We are a team of 3 appliance nurses with the focus on promoting cost-effective, high quality and safe use of appliances across Suffolk and North East Essex. Appliance Nurses assess the provision of appliances by looking at individuals and local populations, improve quality by reducing variations in clinical care and minimise waste to enhance the use of prescribing budgets and NHS spend. This is achieved through formulary and pathway development that collaborates with key stakeholders, such as specialist clinicians across acute, community and primary care services. In order to achieve the best patient outcomes, we develop good working relationships and continue to network across various services to ensure all professionals relevant to the project are jointly involved. This project has been successful since 2017, with many examples of safer and high-quality prescribing. This has a direct impact on patient care by improving local care pathways in relation to appliances and prescribing. The aim of the project is to develop formularies and guidance around appliances and implement through a coaching model.
Medicines Management invested in these 3 roles, which has resulted in 2019/2020 QIPP savings within the team of £199,751 in East Suffolk. Following on from that, our QIPP targets have increased to £283,060 across Suffolk. This oversight on appliances within Medicines Management is often not overseen by nurses in other areas.
We cover all appliance areas, which includes, stoma, skin care, continence, wound care and compression garments. A recent project achieved by the Appliance Nurses focused on the care provision of stoma services and patient care. We worked collaboratively with the stoma nurses to identify areas requiring improvement for the benefit of patient care and overprescribing. It was recognised that many patients across Suffolk were not receiving their annual usage reviews, and as a result were overusing stoma appliances or using these inappropriately/incorrectly. Due to a lack of current provision, many patients were relying on the support and communication offered by the Dispensing Appliance Contractors (DACs). This often resulted in trials of off-formulary products and overprescribing of stoma accessories.
