Sunday, 26 January 2014

Pile them High and Sell them Cheap: Cardboard cut outs and Medical Extensivist’s

A bit of a late start today. Last night I was celebrating Burns Night with some friends from Scotland who know how do so in style. In England, and post Francis, Berwick and Keogh, the demand for more nurses is growing. From my point of view, as an educationalist, it’s difficult in some areas of the UK to see where extra students might be found. Now I don’t do predications but I have a feeling health care educators are soon going to be designing programmes to support the two new additions to the health care workforce announced this week. Up here in sunny Salford (Manchester), the supermarket giant Morrison’s (there are other supermarkets available for your weekly shop) recently ran an initiative that used life size cardboard cut outs of Doctors and Nurses in their stores to encourage customers to shop for healthier foods.

In the study commissioned by the National Obesity Forum, life size images of real doctors and nurses who worked in the local area were placed in the store alongside ‘Lets Shop Healthier’ messages. The trial appeared to be a success. Over the 15 weeks of the trial, customers bought 20% more fresh fruit, 5% more canned fruit and 10% smoked fish. It’s suggested that if the scheme was extended to supermarkets nationally, it could improve the health of the two thirds of the population who currently don’t eat their five daily portions of fruit and veg.

I think this is an idea that could definitely catch on with Universities and educational commissioners alike. We recruit 660 pre-registration nurse students a year in to our School. They all need uniforms, email addresses, Disclosure and Barring Service checks, we need to find them placements, train their practice mentors, invest in expensive simulation laboratories and deal with national student survey results, and rigorous programme approval processes. The UK Government has to find £8.350 a year to pay for each student nurse, so large savings are possible by replacing actual students with cardboard cut outs.

Likewise, it’s estimated that it costs £500.000 to educate and train a doctor. The Government could also make a huge saving by reducing the number of actual medical students by 10% a year, replacing them with cardboard cut outs of the most successful doctors to be found. The idea would work for NHS Trusts struggling to find enough doctors and nurses to staff wards. Why go to the expense of recruiting doctors from Greece and nurses from Spain, when a quick 30 minutes on eBay could secure you half a dozen of each profession for a fraction of the cost.

There is another alternative, which is the so called Medical Extensivist. An import from the US, that’s sure to be a hit with those responsible for community and primary care services. A Medical Extensivist is a clinician, such as an Advanced Practitioner who extends their scope of practice outside the hospital and into the home or other community settings. They tend to work with people with chronic illness and help reduce admissions to hospital. In the US the employment of Medical Extensivists is also aimed at reducing attendances at Emergency Care services by providing routine and regular skilled nursing home visits. Given the current difficulties nationally of educating, training, recruiting and retaining Community and Practice Nurses, this might be just the answer.

If we were able to successfully bring together the Morrison’s Cardboard cut outs model with the US Medical Extensivists model, it seems to me we could have the beginnings of a new form of innovative integrated care being made possible. Let me know what you think.