71INNOVATIVE TRAINING FOR CONSULTANT PRACTITIONERS IN FRAILTY

Abstract

Background: Health Education Wessex (HEW) and Thames Valley (HETV) for Postgraduate Education have run a programme for Consultant Practitioner Trainees (CPTs) since 1991. Senior clinicians are competitively selected to the programme. Training was in Emergency Care, Midwifery, Mental Health, Learning Disability, and Cardiovascular/Neurology. Innovation: In 2015 the programme extended to the field of frailty, following workforce development planning. Four CPTs were appointed, three nurses and a physiotherapist. Academic study is funded in higher education centres at Masters or Doctorate level, alongside clinical placements. The four pillars of Consultant Practice form the backbone for development, namely expert clinical practice, leadership, education and training, and service development through research and evaluation. The aspiration is to develop highly skilled clinical leaders who take innovative roles within the workforce, with passion and expertise to enhance service delivery. Evaluation: The trainees have undertaken placements in Community Geriatric Medicine, Community Older Person's Mental Health, Palliative Care, General Practice and Hospital based Medicine for Older People to date. They influenced changes in practice using Quality Improvement methodology. These included medication management within Care Homes, reducing the risk of inappropriate medication administration, managing end of life care from the Emergency Department (ED), ensuring older people achieve their preferred place of care, remodelling older persons services within General Practice, delivering a plateau in ED attendances and undertaking Gold Standard Comprehensive Geriatric Assessments in Primary Care. Patients report that they appreciate the breadth of experience of the CPTs, and their flexibility in working outside traditional boundaries. Conclusion(s): Observations indicate the inclusion of Consultant Practitioners as part of a reshaped workforce enhances independence in older people; is well received, and cost effective. Health Education England should encourage other local education and training boards to innovate in this way. Health Trusts need to be encouraged to recognise the value of such posts.