Anaesthetic Practitioners Practical experiences

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Anaesthetic Practitioners Practical experiences

• John Carnie Heart of England Foundation Trust
  Hospitals
• Birmingham and Black Country Cluster AP clinical
  lead

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New HorizonsNew ways of WorkingNew
ChallengesHow to avoid getting out of ones
depth
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Practical experiences with Anaesthetic
Practitionersplease read document below
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Practical experiences with Anaesthetic
Practitionersplease read document below
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Practical experiences with Anaesthetic
Practitioners New ways of Doing Things

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Practical experiences with Anaesthetic
Practitionersconsultants sign up/ extras / over
and above
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Practical experiences with Anaesthetic
Practitioners National cluster groups Phase 1 2
sites

• Northumbria Wansbeck (working differently) phase
  1
• Devon and Exeter phase 1
• Heart of England phase 1, 2
• Salford phase 1
• Birmingham Black Country phase 1, 2
• Avon Gloucester Wiltshire phase 2
• North West London phase 2
• North East Yorkshire and East Lincolnshire phase
  2
• North West London phase 2
• Thames Valley phase 2
• North Suffolk and Cambridgeshire (working
  differently) phase 2
• Queen Elizabeth Hospital Gateshead (working
  differently) phase 2

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Practical experiences with Anaesthetic
Practitioners Local Cluster detail
8 Phase 2 1 phase 1 (H of E) Trainees (
Nursing /ODP sourced )
Wolverhampton
Heart of England
Royal Orthopaedic
Walsall
City Queen
Elizabeth hospitals Sept 2006 Phase 3
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Practical experiences with Anaesthetic
Practitioners Local Cluster team detail

• Cluster Clinical Lead
• Cluster Manager
• Medical Clinical reps, including medical trainees
• Nursing and PAM reps
• Patient rep
• Trainee or qualified APs
• PCT commissioning rep
• WDC/SHA reps
• Professional groups regional reps (RCA, AA, NATN,
  AODP)
• Higher Education rep
• Deanery Rep
• HR rep
• Agenda for Change rep

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• Practical experiences with Anaesthetic
  Practitioners
• Issues

• Non issue Feasibility of non medical
  Anaesthetic role

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• Practical experiences with Anaesthetic
  Practitioners
• Training delivery Issues identified over last 2
  years

• Training delivery
• Safety Risk
• Local Need
• Reinventing the wheel
• Incest
• Professional Acceptance

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Practical experiences with Anaesthetic
Practitioners Training delivery and local
resources

• Formal curriculum delivery and academic support
  from University of Birmingham
• Local cluster delivery of formal module
  tutorials bimonthly delivery on rolling rota
  basis (each trust 1 morning of lectures every
  other month) delivered within SA consultant time
• AP attendance at local departmental educational
  meetings
• In service delivery within competency based
  modular programme
• Individual consultant mentor allocation to each
  AP delivered voluntarily within consultants SA
  time
• Individual study promotion

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Practical experiences with Anaesthetic
Practitioners Training delivery Issues
identified over last 2 years

• Training delivery
• Safety Risk
• Local Need
• Reinventing the wheel
• Incest
• Professional Acceptance

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Practical experiences with Anaesthetic
Practitioners Issues -Safety Risk
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Practical experiences with Anaesthetic
Practitioners Training delivery Issues
identified over last 2 years

• Training delivery
• Safety Risk
• Local Need
• Reinventing the wheel
• Incest
• Professional Acceptance

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Practical experiences with Anaesthetic
Practitioners Issues - Local Needs for 3APs 80
medically trained Anaesthetists 1 professor of
anaesthesia ( 112 from 1/4/06)

• Traditional Anaesthetic Role
• Preop Preparation Role
• Elective List Team Working
• Complex list working dead time doubled up
  working
• EWTD break delivery
• 1 medical 2 non medical list work (and
  combinations)
• Advanced Skills Use (MMC consequences)
• Resuscitation
• Advanced airway management / iv access

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• Practical experiences with Anaesthetic
  Practitioners
• Training delivery Issues identified over last 2
  years

• Training delivery
• Safety Risk
• Local Need
• Reinventing the wheel
• Incest
• Professional Acceptance

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Practical experiences with Anaesthetic
Practitioners New cluster experiences
reinventing the wheel

• Supervision issue - ODP trainee within 1 month
  commenced anaesthesia without waiting for direct
  supervision
• Solution decades of experiences with trainees
  and reinforcement of supervision principles

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Practical experiences with Anaesthetic
Practitioners Issues - Reinventing the wheel

• Supervision issues - how soon to allow non
  direct supervision (recall within 2 minutes)
• Solution
• a) Decades of experiences with trainees
• b) Experiences of other cluster members
• c) Adherence to national guidelines

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Practical experiences with Anaesthetic
Practitioners Issues - Reinventing the wheel

• Prescription issues
• Solution
• understanding of difference between anaesthetic
  record procedures
• For drug prescription and hospital drug chart
  recording procedures
• Principle of directed supervised anaesthetic
  care
• Group directives for drugs / working policies
• Supervising anaesthetist 2 minutes away

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• Practical experiences with Anaesthetic
  Practitioners
• Training delivery Issues identified over last 2
  years

• Training delivery
• Safety Risk
• Local Need
• Reinventing the wheel
• Incest
• Professional Acceptance

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Practical experiences with Anaesthetic
Practitioners Issues Incest

• Locally 1 member of local cluster going it on
  their own
• Problem - how to regulate?

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• Practical experiences with Anaesthetic
  Practitioners
• Training delivery Issues identified over last 2
  years

• Training delivery
• Safety Risk
• Local Need
• Reinventing the wheel
• Incest
• Professional Acceptance

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Practical experiences with Anaesthetic
Practitioners Issues Professional Acceptance
National Contribution

• National -England Wales, Stakeholder Board ,
  Shropshire Work force confederation caretakers
  -Successors
• RCA and NWW panel
• (Association of Anaesthetists, Cluster Groups
  Contribution)
• Need for clarification of Manpower case
• Modernising Medical careers, EWTD , Public
  Expectation from Health Service
• Formal Clarification of variable local dimension
  /extent for AP programme

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Practical experiences with Anaesthetic
Practitioners Issues -Professional Acceptance
consultants trainees
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Practical experiences with Anaesthetic
Practitioners Issues -Professional Acceptance
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Practical experiences with Anaesthetic
Practitioners Issues -Professional Acceptance
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Practical experiences with Anaesthetic
Practitioners Issues -Professional Acceptance
Trainees

• Issues -Professional Acceptance

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Practical experiences with Anaesthetic
Practitioners Issues -Professional Acceptance
Trainees
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New Ways of Doing Things
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New ways of Doing Things

• 1871 - Scotland won by a conversion scored
  after an accidental knock on (acceptable in
  Scotland but not in England)
• 2006 - Scotland 18 England 12