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Dual acute and community role pilot


Nurses are to work in both acute and community care settings, under a scheme to be launched by Guy’s and St Thomas’ Foundation Trust in London.

The trust’s older people’s rotation programme represents one way to boost the skills of nurses working in discrete settings.

It will see nurses transfer every six months between an acute medicine ward for the elderly, a specialist elderly care unit and a nurse led intermediate care facility.

While based outside the hospital, nurses will be able to accompany the community nursing team to broaden their experience.

The move comes as the London foundation trust absorbs the provider arms of Lambeth and Southwark primary care trusts.

Heidi Jensen, head of nursing at Guy’s, said the programme would mean staff could follow patients the length of the clinical pathway and get a better insight into the interface between community and hospital..

“It was quite apparent that it would be beneficial for nurses to work across the different areas,” she said. “We are going to attract staff who want their area of nursing expertise to be caring for older people.”

The scheme was put in place by the trust’s chief operating officer and nurse Eileen Sills, who spent a week with the teams at both PCT provider arms when the integration was announced.

Ms Sills said integrated schemes should assure community nurses they were in no way “poor relations”. She added they would not be called into hospitals to cover shifts or asked to perform roles for which they had not been trained.

Associate director of governance, quality and nursing at Southwark Provider Services Kate Moriarty-Bakersaid the rotation programme model could be expanded to other specialisms such as diabetes and end of life care.

She said: “The integration offers nurses the opportunity to move between acute and community nursing, varying their career and not being restricted to one setting.”


Readers' comments (10)

  • " Jack of all trades" spring to mind anyone?

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  • Could this be per chance down to recruitment issues in one of the specific areas???

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  • Michael Sandiford

    I think this could be really useful. Hopefully enhancing understanding of both hospital and community nursing for the staff involved.

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  • Seamless and holistic care, sharing skills learning to appreciate the whole care package. Sounds a great idea for patients, good luck and hope it works

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  • Does sound like a nice idea but hopefully Nurses from the acute sector will also not be asked to perform duties they do not understand. Good luck

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  • We heard yesterday that our Board were also looking at this issue as a possible way forward. Due to our location we do have recruitment issues across all areas. It is even suggested that the community will come into the acute area as well as vice versa.

    Have to be honest I see this as a good thing and can help improve care right across the board and improve outcomes for our patients.

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  • Yes Jack of all trades master of none does come to mind-it will give insight into the patient journey but care in each of these areas is skilled and complex-6 months will not be enough I think to do the role justice and give patients the care they need

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  • It is an excellent idea,perhaps it can teach some ward nurses the true meaning of (effective) discharge planning.
    working in the outpatient enviroment I often come across patients who have been discharged with no proper provision of information about how to obtain the community services they need eg;district nursing services,provision of essential equipment for those requiring chronic care and information about future appointments.
    I am forever having to refer patients back to the ward they were discharged from as I may have no knowledge about their admission and treatment.
    Patients are reluctant to phone the wards after discharge as they dont want to bother them because they are so busy and are told more than often as they are discharged they are the outpatient departments responsibility.
    If I dont know anything about a patient I cannot just magic up community care.
    We are all living longer, using hospitals more and being discharged quicker and we need to get community care right for those returning to it,it is the future for care.
    As long as this isnt a way of making up the shortage of staff in community care as this will result in a lot of staff moving through the community without picking out the skills needed and resulting in a gross lack of continuity.

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  • This is an excellent idea, allowing the staff to experience the full range of service available to patients. It sounds similar to a midwifery programme which is in operation in Bolton!

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  • Rotations within acute areas have been the norm in many trusts for years. Its how I switched from A&E to ICU many years ago. It allows for a better skill-mix if done correctly and benefits both staff and patients. Its an interesting idea to rotate into the community- acute skills can only enhance community nurses who have maybe not worked on a ward in years. As for acute ward nurses, I'm sure seeing how community nurses manage their varied caseloads and work within a primary care setting will be very valuable. Discharge planning was never my strong point and it has recently come back to bit me. Lets hope that this scheme is being done with the best intentions, rather than as a cost-cutting excercise by decreasing the total numbers of nurses across these disciplines- no I am not being a killjoy, just stating a fact. Other trusts have done this within an acute setting and patients have suffered as a result.

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