The economic benefit of training specialist neuro nurses
In collaboration with the RCN Foundation, research has been carried out by The London School of Economics and Political Science to explore the economic case for investing in advanced practice nurse training: an innovative nursing role to support the delivery of specialist coordinated neuro-rehabilitation services for adults following a stroke.
The research identified different interventions delivered by a multidisciplinary care team that would involve a contribution from nurses with an advanced practice role.
The three areas of the stroke care pathway are:
- Acute care/ in-patient rehabilitation;
- Early supported discharge (to community);
- Discharge to specialised rehabilitation centres.
For each area of the care pathways the research examined the change in outcomes compared with current care and whether the effects in terms of those outcomes appear to represent good value for money. For example:
- Costs to the NHS associated with poor physical or mental health;
- Costs to social care (e.g. personal care, aids and adaptations);
- Economic effects of exclusion from or reduced opportunities within the labour market (reduced personal income, lower national productivity, social security benefits);
- Economic impacts on other family members (disrupted employment, impact on income, out-of-pocket payments);
- Costs of unpaid care time;
- Value of wellbeing losses from premature death, reduced quality of life.
Stroke rehabilitation involves a multidisciplinary approach, with nurses performing a central role. Investing in an advanced practice role for nurses to increase patients’ access to multidisciplinary rehabilitation service can be beneficial and bring better health outcomes, patient satisfaction and economic savings. Key conclusions from the report show there is evidence to suggest:
- In Emergency and critical care settings the implementation of advanced practice nursing roles improves outcomes with decreased waiting time to consultation (and to treatment); increased patient satisfaction and comparable length of stay; the APN workforce may reduce demand for health services use and attached costs; specialist rehabilitation with APN role can be cost-saving, especially for high dependency patients; the implementation of acute service reconfiguration proved to be successful in different urban regions. For example, if we assume an urban centre like Greater Manchester with a population size of about 3 million service reconfiguration would achieve about 18,000 hospital days saving over 2 years (equal to £5 million saving in NHS money).
Click here to read the full report.