By Richard Johnstone | 14 May 2012
The government’s plan to shift health care from hospitals to communities is under-funded and under-staffed, the Royal College of Nursing said this week.
At the start of its annual congress in Harrogate, the RCN published the results of a survey of community nurses that found ‘overburdened’ staff had less time to treat patients than a year ago.This was despite the government’s stated aim to transform such local health services to ensure they can provide ‘modern, personalised, and responsive care of a consistently high quality that is accessible to all’, the union said.
Health services in the community often provide care for post-operative patients as well as those with long-term conditions. In November 2010, the Department of Health said that a shift from acute hospitals to community services would ‘support’ the £20bn of efficiency savings needed in the NHS by 2014/15.
However, the RCN today warned that nurses working in these areas are ‘reaching breaking point’ as services are ‘overburdened, underinvested [in] and at risk from cutbacks’.
Only 6% of community nurses agreed they always had time to meet the needs of their patients, as almost all said their caseload had increased in the past year. Nearly 60% of the 2,681 nurses surveyed said they were spending less time with their patients than they did a year ago.
This raises ‘major concerns’ that community services do not have the capacity to deal with the increasing number of patients, including some who are acutely ill, the RCN said.
General secretary Dr Peter Carter said there was ‘a clear and worrying picture of a health service which is struggling’.
He added: ‘It is struggling to keep people out of hospital because of pressures on the community, and it is struggling to discharge them with support when they leave.
‘We want care to be delivered closer to home, and we want community nurses to be empowered to keep their patients out of hospital, but at the moment this shift in the way care is delivered is simply a facade, with the community struggling to cope with the workload it has now, let alone the one it faces in the future.’
The union has also warned that more than 61,000 NHS posts are at risk. It has been collating the data on job cuts across Britain as part of the efficiency drive, and suggests that 26,000 posts have gone in the past two years, with 34,000 more at risk.
However, the government disputes these figures. Health minister Simon Burns said he did not recognise the numbers of potential job losses.
He added: ‘We are giving nurses in hospitals and in the community more time to care. We want to remove excessive paperwork and bureaucracy. This government believes in the NHS.’
The NHS Confederation said that community services played ‘an essential role in keeping patients out of hospital’.
Community care will ‘play a much bigger role in the NHS in the future as we modernise the service and we will need them to be as efficient as possible’, said deputy chief executive David Stout.
‘We would expect to see increased investment in community services in the years ahead to ensure there are the right foundations to deliver the safest care.’
