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Blog: Comfortable deaths and dynamic strategies

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'It was an extravaganza of ideas, motivation and stunning hope for those of us who have laboured for primary healthcare services'

Although I am elderly in working years' time, and therefore a touch cynical when it comes to health reform and political grand intentions, I have to admit to a sense of excitement and fresh optimism following a Department of Health community and primary healthcare strategy event on 15th May.

It was an extravaganza of ideas, motivation and stunning hope for those of us who have laboured long and hard to give a louder voice to the world of community and primary healthcare services. Not that us primary care groupies wish to see the demise of our local district general hospital, more that we believe it to be in the public health interest for the focus of attention to be in the place where disease is prevented, identified and, for the main part managed – the community where we live, work, play and eventually die.

Talking about death, a topic I seem to be thinking more about in my post-middle (but so far, healthy) years, end-of-life care is now receiving the attention it deserves and all healthcare settings have to rethink, re-plan and ensure that patients who die in their care die well.

But the public have told politicians that, given the choice, they want to die in their own home a with partners, friends and maybe a pet Labrador at their side. Medicines are now so sophisticated that, for most patients, all unpleasant symptoms can be so well managed and controlled that death does not have to hold the terror it once did.

But back to the cheerful strategy event. Leading DH lights spoke of the wonder of the community nursing services they had seen during their travels, and that it was the community nurses’ energy and determination which persuaded them that community services really matter.

More investment is promised for community services – hurrah – lets witness rapid expansion of community care and treatment. Most people, however unwell, can be beautifully cared for in the community, but only when the resources are in place to help make services happen.

This blog attempts to provoke both ends of the health spectrum. We now have the technology and wisdom to identify disease even before the person feels unwell, and we understand social marketing techniques which make health promotion a reality. We also have the skill to make death calm, comfortable, and in people's much-loved homes.

With all this and more, surely primary care will take centre stage in healthcare services in the near future.

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