A leading nursing organisation has warned that the movement of services out of hospitals and closer to patients’ homes has failed to happen at the “scale and pace required”.
The warning, from the Queen’s Nursing Institute, comes in the wake of a hard-hitting report earlier this week on the current state of community services.
“The reality is that this simply has not happened at the scale and levels required”
The report, published on Monday by NHS Providers, painted a stark picture of an over-stretched sector struggling with funding shortfalls, staffing shortages and lack of recognition.
It revealed that the vast majority of community healthcare providers were deeply worried about staffing and feared current workforce plans would not deliver enough district nurses, health visitors, and specialist nurses to realise ambitions of providing more services closer to home.
Responding to the report – titled NHS Community Services: Taking Centre Stage – QNI chief executive Dr Crystal Oldman said the document “asks a number of uncomfortable questions”.
“While the narrative of the NHS in England has been to move more care closer to or into people’s homes, the reality is that this simply has not happened at the scale and levels required,” she said.
She noted that the QNI had “repeatedly drawn attention to the growing demand on community services, the lack of long term investment and the staffing shortages” featured in the report.
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Dr Oldman highlighted that, while community services were often regarded with great respect by the public locally, they often lacked a “national profile”.
“It is very disappointing that there is an apparent ‘lack of understanding’ of the importance of community services to the effective functioning of the whole healthcare system,” she said.
She said: “We need to ask if we really do want a health service that invests in health promotion and prevention, that addresses the challenges and opportunities of supporting our ageing population in the home and in the community, or whether the NHS will continue to spend an ever-growing proportion of its budget on reactive, unplanned and emergency care.
The QNI leader also reiterated previous warnings that the number of district nurses leading services in the community had fallen by more than 43% in the last eight years.
She noted that, in January, the QNI had called for the number of district nurses to be returned to their 2010 level and for a “robust national workforce plan” to secure their future in “every village, town and city”.
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“This would help reduce unplanned hospital admissions, facilitate timely discharges from hospital, provide expertise in managing wounds and give the holistic care at the end of life that the majority of people of all ages would like to see delivered in the home,” she added.