As a nurse I have worked in A&E, in occupational health during the construction of the T5 building at Heathrow and as a nurse practitioner at a minor injuries unit in Portsmouth. I have also worked with South Central Ambulance service concentrating on emergency avoidance and education.
I first started working with our local clinical commissioning group South Reading Consortium in October 2011 after taking over from another nurse member of the board. I’m involved with commissioning services, funding of hospital and non-elective admissions as well as looking into musculoskeletal and orthopaedic referrals.At the moment the CCG is still finding its feet but things are moving fast. We currently have bi-weekly meetings to discuss progress where we talk about commissioning services, expenditure and current PCT targets for the delivery of care across a number of healthcare conditions.
Inevitably there are different views on the value that nurses can bring to the board of a CCG, but hopefully I’m beginning to show that there is a valuable role for nurses. The great thing about having a nurse in a CCG is that it gives you an opportunity to break down the barriers. We have a wide skill set and just want to be excellent nurses.
For instance the CCG has recently started to focus on childhood immunisation. This is an area that has traditionally been nurse-led. This means I have been able to make a significant contribution to our strategy for improving take up. We have now started thinking about having surgeries open on a Saturday to help working mothers and also whether we should look at provision through nurse practitioners at the walk-in centre.
Another area where I have had input is in dementia services. I have made the case that nurses have more time to talk to patients and their families and therefore they are more likely to spot the early indications by weaning information out of them. For example, a patient may come in for a dressing change and start talking to the nurse about how they are starting to forget appointments.
The upshot is that we have now started to train our nurses to recognise the early signs of dementia with a view to improving the care pathway. This is something the nurses really appreciate and it has empowered them to take on more responsibility in the management of patients with dementia. They have showed themselves keen to learn and take on greater responsibility.
We have adopted the same approach with COPD which is also nurse-led. New education programmes and medicine management courses that focus on long-term conditions are helping nurses and in turn having an influence on GP prescribing. This is something that as a CCG we are keen to build on.
Having nurses with a vote on a CCG is imperative otherwise it is just paying lip service to the profession. Our CCG is very supportive and I have now managed to set up nursing forums on the website along with monthly nurse meetings where we report back on what the CCG is doing. Nurses come along and find out what is going on but also expand their knowledge of the commissioning process.
My own employers have been very helpful. Virgin Care supports me by allowing me the time to attend meetings and I’m able to talk to the management team here about the intricacies of service provision including the legal and financial aspects.
Nicola Groom is a nurse practitioner and acting lead nurse at Virgin Care’s Reading Walk-in Health Centre