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Sometimes, whatever is going on around us it is important to share good news so that we can keep our spirits and motivation high – thus helping us to carry on the good work, despite the many problems which surround us all. So this week’s blog concentrates on good news by telling Nursing Times readers how a day I spent in Milton Keynes proved to be uplifting, mainly because community nurses were working in harmony with their general practice.

The point of this short story is that whenever the issue of community nurse employment raises its complicated head, there is a wave of disquiet heard from the ranks of district nurses and health visitors, referring to the fact that, no thank you, they have no wish to be employed by general practice.

I know of only one UK general practice (if you know of more please tell me) which has taken the enormous step of employing previously attached and well integrated district nurses and health visitors. When I heard of this set-up, my immediate thought was that this is a practice I must visit.
History is important, and the fact that the DNs and HVs in question had been managed by the practice since 2000 and that considerable efforts had been made over the years in terms of integrating community services with those of the practice was significant.

When the practice offered to employ the community nurses, rather then simply second them from the PCT, the transactions regarding contracts of employment proved easier than anyone anticipated.
Since 2000, huge progress has been achieved for both patients and staff. Strong nurse leadership and enlightened practice management have served the nurses and health visitors well. It is accepted that the community nurses practice with a style of autonomy and independence – GPs make no effort to micro manage them.

Teamwork is exceptional and the healthcare assistants who work with practice nurses and community nurses were happy to talk about their enjoyable and well-supported working lives. One healthcare assistant plans to accept the opportunity to train as a registered nurse.

The moral of this story is that, when we consider changes to organisations and structures of employment, the form is less important then the character of the people involved. I am no longer excited or depressed by structures, but the energy, philosophy, values and style of nurses, doctors, therapists and managers never fail to intrigue me.

Always remember, it is people who provide care, not buildings or policies.

Lynn Young is primary care adviser to the Royal College of Nursing.

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