A day within the lifetime of…senior clinical nurse advisor at 111 Wales

In the second of our ongoing ‘A Day within the Life…’ blog series on the variety of nursing roles, Ms Abby Howells talks about combining her clinical care and leadership responsibilities in her role as Senior Clinical Nurse Advisor at NHS 111 Wales.

(1) What is your position and essential role/responsibilities?
I’m a Senior Clinical Advisor (SCA) at NHS 111 Wales. My role is split into operations and team management. During operational changes, I’ll oversee and manage the service for that change. Ensuring safety and high standards of care across the range of services by providing clinical support and skilled leadership to NHS 111 Wales clinical advisors, dental health advisors, call handlers and health information advisors. I also monitor the systems and processes used across the service, ensuring clinical integrity, patient safety and efficient use of resources.

When I’m not operational, I lead and support the clinical advisor team and ensure they’ve the tools to perform their roles effectively. As a part of this role, I take part in clinical quality audits and be sure that my team’s work is evidence-based and consistent with national guidance, current trends and developments in nursing and the broader NHS.

(2) How did you get into your current role/field of labor?
I became a certified general nurse on the University of the West of England in Bristol in 2000. After 14 years of in depth ward experience in lots of specialties, I applied to work for what was then NHS Direct Wales as a nurse advisor as I had a passion for ward nursing. I used to be weakening and searching for a brand new direction. After intensive training, I began conducting Remote Clinical Assessments. I used to be capable of use my extensive general knowledge and fell in love with nursing again. After 4 years of assessing interviews and developing my skills, I applied for a Senior Clinical Advisor position as a part of my profession progression – a path I highly recommend as I even have the advantage of remaining in a clinical role while also gaining experience leading a team . The variety in my role keeps me challenged and there may be at all times so much to learn. I currently work on the Team Leadership and Development Program provided by the Welsh Ambulance Service Trust (WAST), which equips management students with theoretical and practical management solutions.

(3) Can you tell us what a typical day is like in your role/industry?
Typical days are hard to return by in these unpredictable times, but operational changes normally start with checking the present position of obtainable service. This would come with staff availability, the variety of calls waiting to be entered into the service and monitoring calls already within the ‘queue’ and waiting to be assessed to make sure clinical appropriateness and safety, in addition to checking the health of IT and telephone systems. As NHS 111 Wales is operated by the Welsh Ambulance Service, NHS 111 Wales assesses lower acuity ‘green calls’ in addition to calls coming into the service via 111. Typically lower than 18% of those assessed calls are returned to 999, which brings relief high demand for the 999 service. Time is spent working with emergency physicians and non-clinicians to discover the sort and severity of calls transferred between the 2 services.

I also work closely with GPs, pharmacists and support staff working in Health Boards to supply an out-of-hours GP service for which we call service and perform distant clinical assessments of patients. I’m at all times on the disposal of all facility staff and a source of clinical and practical support.

As a part of my role as team leader, I’m there to supply team members with as much support as they need by way of wellbeing, training and profession development, managing absences and stating services resembling occupational health, human resources, payroll and resource planning, for instance. I could spend the day conducting telephone audits, attending sickness absence meetings, service improvement meetings or having one-to-one meetings with team members. Call auditing is an important a part of this role because it ensures that established and evidence-based procedures are followed to make sure top quality and effective care.

As a part of their leadership role, Senior Clinical Advisors (SCAs) often undertake additional projects to enhance services for each staff and repair users. I even have been involved in clinical work streams for the event of sentimental decision support garments utilized by clinicians, I even have been involved in groups improving audit procedures and developing procedures for the usage of telephony.

(4) What parts of your role would you describe because the “best” or most satisfying?

Working relationships are by far essentially the most rewarding aspect of my role as I’m capable of support NHS 111 Wales staff in carrying out their duties to the most effective of their ability, with the aim of delivering excellence in service delivery to our patients. My goal and that of my colleagues at SCA is to supply high-quality care to patients. The most appropriate care must be provided at the best time and place, consistent with Prudent Healthcare principles.

(5) What advice would you give to others who would really like to follow an identical path?

Our clinical advisors range from nurses to paramedics, but whatever the area they arrive from, it will be significant to have extensive clinical knowledge as no two calls for help are the identical and is probably not possible for any reason. I’d advise you to realize experience in a wide range of specialties by working in a nurse bank or agency, ensure your CPD is current and varied, and undertake additional research into disease processes and distant clinical assessment.

Abby works as a Senior Clinical Nurse Advisor for NHS 111 Wales (@NHS111Wales and @GIG111Cymru).

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