Developing &
Implementing a new role
A Partnership Development
Marion Rogerson
(Former NHS Commissioner)
Other Stakeholders
Mandy Cadge
Dr P & GPs
Heather H
Ann and Jean
M B College
Voluntary
Sector
A ‘Head of Steam’
• NHS podiatry had discharged 4,000 people who needed
routine nail cutting 3 years earlier
• This ‘grey lobby’ were vociferous in their lobbying –contacted
health, social care, local politicians and the media
• Lobbying groups wanted a free service … or at least a very
uniform pricing structure
• Social Care wanted the “political” issue “off their backs”
and offered £25,000 over three years to fund nail cutting
(didn’t renew the budget 3 years later )
• A Director of Strategy (Commissioning) offered £125,000
to bring nail cutting back into the NHS ......... BUT
• The Head of Podiatry had had the CEO’s support to
discharge 4,000 people in order to re-profile the service
and allow for growth in need and wasn’t going to take nail
cutting back
A new role with new
responsibilities
• Development Challenges were:
– Defining what the role would (and wouldn’t) do
– Having time to reflect in a busy world / thinking
outside the box – other industries / models
– Creating a service that was sustainable (£50k max
budget in to the future with growing need)
– Creating a contract of (quality)standards (Lawyers)
• Implementation Challenges
• Helping others to understand the model – eg
Pharmacies and GP practices
• Introducing the new training and role and
“trusting” we had done the right thing!
Securing an Education Provider
• Finding someone to design and deliver the education
and training for the role
• Vested interests can cause barriers – learned that
individuals can make things happen (you just have to
find them!)
• Quid pro quo – we offered creation of the Nail Care
logo as a project for students at the local college. The
Head of Art and Design gave us a way into Hair and
Beauty
• Little profit so ......Find individuals who understand or
who have a passion. How many of you have had to cut
a relatives toenails? How many of you wanted to?
Recruiting to the course
• Avoid ‘calamity and complaint’ early on
• Tried to get a variety of mature people on the first
course
• Home visits, day centres, walk in service
• About sustainability and not relying on training people
from one background or type of employer
• Learned a lot from the first course:
– Subsequent courses required attendees (or their
employers) to pay half the fee
– We changed the order subjects were taught
– People wanting to attend the course had to complete a
questionnaire e.g. Do you like feet? (you’d be amazed)
Supporting Nail Carers
and their clients
• Seizing opportunities to develop the service - Non NHS but a health
related role – investing time and effort in addressing the queries
and concerns of Nail Carers
• Used funding to support with CPD – help line – contract of
standards (for Birmingham Nail Carers) – web site (£25k then £50k)
–
–
–
–
–
Independent Nail Carers ( we never could set that uniform pricing structure)
Nail Carers in domiciliary care
Nail Carers in social care
Nail Carers in day centres
Nail Carers in pharmacy/GP services
• Insurance
• Marketing – 2 for the price of one – introduce a friend and get a
free nail cut! NB No legislation or regulations apply! Common
sense makes sense!
• Developing the customer base – trust, familiarity, quality service at the right
price
What have we achieved?
• Helped to keep people comfortable and
mobile
• Helped to prevent trips and falls
• Given some isolated clients a new lease of life
ly isolated…
Before – Client had been
housebound for many months as
they couldn’t put shoes on
After – Client had immediate relief. They
put their shoes on and went out socialising
with friends that same evening
Working with Skills for Health
• We knew we had a model that worked and we
wanted to enable our good practice to spread
• Saw education as key
• SfH supported us with their expertise to:
–
–
–
–
Develop the Transferable Role Template for Nail Care
Engage with potential Awarding Organisations
Develop the Accredited qualification with 3 AOs
Evaluate the Nail Care role and look at future impact
Judging Success
• Informally – keeping in touch, CPD, Nail Carer of the Year award, no
complaints, clients keep coming (and paying)
• Quantitative - waiting times for routine NHS Podiatry have fallen from
almost 2 years down to just a few weeks
–
–
–
–
–
Over 120 nail carers have been trained to date (estimate that 100 are ‘active’)
Estimated 5,000 clients
Value of the business estimated at £250,000 per annum
Lots of room for growth….
Potentially lots of wider health benefits (although these are difficult to
measure)
• Qualitative – lots of quality areas –
– Visiting a Nail Carer is an opportunity for a meaningful social interaction, really
important for people who are more socially isolated
– The role is a flexible employment opportunity – allowed some people to
transform their life and their careers
Following Birmingham’s success there is huge potential for
growth and spread across the UK
If we can replicate a similar level of coverage across the UK
the value of the Nail Care business could easily exceed
£10million per annum........ And .................
Help to ensure that those who can’t cut their own
toe nails keep active and healthy
and avoid disability!
Skills for Health Evaluation
Videos
• New nail carer role benefits South Birmingham etc...
http://vimeo.com/88043092
• Nail Care, a new career
http://vimeo.com/88043091
• NHS supports creation of new role...
http://vimeo.com/88043089
• Working with Skills for Health...
http://vimeo.com/88043088