Comment on: 'I worry about the future of community nursing'
Hi Jenni, I worry about the future of community nursing too. I was interested to read your opinion piece but surprised to see you write; “No one seems to be standing up and pointing out the error of this, or the problems it might be storing up for the future health of the population – and the health of the NHS budget – by making these sorts of decisions.”
I would have thought that you’d be aware that there’s plenty of people that have been ‘standing up’ and pointing out the absolutely ridiculous situation that the government is causing by cutting community nurse numbers. I’d argue the problem isn’t that nurses aren’t standing up, it’s that the current government don’t have an ideological interest to do something about it, so ignore the complaints.
I know I’ll be keeping ‘standing up’ either till we get a change from the current government or we get a change in government to one that knows the value of community nursing, and proves this by real action.
After years of campaigning against the cuts in health visiting and the years of effort working through the HV Implementation plan, to get the 4,200 more health visitors that were desperately needed, it's terribly depressing to witness the effects that the Conservative government's cuts to public health budgets are having on health visiting.
Pre-2011 I met with Unite/CPHVA members across England who were faced with their services being cut with the arguments that other less qualified staff could come in and do the same jobs. We won the argument then, and got the Implementation plan in place, and yet we are now facing the exact same outcome and having the exact same arguments.
As in the case of Cumbria, local councillors argue that although they face a near annual budget cut of £1million, the new service will in fact be better for the public. In East Riding of Yorkshire (where their budget has been cut by £500,000) band 6 health visitors are being told that they can leave their job on the Friday and return back on Monday as a band 5 staff nurse and this will have no effect on patient care (more here if you're interested: https://davidamunday.blogspot.co.uk/2017/01/deja-vu.html?m=1).
For the DH spokesman to suggest that 'their investment is making sure that local services are in place', is an even greater fraud than local councillors suggesting budgets cut by 10 or 20% will actually result in better care for families! With only 6 weeks left of the '5 mandated visits' legislation, to not have any news on whether they will put anything in its place, smacks even more of a government that is happy to let the service disappear but wishes to take absolutely no responsibility for its actions.
Please support health visitors out there by signing Su Lowe's 38 degrees petition: https://you.38degrees.org.uk/petitions/your-health-visitor-save-our-services.
Jenni, an interesting read. I thought more about your comment about some people distilling nursing into a few key elements. It'd be good if you could highlight some examples of this. When I read it I wondered if a target of the criticism was the 6Cs as I know speaking to front line nurses this is something that does get criticised. We do of course now have the 'Leading change, adding value' strategy launched May 2016. This added the 10 'we's' and if you think of my own profession, health visiting it means that we have:
The triple aim
The four principles of health visiting
The four Ps in the NMC Code
The four levels of health visiting service
The five mandated contacts (at least for now)
The six high-impact ares
The six Cs
The 10 we’s
Therefore for me there's a bigger issue, not that nursing is distilled to too few key elements but no one has the time to read the complexity about what is expected apart from those nurses who don't have to work on the front line. I asked some nurses a few days after the launch of the strategy who had read it (all 133 pages) and who knew of its existence and no one had/did. I wonder how much that has changed in 9 months?
Interested in more? I wrote this blog at the time: http://davidamunday.blogspot.co.uk/2016/05/ten-little-dinosaurs-pirates-and-10-wes.html?m=1
Another point I'd empahsise, nursing managers need to show compassion to their staff. It's really difficult to show compassion in your job if you don't feel or see compassion yourself from your boss. It goes both ways!