Improving General Practice Sustainability Group: 2019 Report

Annex C Case Study: 3 - The Advanced Care Academy, Grampian

The creation of an Advanced Care Academy (ACA) and associated fellowship programme in collaboration with higher education organisations will enable NHS Grampian to provide a replicable model that will support robust initial preparation for ACP/ANP^[31] roles and subsequent career pathways and skills consolidation. It will also potentially enable increased use of NMAHP-led^[32] practice within all aspects of care provision, allowing patients to participate as equal partners in the delivery of their care and provide best value for public funds. The ACA,run by a multi-professional faculty of expert clinicians with teaching expertise, will provide CPD and clinical supervision opportunity to qualified ACPs and support ACPs transitioning to different roles with skills refreshers/additional competencies as well as recruitment of quality candidates for advanced practice roles. "Fellows" will be the Faculty of the future.

Expected benefits:

• Consistent alignment of standards of clinical practice with specific role titles
• Well governed, safe and effective workforce
• Supported workforce: clarity of expectations/role development/career progression.

Achievements to date

The ACA went live mid-April 2018 under the leadership of NHS Grampians two Nurse Consultants for advanced practice. In order to launch, "Fellows" (experienced, ANPs) have been recruited - in the first instance to an ACA bank, pending a more formal programme of development. It is anticipated that future Fellows will have a wider range of healthcare backgrounds, but work within the same triangulated approach to capability: theoretical knowledge; robust clinical competency assessment; effective clinical supervision.

Recruited Fellows have been actively sustaining the 2C provision of general medical services at An Caorann practice (Aberchirder & Portsoy sites) through expert clinical supervision to the ANP trainees which enables continuity of service and robust competency assessment. Fellows and trainees benefit from the guidance and support of the Nurse Consultant for Advanced Clinical Practice in Primary Care, to rationalise provision of service across the two sites.

The ACA is working to provide sustainable workforce solutions to the current challenges faced at Dr. Gray's Hospital, Elgin, which may be alleviated with development of a more blended workforce including tiered ACP provision. Staff workload audit and a service needs analysis is in progress to inform the roles and skillsets required, co-ordinated by the Nurse Consultant for Acute.

The ACA has been supporting the development of enhanced District Nursing roles which map to advanced level practice, the development of custody care with newly developed educational resource and provision of face to face scenario-based training with both NHS and Police colleagues.

Contact: Alison Moggach, Advanced Nurse Practitioner, NHS Grampian a.moggach@nhs.net