• 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.

• 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.

• 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

• 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

• 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

• 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