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Oxford University Hospitals NHS Foundation Trust

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Trust helps nurses work in more innovative ways

18/06/2019
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An innovative approach to working arrangements has made life easier for a nurse at Oxford University Hospitals NHS Foundation Trust.

Kirsty Crozier, who has worked at the Trust as a Myeloid Advanced Nurse Practitioner since 2012, started work at the Churchill Hospital to help set up nurse-led clinics to streamline services for patients with Myeloid conditions.

A large part of her role is managing patients who don't always need to come to clinics, but need fairly regular blood reviews, changes to their medication, or medication prescribed to them. Kirsty would phone them and handle their care this way, making life easier for patients who then didn't have to travel for an appointment.

When she returned to work from maternity leave in June 2017, she soon realised that she couldn't stay in Oxford as her husband needed to travel with the army. The commute from Cambridge to Oxford proved unmanageable, and Kirsty started looking for another job closer to home.

Before starting a new role, Kirsty had an idea. She approached her Matron, saying that there wasn't necessarily a need for her to be in hospital to manage her patients - she just needed to access the hospital systems and be able to contact the patients. She knew her patients well, and they had formed a relationship with her over the years. She suggested a trial of coming into the hospital once a month to maintain practice, while working remotely at home for the remainder of the time.

Kirsty started a six month trial in August 2017. She dealt with her patients over the phone, finding out how they had been, and reviewing whether they needed to continue their current dose of treatment. Kirsty's patients all have blood disorders or a pre-cancerous condition. Half of them receive oral chemotherapy.

"The nurse-led telephone and email clinic had been running for a while, and many of my patients found it beneficial - it saved them travel and bus journeys, often for very routine appointments that could be conducted over the phone. One of my older patients could no longer drive, and would have to take two buses to the Churchill - a quick phone call in the comfort of her own home made things so much easier for her," said Kirsty.

"We kept an eye on how things were going, and monitored if there were any issues with running the clinic from outside the hospital."

While the move benefited Kirsty's patients, it did take some adjustment for her.

"Working remotely can be quite isolating, but I had worked from home before and knew I had the right mindset to do it," said Kirsty.

"You do need to be quite confident in your own abilities, and have the support from your consultants in a different way than before.

"The main point, for me, is that were it not for this adjustment I wouldn't be working for this Trust - I've worked with my colleagues for years now, and have formed bonds with my patients, and the idea of leaving that behind was incredibly difficult for me. The fact that I've been able to keep and adapt my job, and provide continuity of care for my patients, is very important to me."

Hayley Smith, Matron for Oncology and Haematology, said: "When Kirsty came to me with her idea for a new way of working, I thought that we had nothing to lose by trying - her patients became familiar with and fond of her, it made life easier for them, and we got to keep Kirsty as a valued member of staff.

"We kept the arrangement under review, checking in with both Kirsty and her patients after six months, then a year. We were really pleased to say that the vast majority of her patients rated the service as excellent or very good."

One of Kirsty's patients who has been using the services said: "The support provided is excellent. Quick access to results by email reduces the anxiety and saves waiting for a clinic appointment. Not having to come to the hospital makes things far more manageable while working full-time - Kirsty provides an essential service very well, and it's greatly appreciated."

Pictured: Kirsty Crozier

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