CTAC Services in urban context Anne Mitchell Head of Older People - - PowerPoint PPT Presentation

CTAC Services in urban context

Anne Mitchell

Head of Older People & Primary Care Services, Glasgow City HSCP

Derrick Pearce

Head of Community Health Care Services, East Dunbartonshire HSCP

#ctacQI

Community Treatment and Care Services

Anne Mitchell – Head of Older People & Primary Care, Glasgow HSCP Derrick Pearce – Head of Community Health & Care Services, East Dunbartonshire HSCP

11th June 2019

Context

• NHSGG&C - 6 Partnerships – Diverse population
• A whole NHSGG&C approach to ensure consistency for patients and for

GP Practices

• Delivering CTAC for 230 Practices across a predominantly urban setting

but including rural outposts

• Mixed model of delivery – some Partnerships have Treatment Room

services fully embedded through to some who have none at all

Position for Glasgow HSCP – Building on an existing model Variable access across the 3 localities Previous work to establish consistent processes

• 43 rooms within 16 Health Centres
• 40 registered staff & 10 unregistered staff
• 3 band 6 co-ordinators within those numbers
• Limited intervention list – dressings, leg ulcers, bloods, ears, injections
• No scope for less mobile patients
• No non medical prescribing / nurse led clinics

Starting Point

Position for East Dunbartonshire HSCP

• East Dunbartonshire HSCP is least well developed
• Starting from scratch – no current Treatment Rooms Service in place
• All work currently undertaken by GP Practices or via Adult Community

Nursing

• No culture of shared services for GP Practices as a result of limited GP

clustering in Health Centres

CTAC JOURNEY – current developments

• Identify new accommodation
• Recruitment timeline

– Phased – induction programme – planning to do the above on board wide basis where possible

• All registered nurses in a position to carry out micro suction ear care within 8

weeks (Glasgow)

• Exploring hoist provision for non housebound patients (Glasgow)
• Non medical prescribing – staff on v150 and v300
• In discussion with GCU re bespoke leg ulcer training
• ECG Pilot project

Successes

• Ear Care micro suction will reduce the number of nurse led appointments from 3 -

1

• ECG project will allow patients to be seen in Community rather than Hospital
• Non medical prescribing will allow nurses to provide a nurse led service, efficient

and beneficial for patients and reduce GP workload

• Ambulant patients will be able to access services in the Community reducing the

need for District Nursing calls and / or repeat visits to Practice

Challenges

• Accommodation Issues
• Liaison with Labs
• IT to support
• Exceptions – Practices & Patients
• Appointing across a range of sites (choice)
• GPs views on pace
• Delivering consistency
• Prescribing and supplies
• Agreeing standard specification and working to that model
• Treatment of children
• Balancing phlebotomy with wider TR issues

What next

• Expansion of Service as accommodation allows
• Explore new interventions – eg catheter care, NG/Pegs, tracheostomy care etc
• Roll out of ECG recording within City
• Nurse prescribing
• Developing A more Nurse Led service
• Exploring innovative solutions to accommodation – including mobile
• Working across into other areas and with acute

Any Questions?

Our Questions

• Delivery Options – has anyone explored really innovative

accommodation solutions?

• Reflections/Options for full integration of CTAC staff into Adult

Community Nursing – eg rotation?

• Has anyone explored shared model with GP Practices eg using

Practice staff with funding from HSCP/PC?

• What do we see as the future developments within this

workstream that we need to future proof for?