#ctacQI CTAC Services in remote and rural context Kathleen McCulloch Community Lead Nurse NHS Western Isles
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 1 st 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?
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