CTAC Services in remote and rural context Kathleen McCulloch - - PowerPoint PPT Presentation

CTAC Services in remote and rural context

Kathleen McCulloch

Community Lead Nurse NHS Western Isles

#ctacQI

CTAC Services – The Western Isles perspective.

Kathleen McCulloch Lead Nurse Community June 2019

Context (1)

• 30 miles of the West coast of
• Scotland.
• 130 miles sparsely populated
• Islands.
• Pop. circa 26,500.
• 9 Practices, multiple sites,
• multiple vacancies.
• 5 Community Nursing teams

Transformation

• From GP lead CTAC services.
• To Integrated CTAC services operating in

parallel with VTP.

Why Integrated model?

• Ensure a flexible, sustainable and

resilient service.

• Utilise on existing nursing skills.
• Retain local service provision.
• Promote a wider integrated team ethos

between GP practices and CN teams.

Our Journey year 1

• PCIP approved by GP sub Sept 2018.
• Fair share formula allocation of resources

for each GP Practice.

• Distribute available resource across

Community Nursing teams.

• Planned transition period prioritising

phlebotomy and school age children’s vaccines in year 2018/2019.

Progress Year 1

• 1. Investment delay
• 2. TUPE implications.
• 3. Primary Care Programme Board.
• 4. New capacity built into school nursing

team.

• 5. Job descriptions amended.
• 6. Initiate development of CN team to

enable delivery of childhood imms.

Our Journey Year 2

• Additional investment to build generic

CTAC capacity.

• Transfer of staff under TUPE.
• Ongoing staff support and development.
• Building new professional relationships

Progress year 2

• 1. Communication and Engagement.
• 2. Integrated working between GPN’s and

CN’s to develop skills and competencies.

• 3. July 1st implementation .
• 4. Clinical governance.
• 5. Data capture

Challenges and Opportunities

• Communication
• Cultural and pace of change
• Access to current data
• TUPE
• Clinical space
• Standardise practice
• Identity crisis

What next?

• Robust monitoring, review, and

evaluation.

• Data capture.
• Tests of change.
• Autonomy to adapt service delivery to

local context

• Support staff.
• Clinical Governance

We can work together, and yet...

Positive messages

• “She has been very supportive, so

that has made things smooth so far anyway” (TUPE nurse)

• “Practice nurse has been great we

have learned so much” (Community SN) “I feel very positive , I am exited about this change” (Community SCN)

• Any questions?