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Excellent opportunity to discuss opportunities and lives experience of doctorate and further education post advanced practice

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Excellent opportunity to discuss opportunities and lives experience of doctorate and further education post advanced practice

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Why do people undertake Advanced Practice

Want to progress carer but remain clinical.

Barriers encountered -

limited trainee roles in particular in specialist or non-nurse areas.

Difficulty to source good clinical support in practice in trainee role. - -

Difficulty accessing funding for post grad education and AP training, as often there will be a number of people within the same team seeking training and development.

Lack of AP roles once qualified, which means limited movement and development - highlight lack of work force planning provision.

Actions Taken:

Identified need for multi-professional forum / committee for trainee AP's within health board.

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Acknowledged excellent work, patient quality care and service / organisational impact a AP AHP can provide.

Difficulty and limited numbers of AHP and opportunities potentially due to workforce planning, financial ad silo budgets.

Small numbers of AHP's in AP roles.

Acknowledge where is incentive for post grad study with lack of clarity with banding, career progression. No clear pathway for development and consultant roles. Does carry significant patient benefits, prudent health care principles and increased job satisfaction.

Less clear when AHP's are in more specialist roles how fit with clinical AP's, However AP is a level of practice not a specific role and should be applicable.

No portfolio accreditation process for AHP within HB.

AP AHP roles are being identified and prioritised in HB however, lack of clarity and understanding with peers, managers.

Positive - aim for expanding AP AHP's for next conference and push workforce plan.

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Q1. Whats the most rewarding aspect of role?

Autonomy

Role progression

Independence

Holistic Care delivery

Increased Job Satisfaction

Improved services

Ownership.

Q2. Challenges encountered?

Lack of understanding of the role.

Unclear of Identity

Variable supervision

Lack of accreditation

Line management

Lack of governance

No health board lead.

Q3. How challenges addressed?

Could be addressed with a dedicated lead

Multi-professional accreditation

Standardised Banding

Organised supervision

Clear management structure for AP's

Robust clinical governance.

Q4. What training courses have you been able to access?

In house training

Conferences

Triage training

Mandatory training

CTAS training (WAST ONLY)

On-line courses

In hospital grand rounds

Medical / junior doctor training.

Q5. Networks?

WAGACP

College of Paramedics

Multi-professional HB group

APPE UK

6 goals?

Q6. What trainning and opportunities would you like?

Principles of Education (not PgC)

IRMER training

Blood administration

Paeds Training

Formal consent education

Q7. What would you like in the next event?

Case reviews in small groups

Group work AM not PM

Send out presentations before event

Make presentation slides bigger - difficult to read at the back

Up to date NMP guidelines

Perhaps include consultants and enhanced level next time (as per framework)

Include medical colleagues for engagement and their perspective on managing ACP's insight would be interesting.

Commissioning Bodies.

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Rewarding aspects:

Varied and mixed experiences

Opportunities for service developments

Investment in services

Opportunity to share roles and information

Respect of role and value

Able to provide urgent response

Hospital avoidance and impact to patient care

Focused on patient perspective and holistic care

Provide care closer to home

Difficulties:

Lack of Governance

Lack of resources

Lack of clinical provision

Poor patient flow

No exit strategy - limited AP roles

Poor social care provision

Lack of communication between services and primary / secondary care

Lots of negotiation required for financial and educational role provision

Feeling and treated undervalued.

Limited Lead ACP roles and AHP roles

Additional CPD requirements

Challenge of meeting all four pillars with CPD activity

Respect of role and value

Lack of regulation

Limited resources

Lack of standardisation of roles

Difficult if managers understanding of role

Future:

Would like more post graduate level 7 education

Need operational lead

Provide and expand intermediate care services

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Q1. Whats the most rewarding aspect of role?

Positive Patient and family feedback

Implementation and providing education of skills learnt.

Providing an interface between nursing and medical care

Education of peers and staff

Collaborative practice

Peer support

The progress that advanced practice has taken since its initiation.

Autonomous input to improve patient services.

Q2. Challenges encountered?

Colleague opposition (nursing mainly).

Lack of understanding of role from colleagues

Uncertainty about when moving from novice to expert.

Imposter syndrome

Lack of support and role progression

Challenges of role acceptance

Lack of professional respect and devaluing

Professional support.

Q3. How have challenges been addressed?

Time and increased exposure to ACP and level of expertise

Supportive management

Collaboration and building relationships

Q4. What training courses have you been able to access?

Masters AP programme

Masters modules and recent access to e-portfolio

Q5. Networks?

Paeds RCPCH ANP Network

Local AP forums

ANP forum for south Wales

Q6. What training and opportunities would you like?

Specialist CNS ANP masters

Paeds critical care modules for ANP

All Wales paeds specific MSc

Emergency Paeds rotations

Q7. What would you like in the next event?

Paeds presentations

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Challenges:

Management perceptions of roles

Left to own devices

Expectation AP to provide medical cover

Feeling low value in post

Training courses:

AC/RC opportunities

Clinical supervision with Pharmacists

UKKAN ADHD training

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Q1. Whats the most rewarding aspect of the role?

Role progression and development

Evolving role in specialities - leaving a legacy for others and further development

Originally seen as an ad-hoc addition to bolster workforce, but now a established member within the hierarchy.

Q2. Challenges encountered?

Lack of understanding of role from nursing staff.

Seen as "threat" of AP role to workforce.

Lack of training opportunities

No 80/20 split visible

Lack of HB investment

Q3. How have challenges been addressed?

Experience

Time

Communication and clarification

Building trust and rapport with team

Q5. Networks?

ANP

NMP

SEP - limited places mostly England

BSG (Endoscopy)

BTS

All Wales network

Major trauma network

Q6. What training opportunities would you like?

More time allocated and protected for research and development.

Succession planning of roles

Career development - pay progression

Standardise progression and pay

standardisation of role and clarity

Q7. What would you like at next event?

Abbreviations on presentations explained, not obvious to everyone.

More time for questions

More support with research undertaken

Good venue

Good mix of speakers