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NHS Education for Scotland

Summary Report

Scottish Paediatric Advanced Practice Network / Education in Scotland to Support Paediatric

Advanced Practice for Nursing & AHPs

11th February 2010

Apex Hotel, Waterloo Place, Edinburgh

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Contents Introduction Page 3 Overview of Meeting Page 3 Summary Page 8 Appendix 1: Delegate List Page 9 Appendix 2: Programme Page 12 Appendix 3: Group Work Details Page 13 Appendix 4: Group Work Notes Page 15

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Introduction This report is a summary of the Scottish Paediatric Advanced Practice Network and Education in Scotland to Support Paediatric Advanced Practice for Nursing and AHPs event. The event took place on Thursday 11th February in Edinburgh. The audience included nursing and allied health professional managers, staff from Higher Education Institutions, representatives from the Scottish Government and NHS Education for Scotland (NES), advanced practitioners who have undergone or undertaking advanced practice Masters education and individuals who have an interest in advanced practice across Scotland.

Overview of Meeting Jennie King, Project Lead for the NES Child Health Team jointly chaired the meeting with Robin Hyde. Robin is a Trainee Advanced Practitioner in NHS Borders and is the newly appointed chair of the Scottish Paediatric Advanced Practice Network. The event was well attended by 63 individuals (full delegate list in Appendix 1) and consisted of a comprehensive programme (see Appendix 2). The aim of the event was to:

• Learn about the diverse roles of paediatric advanced practitioners across Scotland and how these are supporting service delivery

• Increase awareness of work being developed to support education for paediatric advanced practice

• Offer opportunities to discuss whether education developments will meet advanced practice and service requirements.

A presentation was initially given on the Scottish Paediatric Advanced Practice Network. This is a newly established network which has been set up based on 2 exploratory meetings held with advanced practitioners in July and September 2009. Nominations were asked for a chair and Robin Hyde put his name forward to take on the role. The advanced practitioners requested that they wanted the network to enable practitioners to have the ability to contribute to the development of others, to have opportunities to develop practice, a website and face to face meetings. They also requested that they would like Higher Education Institution staff and managers to be involved in the network. The role and remit of the network was agreed which is:

• To provide an opportunity to strategically look at the role of Paediatric Advanced Practice

• To share and discuss issues / information being experienced

• To contribute to national discussions on the role and role development

• To provide and share education to support the role

• To offer peer support

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A series of presentations followed the information on the Scottish Paediatric Advanced Practice Network which set the context for the day and afternoon group work sessions. The presentations have been published (with permission from the presenters) on the Children and Young People’s Network within the Scottish Paediatric Advanced Practice Network community:

http://www.knowledge.scot.nhs.uk/child-services/communities-of-practice/scottish-paediatric-advanced-practice-network.aspx

A summary of the presentations delivered on the day is provided below:

Paediatric Advanced Practice: Background

Dawn Moss, Educational Projects Manager for NES provided information on the Advanced Practice Toolkit and Career Framework. The Children and Young People’s Services Managed Knowledge Network (MKN) was demonstrated along with an overview of the Scottish Paediatric Advanced Practice Network community of practice on the MKN.

Advanced Paediatric Nurse Practitioner Role Development and Implementation

Clare Logan, Trainee Advanced Paediatric Nurse Practitioner from NHS Lothian provided a comprehensive explanation of the role of the paediatric advanced nurse practitioner. Information was also delivered on how the current Masters education being undertaken is having an influence on the role and the benefits this is having to service.

Paediatric AHP Advanced Practitioner: Paediatric Advanced Practice Succession Planning Development Pathway Susan Horsburgh, Clinical Specialist Physiotherapist from NHS Lanarkshire provided an overview of the how funding is being spent to develop advanced practice as part of the Advanced Practice Succession Planning Development Pathway. This included undertaking an ‘Independent Learning Module’ to develop a physiotherapy pathway for children living in NHS Lanarkshire.

Supporting the Hospital at Night Programme Sarah Tait, Paediatric Nurse Practitioner from NHS Borders provided a thorough overview of the role of the paediatric advanced practitioner nurse in the ‘Hospital at Night’ programme. This included a background to the development of the role including key drivers for change, development of the role, future challenges and the support which has been receive form NES and the Scottish Government.

Paediatric Advanced AHP Practitioner: Shaping Service Development

Sarah Paterson, an Extended Scope Practitioner Physiotherapist from NHS Lothian provided a comprehensive overview of the Congenital Talipes Equinovarus service being run in NHS Lothian. This explained why the physiotherapist needed to be an advanced practitioner, how changes were made in practice to support the service, challenges to establishing the service and what the outcome has had on patient care and service development.

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Overview of Scottish Advanced Practice Education Provision for Advanced Practitioners in the Care of Children and Young People: Development to Date

Mary Boyle, Programme Director from NES provided an overview of the work which has been undertaken in Scotland to support the development of Masters education for paediatric advanced practitioners. This included summarising the consultation undertaken with various Higher Education Institutions (HEIs) and the importance of establishing the Masters education for the future sustainability of the paediatric advanced practice role in Scotland.

Mary described that the Scottish Government have provided funding for paediatric advanced practice modules to be developed. NES are currently in the process of commissioning 4 new Masters modules in response to stakeholder needs and the 4 HEIs who presented at the event have expressed an interest in developing these. The following awards would be available for Advanced Practitioners to gain accreditation (names of awards as examples only):

Post Graduate Certificate Advanced Paediatrics (60 credits SCQF 11) Post Graduate Diploma Advanced Paediatrics (120 credits SCQF 11) MSc Advanced Paediatrics (180 credits SCQF 11)

Higher Education Institutions: Overview current work being undertaken to support Paediatric Advanced Practice

Staff from HEIs provided an outline of the proposed education which they are currently developing to support paediatric advanced practice Masters education in Scotland. This is in direct response to the NES commissioning process currently being undertaken. The HEI representatives were:

• Margaret Coulter, Lecturer, Queen Margaret University, Edinburgh

• Lynn Kilbride, School Director Academic Development, Edinburgh Napier University

• Kevin McFarlane, Lecturer, University of Dundee

• Irene McTaggart, Senior Lecturer in Nursing and Programme Manager Child Nursing, University of Dundee

• Marion Struab, Lecturer, University of West of Scotland The presentations outlined a proposal that suggested that the following 4 modules could potentially be developed with a specific paediatric focus: Pathophysiology Edinburgh Napier University Assessment and Diagnostic Skills University of Dundee Clinical Decision Making University of West of Scotland Early Years Queen Margaret University In addition there was the concept of a Work Based Learning module which could be delivered separately or collaboratively. Table 1 outlines an example (based on the proposal by Edinburgh Napier University) for undertaking the education and exit points for the awards. Other HEIs proposed similar structures emphasising that to exit with a Postgraduate Certificate all modules would have to be undertaken with one HEI.

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Each HEI also outlined what option modules they could offer. This information is provided in the presentations on the Children and Young People’s Services Managed Knowledge Network: http://www.knowledge.scot.nhs.uk/child-services/communities-of-practice/scottish-paediatric-advanced-practice-network/meetings-and-events/paediatric-advanced-practice-network-meeting-11th-february-2010.aspx Table 1 - Example of education structure and exit awards.

Year of Study

Module Title Module Title Module Title Award

Year 1 Core Pathophysiology (Edinburgh Napier)

Compulsory Work Based Learning (Edinburgh Napier)

Compulsory Work Based Learning (Edinburgh Napier)

PG Certificate Note all modules at this level need to be taken with one institution

Year 2 Core Module Assessment & Diagnostic (Dundee University)

Option Module

Core Module Clinical Decision Making (UWOS)

PG Diploma

Year 3 Dissertation Or Option Module

Compulsory Dissertation

Compulsory Dissertation

MSc

After the delivery of all the presentations delegates were divided into 4 groups (see Appendix 3). The groups consisted of a mixture of nursing and AHP practitioners, managers and HEI staff. 2 groups focused on only nursing and AHPs and whether the education would meet their discipline specific requirements. The groups were asked to discuss the following questions:

1. Is the proposed education being developed meeting service delivery and advanced practice requirements?

2. How might it compare to the education already available? 3. What else should be included to support service delivery? 4. What mentorship/support would be required to facilitate current advanced

practitioners to teach on future modules? The groups were facilitated by a member of staff from NES and notes taken on the discussions (see Appendix 4). Based on this the feedback it was generally suggested that it would be beneficial to have paediatric education modules to support advanced practice in Scotland which are interdisciplinary. A summary of the group work discussions for each questions is as follows:

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1. Is the proposed education being developed meeting service delivery and advanced practice requirements?

Feedback indicated that the proposed education would meet service development. To ensure sustainability it was suggested that the NHS workforce planning needed to be undertaken to identify requirements of advanced roles and define what the role of the advanced practitioner would be within each organisation. The delegates also highlighted that it would be beneficial if NHS health boards identified the numbers of staff requiring education. Primarily the education should be flexible with a blended approach which had distance learning and live elements.

2. How might it compare to the education already available? The delegates suggested that as the current education available is mostly adult based there definitely needs to be specific paediatric education available. The proposed education would not exactly provide the same type of education as the Liverpool John Moores University courses but these are costly and have a different outcome. Finally, discussions highlighted that what is proposed is very acute focused which was thought not to be applicable to many AHPs.

3. What else should be included to support service delivery? Responses to this question indicated that communication skills are integral to the successful implementation of the role. Research, leadership and child protection should be part of all modules and a consistency of assessment undertaken. The delegates also suggested that education delivery should be part of the programme to enable mentorship and lecturing opportunities to occur and ensure sustainability of the role.

4. What mentorship/support would be required to facilitate current advanced practitioners to teach on future modules?

Clinical support for the clinical component of education was highlighted as essential. The delegates suggested utilising the Clinical Supervision Model to offer support as this includes work based learning facilities and that an expert clinical faculty should be set up. This should include experienced educators, advanced roles and clinical specialists with a mixture of medical, nursing and AHPs. The group work also highlighted that the HEIs should ask for a teaching input into the modules via the network. Finally advanced practitioners needs to be able to develop formal and informal teaching skills by utlising differing communication skills and facilitation of active learners.

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Summary The event was well attended and provided a beneficial forum and atmosphere for the delegates to discuss the paediatric advanced practice role and what education is required to support service delivery in Scotland. The delegates evaluated the event positively and considered it to meet the aims of the day. They valued being involved in discussions about Masters level education provision to support paediatric advanced practice. Please contact jennie.king@nes.scot.nhs.uk for further information about the event.

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Appendix 1 : List of Delegates

SURNAME FIRST NAME JOB TITLE ORGANISATION

Ashford Alison Team Leader, Children’s Occupational Therapy (North Sector) NHS Forth Valley

Auchnie Kathryn Department Manager NHS Grampian

Booth Elaine Podiatry Manager NHS Tayside

Boyle Mary Programme Director NHS Education for Scotland

Buchanan Mary Education Coordinator NHS Lothian

Burns Kirstine Acting Nurse Manager NHS Dumfries and Galloway

Campbell Heather Clinical Nurse Manager and Student Advanced Paediatric Nurse Practitioner NHS Lanarkshire

Colquhoun Lucy Project Manager Scottish Government

Colvine Claire Student Advanced Paediatric Nurse Practitioner NHS Ayrshire and Arran

Coulter Margaret Lecturer Nursing Queen Margaret University

Cowie Kathryn Paediatric Cardiac Nurse Practitioner NHS Greater Glasgow and Clyde

Cruickshanks Pamela Advanced Paediatric Nurse Practitioner NHS Fife

Davies Jean Senior Paediatric Nurse NHS Ayrshire & Arran

Dhouieb Elaine Physiotherapy Respiratory Clinical lead NHS Lothian

Downie Alison Speech and Language Therapy Team Leader NHS Lanarkshire

Dunhill Zoe Independent Child Health Consultant Independent

Fairley Elizabeth Trainee Advanced Nurse Practitioner NHS Lothian

Fitzgerald Jeanette Head of Paediatric Nursing NHS Tayside

Forbes Ellie Clinical Education Lead, Paediatric Emergency Care NHS Borders, Lothian, Fife & Forth Valley

Gracie Edith Charge Nurse NHS Greater Glasgow and Clyde

Grant Mo Head of Physiotherapy NHS Lothian

Grundy Maggie Programme Director NHS Education for Scotland

Hagger Jenny Clinical Specialist Physiotherapist NHS Lothian

Horsburgh Susan Clinical Specialist Physiotherapist NHS Lanarkshire

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Humphrys Anna Speech and Language Therapist NHS Forth Valley

Hyde Robin Advanced Paediatric Nurse Practitioner (Trainee) NHS Borders

Kilbride Lynn School Director Academic Development (Post Graduate and Lifelong Learning) Edinburgh Napier University

King Jennie Project Lead NHS Education for Scotland

Lamb Chris Advanced Nurse Practitioner / Retrieval Nurse Practitioner NHS Greater Glasgow and Clyde

Logan Clare Trainee Advanced Paediatric Nurse Practitioner NHS Lothian

Lumsden Lesley Sister NHS Grampian

McAuley Mary Head of Nursing for Children and Young People NHS Grampian

McCallum Isabel Clinical Director, Reprovision of RHSC NHS Lothian

McCormick Deirdre Nursing Officer: Children, Vulnerable Families and Early Years Scottish Government

McDerment Catherine Lead Occupational Therapist NHS Lothian

McFarlane Kevin Lecturer University of Dundee

McGill Susan Clinical Nurse Manager NHS Lothian

McIntosh Louise Speech and Language Therapist NHS Ayrshire & Arran

McTaggart Irene Senior Lecturer in Nursing Programme Manager Child Nursing University of Dundee

Mearns Caroline Project Coordinator NHS Education for Scotland

Morse Jerry Manager of Clinical Skills at the Suttie Centre for Teaching and Learning in Healthcare University of Aberdeen

Morrell June Senior Registered Children's Nurse NHS Dumfries and Galloway

Moss Dawn Educational Project Manager NHS Education for Scotland

Murtagh Eamon Senior Chief Paediatric Cardiac Physiologist NHS Greater Glasgow and Clyde

Mushet Lynn Community Nurse Manager NHS Fife

Paterson Sarah Extended Scope Practitioner Physiotherapist NHS Lothian

Pethybridge Emma Music Therapist NHS Lothian

Reid Jane Educational Project Manager AHP NHS Education for Scotland

Reilly Laura Clinical Nurse Manager NHS Lothian

Richardson Nicola Senior Occupational Therapist Armitstead Child Development Centre

Robertson Natalie Paediatric Cardiac Nurse Practitioner NHS Greater Glasgow and Clyde

Sabin Michael Nursing Officer Scottish Government

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Straub Marion Lecturer University West of Scotland

Tait Sarah Paediatric Nurse Practitioner NHS Borders

Taylor Jacqueline Advanced Paediatric Nurse Practitioner NHS Fife

Todd Donald Lecturer Robert Gordon University

Walker Katrina Speech and Language Therapist - Lead Clinician NHS Ayrshire and Arran

Wardrop Joanna Student Advanced Paediatric Nurse Practitioner NHS Ayrshire and Arran

Wiggins Laura Lead Paediatric Physiotherapist NHS Greater Glasgow and Clyde

Wilkinson Sally Physiotherapy Lead, Neonatal Hip Screening NHS Lothian

Wilson Jan Speech and Language Therapist NHS Tayside

Wilson Jean Clinical Education Lead NHS Education for Scotland

Wood Sarah Senior Lecturer Queen Margaret University

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Appendix 2 : Programme

Thursday 11th February 9:30am – 4pm

Waterloo Suite, Apex Waterloo Hotel, 23-27 Waterloo Place, Edinburgh

9.30 Coffee and Registration

10.00 Welcome Jennie King, NHS Education for Scotland Robin Hyde, NHS Borders

10.15 Paediatric Advanced Practice: Background Dawn Moss, NHS Education for Scotland

10.30 Advanced Paediatric Nurse Practitioner Role Development & Implementation Clare Logan, NHS Lothian

10.45 Paediatric AHP Advanced Practitioner: Paediatric Advanced Practice Succession Planning Development Pathway Susan Horsburgh, NHS Lanarkshire

11.00 Panel Discussion Dawn Moss, Claire Logan & Susan Horsburgh

11.15 Break / Networking

11.45 Supporting the Hospital at Night Programme Sarah Tait, NHS Borders

12.00 Paediatric Advanced AHP Practitioner: Shaping Service Development Sarah Paterson, NHS Lothian

12.15 Panel Discussion Jane Reid, Sarah Tait & Sarah Paterson

12.30 Lunch / Networking

13.15 Overview of Scottish Education Provision for Advanced Practitioners in the Care of Children and Young People: Development to date Mary Boyle, NHS Education for Scotland

13.30 Higher Education Institutions: Overview current work being undertaken to support Advanced Practice Lynn Kilbride, Edinburgh Napier University

Kevin McFarlane/Irene McTaggart, University of Dundee Marian Straub, University of the West of Scotland

Margaret Coulter, Queen Margaret University

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Group Work Discussions Tea and coffee will be available during discussions

15.30 Key Feedback Group work facilitators 16.00 Close

Education in Scotland to Support Paediatric Advanced Practice for Nursing and AHPs / Paediatric Advanced Practice Network Meeting

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Appendix 3 : Group Work Details

GROUP A - WATERLOO SUITE

Mary Boyle Programme Director NHS Education for Scotland

Pamela Cruickshanks Advanced Paediatric Nurse Practitioner NHS Fife

Zoe Dunhill Independent Child Health Consultant Independent

Jeanette Fitzgerald Head of Paediatric Nursing NHS Tayside

Ellie Forbes Clinical Education Lead, Paediatric Emergency Care

NHS Borders, Lothian, Fife & Forth Valley

Anna Humphrys Speech and Language Therapist NHS Forth Valley

Louise McIntosh Speech and Language Therapist NHS Ayrshire and Arran

Eamon Murtagh Senior Chief Paediatric Physiologist NHS Lothian

Marion Straub Lecturer University of West of Scotland

Sarah Tait Paediatric Nurse Practitioner NHS Borders

Donald Todd Lecturer Robert Gordon University

Katrina Walker Speech and Language Therapist NHS Ayrshire and Arran

GROUP B – CALTON ROOM

Dawn Moss Education Projects Manager NHS Education for Scotland

Lucy Colquhoun Project Manager Scottish Government

Lynn Kilbride School Director for Academic Development Edinburgh Napier University

Chris Lamb Advanced Nurse Practitioner / Retrieval Nurse Practitioner NHS Greater Glasgow and Clyde

Clare Logan Trainee Advanced Paediatric Nurse Practitioner NHS Lothian

Natalie Robertson Paediatric Cardiac Nurse Practitioner NHS Greater Glasgow and Clyde

Jacqueline Taylor Advanced Paediatric Nurse Practitioner NHS Fife

Kathryn Auchnie Department Manager NHS Grampian

June Morrell Senior Registered Children’s Nurse NHS Dumfries and Galloway

GROUP C – REGION ROOM

Jane Reid Education Projects Manager NHS Education for Scotland

Alison Ashford Team Leader, Children’s Occupational Therapy NHS Forth Valley

Elaine Booth Podiatry Manager NHS Tayside

Elaine Dhouieb Physiotherapy Respiratory Clinical Lead NHS Lothian

Susan Horsburgh Clinical Specialist Physiotherapist NHS Lanarkshire

Catherine McDerment Lead Occupational Therapist NHS Lothian

Kevin McFarlane Lecturer in Nursing University of Dundee

Sarah Paterson Extended Scope Practitioner Physiotherapist NHS Lothian

Nicola Richardson Senior Occupational Therapist Armistead Child Development Centre

Laura Wiggins Lead Paediatric Physiotherapist NHS Greater Glasgow and Clyde

Sally Wilkinson Physiotherapy Lead, Neonatal Hip Screening NHS Lothian

Jan Wilson Speech and Language Therapist NHS Tayside

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GROUP D – WATERLOO SUITE

Caroline Mearns Project Coordinator NHS Education for Scotland

Mary Buchanan Education Coordinator NHS Lothian

Kirstine Burns Acting Nurse Manager NHS Dumfries and Galloway

Margaret Coulter Lecturer Queen Margaret University

Kathryn Cowie Paediatric Cardiac Nurse Practitioner NHS Greater Glasgow and Clyde

Mo Grant Head of Physiotherapy NHS Lothian

Robin Hyde Advanced Paediatric Nurse Practitioner Trainee NHS Borders

Mary McAuley Head of Nursing for CYP NHS Grampian

Susan McGill Clinical Nurse Manager NHS Lothian

Jerry Morse

Manager of Clinical Skills at the Suttie Centre for Teaching and Learning in Healthcare University of Aberdeen

Emma Pethybridge Music Therapist NHS Lothian

Joanna Wardrop Student Advanced Paediatric Nurse Practitioner NHS Ayrshire and Arran

GROUP E – WATERLOO SUITE

Jean Wilson Clinical Education Lead NHS Education for Scotland

Heather Campbell Clinical Nurse Manager / Student Advanced Paediatric Nurse Practitioner NHS Lanarkshire

Claire Colvine Student Advanced Paediatric Nurse Practitioner NHS Ayrshire and Arran

Jean Davies Senior Paediatric Nurse NHS Ayrshire and Arran

Alison Downie SLT Team Leader NHS Lanarkshire

Edith Gracie Charge Nurse NHS Greater Glasgow and Clyde

Maggie Grundy Programme Director NHS Education for Scotland

Jenny Hagger Clinical Specialist Physiotherapist NHS Lothian

Dierdre McCormick Nursing Officer: Children, Vulnerable Families and Early Years Scottish Government

Lesley Lumsden Sister NHS Grampian

Sarah Wood Senior Lecturer Queen Margaret University

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Appendix 4 : Group Work Notes Group A – mixture of nursing and AHP representation Question 1

• Mixed response

• Needs to be “Future Proofed” and flexible

• Focus on processes for adv practice, low on detail of specialties

• Order of modules – patho-physiology must be first Question 2

• Comparison of proposals

• People for LJMU uptake issues o Need to be creative e.g. use teleconferencing for students for ‘live’

lectures Question 3

• Other support o Continue MKN o Continue network o Parity across boards o Does qualification in advanced practice make you an advanced

practitioner? Question 4

• Who supervises advanced practitioners and who should supervise (i.e. answers)

• Are there any guidance for governance (one member felt this was urgent) Overall discussion – need for clarity of terminology Across boards, HEIs and disciplines there are a variety of perceptions around what constitutes an advanced practitioner.

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Group B – nursing only representation

Question 1

• Proposed education – positive comments

• All compulsory modules. Good as it ensures continuity but it would be good to have option possibility

Question 2

• Proposed component won’t have exactly same product as LJMU o Costly, different focus and outcome

• Scottish programme inter-disciplinary

• Need input of clinicians

• APNP – physiology but communication skills still as important

• Work Based Learning – could focus on priority area

• Costs £3500 for Masters in Scotland Question 3

• Funding needed to do this. Difficult in current financial climate o Needs to be enough people in place

• Anxiety about ensuring consistency of assessment of advanced practice

• Potential to share across the UK

• Need for knowledge regarding a business culture Question 4

• Like idea of clinical faculty

• Napier idea to ask for teaching input via network

• Development of assessors o Existing nurse competencies o What about mentors’ competency?

Key Points

• Agreed proposed education needs to meet needs of diverse range of service needs

• Good support essential – friendly, clinical

• Flexibility welcomed

• Possibility for adapting

• WB learning module

• Differences in job descriptions

• Agreement core module are appropriate for PANP Successful implementation � influence of adv practice network also influence of other disciplines to support development of paediatric adv practice

• Clinical faculty – good idea, but onus on practitioner to have a regular teaching commitment but can guarantee teaching lesson

• D/C about sage practice, need to ensure consistent assessment o Scrutiny if something goes wrong

• Education fit for purpose for service

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Group C – AHP representation only

Overall Points

It needs to be acknowledged that paediatrics in itself is a specialty with many sub- specialties for all professional groups. However, having said that it has to be recognised that it is not possible to go down into the minutiae of each area as not only would education provision be unviable but it would also not lend itself to a meaningful qualification.

It is therefore important in recognising the need for paediatric advanced practitioners that the individuals need to have a broad base of knowledge in their area and then apply advanced analytical skills.

Potential for the whole succession planning pathway to be accredited? As well as the development of the Post Graduate Certificate/Diploma. Very positive about a formal advanced paediatric qualification

? Need to help state minimum requirements to get on the course

Need to have discussions as to the order modules are completed/delivered and recognition in the core modules that it is not a level playing field from the start. AHP’s are autonomous and able to assess and diagnose from qualification and therefore it truly is advanced reasoning and decision making that is required

Some discussion re the funding for nurses to do advanced practitioner training at LJMU and not for AHP’s. Is it possible to look at this somewhere? Modules Discussions It is imperative that modules are able to be applied to individual’s workplace and that specialist elements can be brought out in the assessment. There needs to be demonstrable understanding of paediatrics and the decision making is at an advanced level. Although for some it is important to learn advanced clinical skills this is by no means a given and it is particularly these elements that could be the Work Based Learning modules or another option discussed was a “blank special studies module” that could be clinical skills and could actually be offered and medical staff too. Alternatively these are the modules where a mentor/supervisor in practice would “sign off” Some of the areas where there needs to be advanced specific specialist clinical skills included:

- Botox; Spasticity Management - Video-fluoroscopy - Paediatric joint injection

However again the key element behind the “tasks” is the decision making and reasoning process

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Although non medical prescribing might be a module that some Advanced Practitioners would wish to pursue it should definitely not be a core one as, at present, not all AHP’s can be prescribers and indeed would not be appropriate in their roles

Question 1 Suggestion that it is important prior to this that it is clearly identified what an advanced practitioner looks like across the spectrum

The idea of distance learning is attractive however it was also noted that there needs to be “live” elements to it. Whether that is face to face in a classroom or via VC or synchronous chat sessions with e.g. Wimba or similar was not necessarily decided other than it was a requirement.

Question 2 Some of the education out there and proposed is very acute focussed and also task focussed. This is not thought to be applicable to many AHP’s

It would be helpful to use the MKN to highlight in greater depth what is already available and for the HEI’s to share information better with NES in doing this e.g. Module descriptors as it can be difficult to find enough info to make informed choice

Question 3 Questions were asked re NES’s funding plans It was also discussed that there needs to be a means to allow back fill at the workplace and this links closely with engagement with regional planners, AHP directors, commissioners

Advanced practice needs to be part of the NHS Health Board vision It needs to be accepted that there needs to be time to reflect upon learning and put into practice Needs clarification of career structure and links to education to achieve this.

Question 4 It was agreed that as an advanced practitioner facilitating learning and enabling others to learn by problem solving was a core skill. Additionally individuals are often teaching other disciplines therefore it is important to have the credibility and confidence in teaching/facilitating learning. Need to be able to develop formal and informal teaching skills, differing communication skills and facilitation of active learners

Discussion focussed on the Dundee University (diabetes nurse specialist) multi-professional facilitating learning 15 point module. Delivered over 3 days a month apart with mentorship support Essential Core Elements of Programme

- Advanced Clinical reasoning - Clinical leadership; including elements like service re-design - Facilitation of learning - Research

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Group D – mixture of nursing and AHP representation Question 1

• Order of modules impact

• Core � patho-physiology has to be first � advanced health assessment

• Need more investment with what service needs

• Workforce planning – extremely important identify post – advanced roles

• Numbers

• Managers know what advanced practitioner need � don’t know numbers

• Good Scottish based programme needed

• Service – strategic plans need to identify where they are with advanced roles

• Assorted cost

• Clinical placements – can that be available in another HB – i.e. Shetland o Can this be built in to education programme

Question 2

• Clinical decision making module – costing

• Masters level

• Mostly adult based education def need specific paediatric education

• Customising programmes for adults working with children e.g. Gmed

• With the night education adult nurses could become APNP

• = Competence and confidence Question 3

• Placements – can this be built into education programme – available in other HBs?

• Educate medical colleagues to support advanced roles

• Clinical supervision model o Including work based learning facilities

• Pool of experienced educators o Mix of medical and nursing

• Formal medical support

• Bonding – where do they start? o 5 � 7 o Succession planning

• Stronger MKN Advanced Practice Network o More multidisciplinary

• How do we measure quality of advanced roles> o Method needs to be in place to support development

• What do patients/CYP/families want? o Who do they want their care to be delivered by? o Need to explore

• Share good practice

• Publish

• MKN as platform

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Question 4

• Education as part of Framework / programme

• Membership in both HEI and Clinical o Honorary contracts

• Will teaching be part of the paediatric advanced practitioner? o Built into role

• E-Learning opportunities

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Group E - mixture of nursing and AHP representation Question 1 Core modules need to be systematic; such as anatomy, physiology; assessment, Clinical Decision Making etc. Suggest that rather than taking an advanced specialised module first, makes sure that they know the basics. There does not seem to be any mention of research, leadership, GIRFEC, Child Protection components which should be integral in all modules. LJMU has embedded these components from day one. Need to define core modules – AHP very specialised roles, do they need to undertake core component. Essential that each NHS Health Board identifies their needs and define the advanced nurse practiitoner role. There are now discussions at hospital settings as to what shall we do with these roles when the medical numbers increase. It is essential to see this role as complimenting the medical professions not supplementing. Chicken and egg scenario, education programme now available, however, not clear on current need Could we use already tested successful analyses to evaluate local need. Analyses needs to be done ASAP as this education programme ready for use now. We need to use the Competency Framework to inform the outcome. Many experienced practitioners have undertaken higher level education, can this be recognised. Proposed modular approach can support clinicians who are not academics, through to those who are looking to achieve master education. PG Cert. Diploma, although not fully completed a masters, they have achieve academia at master’s level. ?? attractive to experienced senior clinicians. QMU seems to have better options for AHP’s more community options. More relevant, ???? Core modules would not be necessary for some of these clinicians Question 2 May still need to assess stand alone specialised modules; combine Research and Leadership. Combine core modules with specific regulation of advanced practice??? This may determine the need for the complete package. Expert Clinical Faculty, Advanced Roles, Clinical Specialists- to meet the need for support. Flexibility to meet the needs of nursing and AHP. Concern for funding and release Accredit Work Based Learning and Experience. Discussed - experienced staff who trained in modular training before P2000 may benefit undertaking the core modules.

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Advanced paediatric nurse [practitioner not good at demonstrating their previous learning, have a template tool to identify the learning outcomes necessary; in order to establish where previous experienced demonstrated. Still disparity – open doors for AHP access - ?? AHP need different core modules Competence framework to support all. Combination of academic education, with Clinical expertise. Question 3 Specialist Forum – Peer group support Indemnity, Insurance – Governing Body – agree and support practitioners Scope of Practice Job Plan essential linked to KSF Need clear cooperation to facilitate access to radiology – PACs system, Blood product High level communication - vision and awareness of advanced roles. WIMBA – Blended approach, include face to face component LJMU successful Ensure engagement with supporting clinical staff in placements Pre-requisite – preparation module for computer skills Electronic support at an appropriate level Question 4 Mentorship - good clinical support for clinical component essential. Mentorship should be part of the core Current students excited to be part of the succession planning and be mentors for following cohorts Will have good understanding of students’ need This should be seen as part of the role. NES fund a teaching component for these advanced practitioners