Community nursing 'will fail without investment'

Columnist and Senior Features Writer

Monday 14 May 2012

COMMUNITY health care in Scotland will falter unless more investment is made to meet growing demand, according to the Royal College of Nursing.

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SUSAN SWARBRICK

Increasing caseloads and less time spent with patients are among the key issues facing community nurses, a new survey has found.

Figures released by the Royal College of Nursing (RCN) Scotland show that nearly two-thirds (61%) of registered nurses claim staffing levels have decreased in the past year.

More than three-quarters (78%) said their caseload had increased in the last 12 months, while almost half (49%) reported spending less time with patients than they did a year ago.The findings appear to fly in the face of Scottish Government claims that there has been a rise in the number of community nurses. RCN Scotland director Theresa Fyffe said: "The laudable aspiration of delivering more care closer to home rather than in hospitals will remain just that – an aspiration – unless the community nursing workforce is bolstered over the next few years. "Community nurses are telling us that they are overburdened already, so shifting more services to the community is simply not going to work unless action is taken to ensure we have enough community nurses to deliver them." While the RCN said it supported the shift from hospitals to community care as being in the best interests of patients, many nurses responding to the survey voiced concerns. These included the potential for vulnerable patients to be discharged from hospital before social care support was in place, which, said the RCN, could result in people "bouncing" between overstretched services. One nurse is quoted as stating: "Social care cuts have meant an increase in our workload as, in addition to our nursing role, we are sometimes making patients their meals and sometimes even doing their shopping. "You can't leave someone without food, so what choice do we have? We report it to the Social Work department, but they just say they can't provide any care at the present time. It's so sad." Another said: "A patient was at risk of developing pressure sores as his social care package did not provide for him to be moved regularly enough. "As a result, he either had to stay in bed for 24 hours or be in the same seated position for too long – and he developed a pressure sore."Ms Fyffe added: "If social care keeps being reduced as councils struggle with reducing budgets, and community nursing teams continue to be under-resourced, the revolving door syndrome of people being readmitted to hospital because they can't get the support they need at home will continue to grow."A Scottish Government spokesman said: "Figures show there are now around 10,600 nurses working in communities across Scotland – 2400 more than in 2006. This figure is set to increase – more adult health and social care services are being provided closer to home and more health staff are set to work in the community as this shift in the balance of care gathers pace. "A Scotland-wide Modernising Community Nursing Programme supports NHS Boards to meet community care needs through a development approach that will provide high-quality, person-centred care and ensure patient safety."Ahead of its annual conference in Harrogate this week, the RCN highlighted that 61,000 posts were at risk of being slashed across the National Health Service UK-wide, with 26,000 already lost in the two years to April. This figure includes 402 planned nursing job cuts in Greater Glasgow and Clyde, along with 398 in Lothian, in the last financial year.

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Community nursing 'will fail without investment'

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