Title: Building a Community Nursing Service Fit for the Future
1Building a Community Nursing Service Fit for the
Future
- RCN Conference
- Paul Martin
- CNO
2Introduction
- Why now?
- What is the purpose of the Review?
- What are the challenges?
- What are the opportunities?
3Why now?
- Clear picture of health needs and where resources
need to be targeted - Many different practice roles, titles and models
does it make sense? - Framework against which services and
educationalists can plan workforce to meet needs - Ensure that we know how nurses contribute and how
to maximise their potential
4Demography
- Diminishing numbers of work-age adults
- Implications for recruitment
- Increasing numbers of older people
- Proportion of people aged 60 and over predicted
to rise from 15.9 in 2001 to 26.6 in 2031,
increase of 67 - Proportion of people aged 80 years and over will
rise by 116 over the same period, from 3.8 to
8.2 - Smaller pool of unpaid carers
5Older people more likely to
- Live alone
- Have functional dependency and sensory impairment
- Have chronic disease and co-morbidity
- Multiple medication
- Move cognitive impairment and mental disorders
- To develop complications of acute illnesses
6Long-term Conditions
- 80 of all GP consultations
- 60 hospital bed days
- Of 11 leading causes of hospital bed use in UK 8
are due to conditions that with strengthened
community care would lead to a fall in bed usage
7Health Inequalities
- Gap between rich and poor increased by 5.9 years
between 1991 and 2001 - Present with at more advanced stages of disease
- Shorter consultation times with GPs
8Children and Young People
- Increase in obesity
- Increase in mental illness
- Reduced exercise
- Increase in alcohol and substance misuse
9Delivering for Health
- Reducing the health gap
- Enable people with long-term conditions to live
health lives - Establish new health and social care services
- Build on recent progress on waiting times
- Streamline unscheduled (emergency) hospital care
- Separate planned from unscheduled care
- Remove bottlenecks in diagnostic services
- Strengthen health care in remote and rural areas
10Aim of the Review
- To identify the core components of a modern
community nursing service which is flexible and
responsive to meet the needs of patients and
communities in Scotland within a
multidisciplinary setting and make
recommendations for the future.
11Key Messages for the Review
- improving health and well-being
- maximising individuals communities self-care
potential - reducing inequalities
- delivering safe effective services in a
multi-disciplinary, multi-agency context - Supporting social health care services in
protecting the public from harm
12Foundation elements of the proposed framework
- The need to design services around the needs of
individuals and communities - The need to ensure that the true value of nurses
and the contribution nursing can make is realised - The need to build on the strengths of the present
as well as the needs of the future - The need to support nurses to move between teams
and offer attractive career choices
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14Where the nursing team sits within the
multi-disciplinary, multi-agency team
Patients, carers and communities
Consultant nurse
Advanced Practitioner/Clinical team leader
Maternity services
Community Health Nurse (HCN)1 working directly
with individuals and their carers clinically
managing and leading services delivered to
patients supporting self care multi-disciplinary
and multi-agency team working meeting health
needs of communities health promotion
Acute Sector
Non-statutory sector care providers
Community Hospitals
Primary Health Care Team, including pharmacists
etc
Local Authority teams
Mental health learning disabilities
Childrens young peoples service
Community staff nurse
Health care support worker
1 Working title
Patients, carers and communities
15What are the opportunities?
- Where and how nurses do and can make a difference
- Harness new organisational systems, legislation
and technology - tools - Build on current practice and recent nursing and
service strategies - Enhance career options
16What are the opportunities?
- Single point of access for patients
- Builds on current practice
- Promotes a public health approach
- Improves career structure
- Develops whole systems thinking
- Works with communities
17Where and how can Nurses make a difference?
- Anticipatory care
- Working with disadvantaged communities
- Increasing support for self care and closer
working with carers - Early interventions to prevent hospital
admissions - Fully utilising skills of all professionals
- Delivering on waiting times
- Increasing the range of locally available
diagnostic services
18The Tools
- Systems
- Integration in NHS
- Joint Future
- GMS Contract
- Legislation
- Nurse Prescribing
- Technology
- Tele-medicine
- Electronic Records
19Building on what is already there
- Caring for Scotland
- Nursing for Health
- Framework for Nursing in Schools
- Framework for Nursing in General Practice
- Promoting Health, Supporting Inclusion
- Framework for Cancer Nursing
- Framework for Maternity Services
- Review of Mental Health Nursing
20Nurses need to
- Be visible and accessible to patients and carers
- Be accessible to health social care workers
- Provide value for money
- Facilitate integration of care
- Have the knowledge skills to support people
with LTCs or who are ill engage in health
promoting public health activity - Be able to respond to changing demands
- Take advantage of flexible career pathways
- Provide effective professional managerial
leadership
21Way Forward
- Challenge the status quo
- Consider the evidence
- Ensure we recognise our leadership
responsibilities as advocates for patients the
profession - Listen to patients and carers
- Look forward
22Man cannot discover new oceans by keeping his
eye on the shore Anon
23Thank you