Advanced nursing putting Cumbria on the world map

Advanced nursing roles allow nurses to develop their clinical skills and expertise to support patients, their team and the wider health system. In Cumbria a small number of advanced nursing practitioners and nurse consultants provide an innovative recruitment solution that has been recognised nationally and internationally for the benefits it brings to patient care.

Valerie Provan is a Nurse Consultant on Ruskin Unit, an assessment unit in Carlisle for older adults with organic mental illnesses such as Dementia. It is the only nurse led treatment centre of its kind in the country and several other trusts have visited to see how it could be replicated elsewhere.

Valerie explains how the role and innovative work on Ruskin Unit has helped to put Cumbria on the map:

I qualified as a nurse in Glasgow in 1987 and worked in a variety of mental health settings including hospitals and community care. I was given the opportunity to become the link nurse for University of Glasgow, supporting the development of trainee mental health nurses, and helped to develop the Scottish guidelines for mental health specifically around older adults with depression and nutrition issues

I started the nurse consultant post in Cumbria over 15 years ago and have been able to develop the role over this time to make a real different to patient care. A review of the Mental Health Act in 2007 meant that I was able to train as a Responsible Clinician, a role previously only held by Consultant Psychiatrists, which means I have overall responsibility for care and treatment of service users on Ruskin who are being assessed and treated under the Mental Health Act.

I manage patients from admission onto the ward to their discharge, and can review their medication and how the Mental Health Act has been used (for example, renew detentions, grant leave and discharge from detentions) in my areas of expertise – older adults and dementia care. I can’t make the decision to detain patients but work closely with consultant psychiatrists where necessary as well as GPs to review patients’ physical health needs.

Last year I was invited to chair the World Nursing Conference in Las Vegas and talk about my role, which is still quite unique internationally. It generated lots of interest and we’ve since had other trusts come and see how they can learn from our model on Ruskin.

Many nurses progress into management roles but I always wanted to continue my clinical work so this has been a fantastic way to progress. For patients on Ruskin my role, and the nurse led approach, means that we have more time to get to know patients and look at alternatives to medication. Nurses on the ward are empowered to take on more responsibility and each manages their own case load of patients, with my support for those with complex needs.

Advanced nursing roles, educated to masters level, are helping to develop a more sustainable workforce in Cumbria and address a national shortage of Medical consultants. They are one of many innovative ways the NHS is meeting the changing needs of our population.