peer Group

Education

Providers

Nurse Leads

Practice Managers

WIFM – WHAT’S IN IT FOR ME?

Creation of workplace capacity – clinicians

Having the right people in the right role with the right skills – cost implications

Improved access to care

A better patient experience of care

Funded capability development opportunity

Potential growth role for incumbent admin staff

KEY IMPLEMENTATION CONSIDERATIONS

Start with the willing to test the Framework – review and amend model

Seek out team champions/early adopters of change

Identify people of influence to socialise the role to the wider team

Make a plan – think about the how.

Be clear about the purpose of the role within the team

What will their/your integration needs be?

Align the job description to reflect the activities – these can be admin/clinical or clinical

Is the team aware of Direction and Delegation responsibilities?

Review the Training and Development Workbook, does it reflect the needs of your practice?

Inhouse PCPA training OR working toward OR completed a relevant NZQA qualification.

Tasks are substantially outside of the initial training. Qualified at least 6 months.

Tasks are substantially outside of the initial training. Qualified at least 12 months.

Tasks are substantially outside of the initial training. Qualified at least 18 months.

Understanding the PCPA role within the broader team

Demonstrated competency in PCPA level

1 tasks as per competency based skills list for a period of no less than 3 months

Demonstrated competency in PCPA level

2 tasks as per competency based skills list for a period of no less than 3 months

Demonstrated competency in PCPA level

3 tasks as per competency based skills list for a period of no less than 3 months

Understanding roles within the team

Has completed at least 6 skills training activities from L2 that support clinical activity.

Has completed at least 6 skills training activities from L3 that support clinical activity.

Complete at least four L4 skills training activities that focus on clinical support lead activity, e.g. facilitation, patient education, health promotion activity

Orientation to day to day practice activities

Maintained competency in L2 skills for a period of no less than 3 months

Maintained competency in L3 skills for a period of no less than 3 months

Demonstrated competency in chosen L4 skills is monitored via RN mentoring and the practice annual appraisal process.

Review of key practice policies

Consolidate learning by linking theory to practice under guidance of RN

Demonstrates competency in PCPA level

1 tasks as per competency based skills list

Consolidate learning by linking theory to practice under guidance of RN

Demonstrates competency in PCPA level

1 tasks as per competency based skills list

Demonstrates competency in PCPA level

2 tasks as per competency based skills list

Competency - based training can be internal / external. Evidence of the training record should be signed off by a designated trainer and should be a clinician for all clinical activity. Ongoing monitoring of competency from L4 onwards can be managed via the practice annual appraisal proces. s

PCPA PEER SUPPORT GROUP - PURPOSE

• Shared learning and development.

• The ongoing development of the PCPA role in General Practice.

• Development opportunities for PCPAs for the purpose of improving a patient/whānau experience of care.

….AND TO FINISH…

A team is not a group of people who work together.

A team is a group of people who trust each other.

Simon Sinek

New Practice Staff – PHO Onboarding

Process/Document

Intention/ Purpose

PHO support to supplement existing practice onboarding process

To reduce pressure on in-practice training around PHO Processes & Topics

Aimed at staff who are new to the: organisation/ region/ healthcare sector

Content can be adapted to be delivered to: Admin, Clinical, Managers

Guidance Document & Links Supported with an in-person practice visit with individual/group

How Can We Help?

Please take 5 minutes to consider if and how this may be helpful to you...

1. Is this something you’d like our support with?

2. What is the most useful support we could provide during onboarding of new staff?

 What Topics would you like covered?

Please consider topics for Admin, Clinical and Managerial Staff

(Draft) Guidance Document & Checklist

Open Forum Session

Any Other Business?

Kia tau

Karakia Whakamutunga (closing)

Kia tau

Kia tātou katoa

Te āio, te aroha me te marutau

Tīhei Mauri Ora

May peace, love and safety

Be upon us all Let there be life