It was a nurse who shadow health secretary Andy Burnham credited as giving him his “penny drop moment” in his strategy to integrate health and social care budgets (see news page 5).
A ward sister at the Royal Derby told Mr Burnham that the thing nurses were finding a real struggle was staffing levels, which meant they were incapable of meeting the demands imposed upon them by an ageing society.
Unlike when that ward sister first qualified, hospitals are now full of patients in their 80s and 90s who are frail with complex medical conditions and are therefore highly dependent on nursing care. Hospitals have not changed to accommodate this demographic shift - and it is this that stretches nurses beyond their limits.
Should Labour win the next general election, Mr Burnham plans to combine the currently separate health and social care budgets.
He believes the NHS’s concentration on curing disease prevents it from keeping people physically and mentally well, for example by installing grab rails and walk-in showers in older people’s homes. This sort of intervention has up-front costs, of course, but makes patients less likely to need expensive NHS treatment later.
Nurses are often the ones looking after patients with long-term conditions in their own homes - able to spot where a rail or lowered step could make all the difference
It is, without doubt, a laudable aim, and an approach that will bring huge benefits to nursing as well as preventing people “fearing old age”, as Mr Burnham believes many people do now.
Nurses are often the ones looking after patients with long-term conditions in their own homes - able to spot where a rail or lowered step could make all the difference to keeping them healthy and out of hospital. They are also sorting out the discharge at the end of a hospital stay, and are well-placed to recommend to social care teams how to best look after their patient.
Of course, some collaborative care does happen now in pockets of the country, but his plans could make it more consistent.
There are questions raised over how Mr Burnham’s initiative, “Whole-Person Care: A One Nation Approach to Health and Care for the 21st Century”, will be funded. But when he announced it at the King’s Fund last week it was broadly welcomed.
This new approach seems radical - but there’s a feeling that only radical will do. As Mr Burnham said - if something is not done now, we are likely to “hear more and more stories of older people failed by a system that is simply not geared up to meet their needs”.
Mr Burnham has convinced many health professionals and experts of the merits of his plan - now he just needs to show how it can work.
Jenni Middleton, editor
firstname.lastname@example.org. Follow me on Twitter @nursingtimesed