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'Does Burnham have the solution to failing system?'


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 Follow me on Twitter @nursingtimesed































Readers' comments (19)

  • and the benefit of this compared to section 75 of the nhs act 2006 is...?

    or section 31 of the health act 1999...?

    my last community post ended as a (very small) contribution to the local authority's saving £50million. so much for joint commissioning, integrated teams and joined up thinking!

    if an nhs post can be put at risk to save local authority money under the current arrangements, what are the chances that'll improve when they get their hands on ALL our jobs?

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  • This "penny drop" moment is not actually rocket science is it? I left district nursing last year after 25 years. I was passionate about district nursing, but hated what it had become and was fed up and exhausted by the demands of the job. Which included trying to do the best for my patients whilst arguing about who should fund equipment, carers etc. I have referred many patients to social services for rails, showers etc only to be told that there will be a 3 week wait before they are even assessed! Yes we need to collaborate better on care. But doesn't this just come down to the same problem again, that of staffing?? When will someone realise that's where the money needs to be invested if we are to provide the "wonderful" ( and very patronising) 6 c's and make nursing a profession we can be proud of again.

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  • Tinkerbell

    Anonymous | 30-Jan-2013 8:33 am

    same here. I sit in long winded meetings whilst they discuss who's going to fund what. Naively thinking it might be sorted and that the 2 1/2 hour meeting has not been a complete waste of time only to be told they have to go and have another meeting and put it to the 'panel'.

    Meanwhile the patient, oh never mind about them, we have a new battle on our hands on top of everything else that would cause a nurse to grow so weary of it all.

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  • positive change doesn't happen overnight, so I heard on the radio the other day! it is a process! the speaker said that the problem is that people expect something to be explored or discussed and the change will be made the next day.

    I have been naive enough to believe all the long years of my career that although nursing and everything else in general in our world, with all our technological advances and rapid increase in knowledge, things could only continue to get better. However, although change is rapid simple and obvious things which can make a big difference to our lives seem to take a long time to resolve and no one person seems to have responsibility for making even the most simple decisions any more.

    just ringing any company to try and get a quick answer to something proves this, in many cases they may tell you they will get back to you as soon as possible but never do, or ask you to ring back later only for you to have to start the call centre process all over again still without getting the response you need. they may tell you to write in or even e-mail and it may take weeks to get a response.

    The very mention of the word 'Meeting' seems to say it all!

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  • Tinkerbell

    the only thing i managed to achieve from a recent meeting was being offered a plate of biscuits. I still have the jammy dodger and custard cream wrapped up in a tissue in my coat pocket for the next long winded meeting that doesn't offer biscuits.

    Perhaps some meetings don't have a biscuit funding.

    I don't quit easily but i am almost at the point of giving up now that i see the patient doesn't feature. Perhaps i should eat my 2 biscuits now. I've had them in my pocket for a week now for a blood sugar emergency during another long winded meeting to chomp on in case it's a non biscuit meeting.

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  • I think Lansley used up the biscuit budget! His spending was reported last year in the Telegraph.

    How is he getting on in his new job by the way?

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  • Tinkerbell

    Anonymous | 30-Jan-2013 2:20 pm

    what job does he do now, don't hear much about him anymore.

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  • UGG® Lansley for Women | Cozy Warm Boots at


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  • Rather than redefine and reorganize primary care trusts could just create fast track teams to do all this. As usual a common sense approach that doesn't rely on massive amounts of meetings and umming and erring.

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  • Add up the salaries of everyone at these 'meetings' and you could supply oodles of equipment

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