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Patients should not be faced with 'queue' of community nurses


Community matrons will play an increasingly key role in “case managing” care for the rapidly rising number of people with long term conditions, the government’s national clinical lead for quality and productivity has told Nursing Times.

GP Sir John Oldham said patients benefited from having one person to co-ordinate their care and bring in specialist advice when needed – rather than seeing a “Monty Pythonesque queue of case managers, who only deal with one illness”.

Speaking to Nursing Times ahead of a London conference on long term conditions and NHS modernisation last week, he called for community nurses in general to work in a more integrated way. He noted that many areas were now looking at linking district and community nurses with particular practices, as has already taken place in East Kent (news, page 6, 15 March).

Sir John said nurses could “be part of a greater whole and be a contract for patients, rather than working in silos”.   

He also suggested telehealth – expected to be backed later this year by results from large-scale NHS trials – would lead to widespread changes in working for community nursing teams.

This would see nurses remotely assessing results from patient self-monitoring – potentially reducing the workload of community staff, who otherwise would have to visit them.

Sir John’s comments came as health secretary Andrew Lansley warned that the number of people with two or more long-term conditions would increase by 252 per cent by 2050.

“The average cost of someone without a long-term condition is around £1,000, which rises to £3,000 for someone with one condition and to £8,000 for people with three or more conditions, the additional associated cost pressure of caring for people with multiple co-morbidities could reach £4bn by 2016,” said Mr Lansley, who was addressing a conference on long-term conditions today.

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Readers' comments (6)

  • Telehealth - the great solution to all our problems, just like the national programme for IT.

    For the patients who are going to actively take an interest in their health, who will take proactive steps to prevent illness a suitable telehealth solution could well be a mobile phone, existing BP machine, pulse oximeter and a set of scales. The well motivated and engaged person would phone through their results each morning, or probably only phone by exception.

    For those who aren't compliant with treatment, who have no engagement, who don't care about their health - a £2000+ piece of kit with expensive monthly contract is not going to do anything but gather dust and will only be used for readings when they are feeling really unwell.

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  • sounds like the super highway to dehumanising patient care and punishing those who are demotivated for whatever reasons, often depression and loneliness, for taking care of themselves when sometimes all it takes to get them back on the right track is supportive visits from a competent and caring healthcare professional.
    yet more british mean spirited cost saving measures which panda to the government rather than healthcare professional initiatives which should have the interests of patients as individuals at heart.

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  • patients have the right to choice of treatment and respect for their needs and wishes. however, if they decide against a medication for whatever reason (which they are not obliged to disclose but commonly due to inadequate information on the dangerous side effects because they have not been properly tested) they are labelled 'NON-COMPLIANT'!

    if a patient makes their own arrangements for screening and do not take up nhs tests 'REFUSED' is entered on their notes even if the results of the alternative test have been provided.

    More appropriate terminology should be used which does not point the finger of blame at patients who determine their own health needs as these notes are transmitted to third parties such as insurances, occupational health of prospective employers, or even other professionals who may be involved with the care of the patient who have an unpleasant habit of stereotyping their patients as 'non-compliant' or 'refusing' treatment. these narcissistic 'professionals' have an issue with power struggles and tend to use the patient as weakest link in the chain on whom they attempt to wield their power.

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  • telehealth not very advanced, sophisticated or well developed but maybe depends on the programme being used.
    one experience of it from insurance company which was negative.
    the information was stereotyped and what I knew already or any idiot could have found on the internet anyway.
    was given advice which was totally impractical for my situation and the doctor got stroppy when I said I was unable to do what she suggested and was looking for an alternative solution. she merely said i had asked for advice and she was giving it to me and if i did not want to take it it was up to me. I am paying this insurance company, but I supposed she could tick the box for target met which was all that mattered.

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  • Non-compliance means you are not hitting the goverments targets, which in turn negates patient choice. The both don't go together.

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  • we need to get rid of the government targets concept. we are dealing with human beings not manufactured goods where this idea came from.

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