Challenges in POA by kvp14729


									Challenges in POA
  Mrs Jane Jackson SRN MPhil MCGI
            Consultant Nurse
Honorary Fellow University of Hertfordshire
Early beginnings – but were
they patient centred?

 • 1930’s
   Consultant led service only for complex
How has POA developed?
• Day Surgery

• 1993 - POA for all patients

• Worldwide delivery of care / sharing of
  knowledge and experience

• From Nurse led to Patient Led care
  possibly as a Nurse run service
Shaping of the POA service
• Healthcare professionals
• Delivery of service, audit, patient survey
• e-mail and Internet and networking exchange
  of POA procedures / delivery of care
• Demands for efficiency, lean thinking, lean
• Advances in Day Surgery
Life expectancy at age 65 yrs.
Life expectancy Source: Office for National Statistics; Government Actuary’s Department

                               Life expectancy at age 65, United Kingdom
The most common causes of
death in England and Wales
Age-standardised mortality rates for selected broad disease groups, England & Wales
Department of Health / CNO
• Health of the Nation – 1998;
• The NHS Plan 2000;
• Creating a patient led NHS Delivering the
  NHS Improvement Plan 2005;
• Healthcare Associated Infections 2006 -
  reduction in the rates of MRSA / C.Diff;
• 18-week patient pathway 2006;
• Patient Choice 2007;
• Healthy weight, healthy lives 2008.
Clinical practice
                    • NICE clinical
                    • European working
                      times directive

                    • For nursing staff,
                      nursing careers
18 week pathway
• 85% compliant in
  England and Wales
  by March 2008
• 90+% compliant by
  Dec 2008
Key words
Patient led care
Clock starts – referral
Clock stops - treatment
POA at decision to treat

 Referral         CATS /OPD         dtt

     +/- investigations

                          not ffs         ffs   W/L
Challenges of 18 week
delivery through one stop POA
• Re-organisation of the OPD / POA /
  admission process
• Involves changes for all the surgical
  division – Consultant, secretary, POA,
• Primary and Secondary care cohesion
• Key – clarity for patient of the 18 week
Benefits of 18 week
• Short journey for patient
• Lean thinking and lean working
• “…the patient receives the right care, at
  the right time and of the right quality
  without unnecessary delays.”  Delivering the 18 week patient
 pathway DOH 2007

• Effective use of resources - notes
• Appropriate referrals
Patient led care through

Inter professional teamwork
                      Annual Conference –
                       “A Risky Business”
                       6th November 2008
                 Royal Court Hotel, Coventry

Registration:     £190 (members of the POA)
                  £225 (non-members)

For further details including registration forms, please visit www.pre-
      or contact
Pre Operative Assessment 2008

• Providing a service for the user

• Effective assessment

• Location – convenient to the patient
A practical guide to developing
and running effective pre
                    • Predicting and
• Legal aspects       explaining risk of
• Career              surgery
  developments      • Developing a POA –
                      face to face and
• Team leadership     telephone
• IT support        • How to set up POA
• Audit             • The role of POA in
                      meeting the 18-week

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