All GP surgeries in Northern Ireland will have a named district nurse and health visitor by Spring next year, under a new 10-year vision for health and social care.
The plans, launched by health minister Michelle O’Neill, also include investment in advanced nursing roles and a pledge to transform core district nursing services.
“Meaningful change does not happen overnight – this will take time”
The vision – titled Health and Wellbeing 2026 - Delivering Together – encompasses changes to primary care that will see multi-disciplinary teams “embedded around general practice”.
“These teams will include GPs, pharmacists, district nurses, health visitors, allied health professionals and social workers, and new roles as they develop such as advanced nurse practitioners and physician associates,” stated the Health and Wellbeing 2026 document.
By March next year, GP surgeries will have named district nurses and health visitors to work with, while a district nursing framework will set out plans for core district nursing services.
Training for the first advanced nurse practitioners in primary care and a new physician associate post-graduate degree programme have been developed and will start in early 2017, added the document.
Named community nurses for Northern Irish practices
New models will include Acute Care at Home, which will see mainly frail and elderly patient treated at home by doctors, nurses and other staff.
The service is aimed at those with conditions like chest infections, urinary tract infections and dehydration that can safely be treated at home without the need to admit patients to hospital.
“Patients have, within their own home environment, the same access to specialist tests as hospital patients and receive consultant-led assessment and treatment,” said the document.
The aim is to roll out the model to all part of Northern Ireland within the next three years.
The vision, which includes the development of a new workforce strategy that will cover issues like recruitment and retention of nurses, follows a report by an expert panel stressing the need for change in the way health and social care services work.
The report highlighted nurse staffing shortages and called for a renewed effort to lift the pressure on hospitals by providing more care at home and through GP surgeries.
It also advocated the development of new nurse-led models of care such as the Buurtzog district nursing model developed in the Netherlands, as recently reported by Nursing Times.
Panel chair Professor Rafael Bengoa said the health and care system in Northern Ireland faced “a stark choice”.
“It can either resist change and see services deteriorate to the point of collapse over time, or embrace transformation and work to create a modern, sustainable service that is properly equipped to help people stay as healthy as possible and provide them with the right type of care when they need it,” he said.
Meanwhile, Ms O’Neill acknowledged that the system was “at breaking point” and said the new vision was an opportunity for a “fresh start”.
She confirmed Northern Ireland will look at the Dutch model but also announced recently that the country would not follow England in scrapping bursaries for student nurses and midwives.
The Northern Ireland government has already increased student numbers for 2016-17 by more than 100. The number would be maintained at that level at the very least into 2017-18, said Ms O’Neill.
The plans include the formation of a new Nursing and Midwifery Task Group, to be directed by Northern Ireland’s chief nursing officer Charlotte McArdle.
It will report back within 12 months with recommendations on how to “maximise the contribution nursing and midwifery can make to improved outcomes for the population”.
Ms O’Neill stressed change would take time and would need the support of clinicians. “This is not a ‘Big Bang’,” she said.
“Meaningful change does not happen overnight – this will take time, money and the support of staff, those who use our health and care services as well as the support of government,” she added.