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The Action on Community Education and Training (AvOCET)

The Action on Community Education and Training (AvOCET) Project is a joint project between Wessex and South Eastern Hampshire Clinical Commissioning Group (CCG).

The purpose of the project is to ensure sustainable development of a knowledgeable and skilled non-medical workforce that is able to meet the needs of patients across the health and social care continuum.

This will support the move of people out of hospital settings into primary and community care. The project covers the Portsmouth, South Eastern Hampshire and Fareham and Gosport CCG areas which fall under Portsmouth City Council (PCC) and Hampshire County Council (HCC) jurisdictions.

The project lead is Sue Clarke, Email: susan.clarke17@nhs.net.




Project Oversight Group

  • Julie Pennycook, Director of Human Resources and Organisational Development, Solent NHS Trust
  • Sue Clarke, Project Lead, PSEH Community Workforce Development Project
  • Julia Barton, Director of Quality, SEH & F&G CCG
  • Professor Allan Jolly, Director of Education and Quality, Health Education Wessex
  • Dr Nigel Watson, Wessex Local Medical Committee Chair

Project Group Members

Membership was not intended to be representational of organisations but determined by expertise and was flexible according to the programme or individual project work stream needs. The project group met bi-monthly between May and November 2014.
For a list of members download AvOCET Project Group Members in the related documents section below.

Project Framework

Download the AvOCET project framework in the related documents section below. This framework provides on overview of project work-streams, it was developed under the remit of the AvOCET Project Group Members between May 14 and November 14.

Primary Care Learning Network

A pilot testing the development of a primary care learning network across a primary care locality took place in Gosport. Eleven general practices engaged and a steering group meets monthly. The AvOCET work streams (below) are being developed / tested in collaboration the Gosport primary care learning network. AvOCET is currently scaling out the framework for developing primary care learning networks to other general practice localitie

Care Coordinator

Within the AvOCET project the role of care coordinator sits within Southern Health Foundation Trust (SHFT) and is called the Integrated Care Team (ICT) Coordinator. The AvOCET programme board agreed a process to develop an ICT Coordinator development pathway. This pathway was developed through a steering group from across the various stakeholder organisations and patient / carer representation. Existing SHFT continuing professional development (CPD) was mapped to the ICT coordinator job description and a level 4 module “ICT Navigator – Context of Service Provision” has been developed and validated with Southampton Solent University. This forms an framework to support the development and career progression of the Care Coordinator role.

Support Workforce

  1. The AvOCET programme board agreed to critically analyse the role of a generic health and social care support worker as part of the project. A steering group was set up to identify, with stakeholders, the common competences necessary to effectively assist frail people to live independently, live well and remain out of hospital. A framework of common competencies has been developed.
  2. AvOCET is piloting three approaches to developing the primary care health care assistants (HCA) workforce.
    1. A cohort of HCA from across primary care learning networks will undertake a QCF (level 2 or 3) Diploma in Clinical Health Care.
    2. In collaboration with SHFT a cohort of HCA from across primary care learning networks and HCA from community teams will undertake a Level 5 Diploma for Assistant Practitioners in Healthcare.
    3. A cohort of HCA from across primary care learning networks will pilot use of the Open University route to pre-registration nurse training.

Student Nurses / AHPs / Return to Practice

  1. Within the pilot area of Gosport primary care learning network and working with University of Southampton (UoS) two proposed placement pathways have been developed for undergraduate student nurses focusing on either a general practice route or a community ICT route. These placement pathways consist of 50% of placements in an out of hospital (community care or primary care) setting. Currently nine pre-registration student nurses are on this pilot placement pathway. 
  2. A process and framework to develop the infrastructure to provide student nurse placements has been developed in the pilot primary care learning network and is now being scaled out to other areas of primary care.
  3. AvOCET is working with the current Health Education England (Wessex) work to encourage registered nurses (who are no longer on the NMC register) back to the nursing profession. Two potential practice nurses have commenced the October 2015 Return to Nursing programme supported by general practice surgeries. This has been made possible by collaboration with SHFT to ensure these nurses can meet their entire learning outcomes.

Advanced Practitioners

The GP workforce is shrinking, and recent recruitment campaigns have not delivered the numbers of GP trainees that were anticipated. Development of alternate models of highly skilled workforce, with efficient and effective use of the multi-disciplinary team is being tested in AvOCET primary care learning networks. Roles currently being examined and developed are advanced nurse practitioners, physician’s associates, advanced AHP practitioners, emergency care practitioners and pharmacists to undertake roles that have historically fallen under the remit of the GP.

Community Up Skilling Programme

Testing of integration of health and social care workforce development is underpinning some recent AvOCET educational developments.

  1. A ‘Foundations of Integrated Care’ course aims to enhance professionals working in partnership with one another to enable delivery of person centred services through effective integrated care. The 8 day course enable professionals to develop an understanding of one another’s roles and responsibilities, operating frameworks/legislation and codes of practice that influence individual practice. It also enables professionals to recognise, acknowledge and utilise skills and expertise of one another; and to trust one another’s judgements and decision making to enhance an integrated delivery of service to the individual. The course looks at concepts of integration and includes sessions on how the following issues can be addressed across the integrated care agenda: Co-morbidities in Older People, Long Term Conditions, Mental Health issues, Dementia, supporting carers, end of life care and Public Health. The first of two pilots of this course is currently running, with a second planned for Feb 2016.
  2. A ‘Front Line Leadership Course for the Integrated Workforce’ has been designed for front line clinical leaders working in partnership with each other to develop their collaborative leadership skills in order to work with others to impact outcomes across health and social care systems. This course is open to any front line clinical leader who would like to enhance their leadership skills in working across the integrated care agenda. The programme aims to enable professionals to take a outcome focused approach to understanding the opportunities and challenges facing leaders across different types of health and social care organisations, iidentify strategies that enhance multi-disciplinary teamwork and multi-agency  working, explore barriers, opportunities and solutions aiming to develop skills to support staff through change and within the group create a shared vision of integrated care, identifying a common purpose, and a culture of collaboration. The first of two pilots has completed with a second one running in November 2015.
  3. A system wide approach to a learning and development solution to the recognition of deteriorating physical health in mental health patients is currently under development.
  4. A carer’s hub is currently being piloted in Gosport primary care learning network with the aim of developing and supporting patients and their carer’s to self-manage their conditions.
  5. Surgery Sign posters is a pilot scheme running in Gosport primary care learning network to see if local patients can benefit from being put in touch with voluntary and community services to improve their wellbeing. AvOCET was involved in developing the induction and development framework for this voluntary role.

Drivers (you will find the files in the related documents section below)

Policy drivers from the Transforming Community Services (DH 2009) and Transforming Primary Care (DH 2014) documents, the Government’s mandate to Health Education England (DH 2013), and strategy documents on our Plans and Documents page.

presented a need to accelerate the pace at which we transform clinical pathways and in order to do this we need to specify and train a new style of workforce so that the next generation of clinicians have the skills and mind set to provide ever greater elements of care in the home and/or community environment. More recently the Five Year Forward View and The future of primary care: Creating teams for tomorrow have further informed and driven the work that AvOCET is undertaking.

Project Lead, Sue Clarke: susan.clarke17@nhs.net

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