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Challenges in POA. Mrs Jane Jackson SRN MPhil MCGI Consultant Nurse Honorary Fellow University of Hertfordshire [email protected] 1930’s Consultant led service only for complex surgery. Early beginnings – but were they patient centred?. How has POA developed?. Day Surgery

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challenges in poa

Challenges in POA

Mrs Jane Jackson SRN MPhil MCGI

Consultant Nurse

Honorary Fellow University of Hertfordshire

[email protected]

early beginnings but were they patient centred

Consultant led service only for complex surgery

Early beginnings – but were they patient centred?
how has poa developed
How has POA developed?
  • Day Surgery
  • 1993 - POA for all patients
  • Worldwide delivery of care / sharing of knowledge and experience
  • From Nurse led to Patient Led care

possibly as a Nurse run service

shaping of the poa service
Shaping of the POA service
  • Healthcare professionals
  • Delivery of service, audit, patient survey
  • e-mail and Internet and networking exchange of POA procedures / delivery of care
  • Demands for efficiency, lean thinking, lean working
  • Advances in Day Surgery
Life expectancy at age 65 yrs.Life expectancy Source: Office for National Statistics; Government Actuary’s Department

Life expectancy at age 65, United Kingdom

The most common causes of death in England and WalesAge-standardised mortality rates for selected broad disease groups, England & Wales
department of health cno
Department of Health / CNO
  • Health of the Nation – 1998;
  • The NHS Plan 2000;
  • Creating a patient led NHS Delivering the NHS Improvement Plan 2005;
  • Healthcare Associated Infections 2006 -reduction in the rates of MRSA / C.Diff;
  • 18-week patient pathway 2006;
  • Patient Choice 2007;
  • Healthy weight, healthy lives 2008.
clinical practice
Clinical practice
  • NICE clinical guidelines
  • European working times directive
  • For nursing staff, Advanced practice Modernising nursing careers
18 week pathway
18 week pathway
  • 85% compliant in England and Wales by March 2008
  • 90+% compliant by Dec 2008

Key words

Patient led care

Clock starts – referral

Clock stops - treatment

poa at decision to treat
POA at decision to treat




+/- investigations




not ffs

challenges of 18 week delivery through one stop poa
Challenges of 18 week delivery through one stop POA
  • Re-organisation of the OPD / POA / admission process
  • Involves changes for all the surgical division – Consultant, secretary, POA, records.
  • Primary and Secondary care cohesion
  • Key – clarity for patient of the 18 week process
benefits of 18 week
Benefits of 18 week
  • Short journey for patient
  • Lean thinking and lean working
  • “…the patient receives the right care, at the right time and of the right quality without unnecessary delays.”Delivering the 18 week patient pathway DOH 2007
  • Effective use of resources - notes
  • Appropriate referrals
Annual Conference –

“A Risky Business”

6th November 2008


Royal Court Hotel, Coventry

Registration: £190 (members of the POA)

£225 (non-members)

For further details including registration forms, please visit or contact [email protected]

pre operative assessment 2008
Pre Operative Assessment 2008
  • Providing a service for the user
  • Effective assessment
  • Location – convenient to the patient
a practical guide to developing and running effective pre assessment
Legal aspects

Career developments

Team leadership

IT support


Predicting and explaining risk of surgery

Developing a POA – face to face and telephone

How to set up POA

The role of POA in meeting the 18-week pathway

A practical guide to developing and running effective pre assessment