HaN Conference

An excellent Hospital at Night (HaN) conference was held on 29th January at 76 Portland Place in London.

The chair Roderick Knight, non-executive director at Dorset County Hospital, highlighted the innovation and commitment of the presenters who had provided captivating presentations on a wide range of Hospital at Night topics. One area where practical advice and tips are always needed is developing and protecting training opportunities when implementing HaN and EWTD solutions. One key speaker who gave advice in this area was Eddie Docherty, nurse consultant, Practice Development, NHS Ayrshire and Arran. Mr Docherty highlighted the main roles and function of the advanced nurse practitioner in HaN.

Role and Function of the Advanced Nurse Practitioner
He gave useful insights into the experiences nurses will have undertaking this role for the first time, explaining that it will be hugely challenging and will involve practitioners questioning their ability as they are questioned by others. "Surprisingly", he said: "Nurses taking on the role will initially feel they have lost their status - if they were used to being an Intensive Therapy Unit (ITU) nurse specialist for example."

He advised that nurses should take time to get to know the role as the team develops and they settle into the job.

"The other hard part will often be an initial hostility to HaN which will have to be managed and overcome. On the plus side though, there is a great buzz to managing the acutely unwell patient."

Mr Docherty went on to say that it was crucial to strengthen people in these roles through continuous development. He presented several ways to do this including a clinical log book and a case note review process where staff present a set of 10 case notes. Competency can also be measured through a range of tools. Competence frameworks and a Postgraduate Certificate in Advanced Clinical Practice have been key to the success of the role in NHS Ayrshire and Arran.

Harnessing technology in this process can be very useful; in Mr Docherty's organisation they use the Hector IT system which keeps track of all sick patients. The system links to competency development as it enables tracking of which clinician has seen what condition and can manage development as staff build up a range of cases. Mr Docherty also highlighted the importance of nurses in academic roles similar to those of junior doctor clinical fellows, so that there are nurse 'scholars' in the hospital.

John Coakley, medical director at The Homerton, a Skills for Health - Workforce Projects Team EWTD pilot site, also highlighted training and illustrated how this could be achieved for junior doctors in a 48 hour week rota. He said that his FY2 - ST2 doctors undertake 16 weeks per year experience in acute work and the rest of the year is protected in their cold specialty with no night or weekend work. Most of their ST3 doctors undertake 12 weeks acute work, again, with the rest of the year protected in their cold specialty. This allows a good balance between hot and cold work and service and training.

A copy of Eddie Docherty's slides and more information on our EWTD pilot sites, is available on the healthcare workforce portal.