1. abcdefghijkl Building a Community Nursing Service Fit for the Future Jane Walker Nursing Officer Primary Care

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3. DELIVERING FOR HEALTH Geared towards acute conditionsGeared towards long-term conditions Hospital centredEmbedded in communities Doctor dependentTeam based Episodic careContinuous care Disjointed careIntegrated care Reactive carePreventative care Patient as passive recipientPatient as partner Self care infrequentSelf care encouraged and facilitated Carers undervaluedCarers supported as partners Low techHigh tech

4. abcdefghijkl The Challenges  The context is changing  The demand is changing  The demographics are changing  Workforce issues

5. abcdefghijkl The Challenges  Tackling health inequalities  Sustainable services for the future  Developing new skills and ways of working  Integrating new roles  Whole systems thinking

6. abcdefghijkl The Opportunities  Emphasis on Primary Care  Review of Nursing in the Community  Family Health Nurse  Public Health Approach  Extended Roles  Nurse Consultant

7. abcdefghijkl The Opportunities  Seek innovative ways of working  E.g. Nurse Prescribing & Nurse led clinics  Work with & through others  Team/partnership working with LA & others  CPD & Life long learning commitment  Contribute to current ill-health  E.g. LTC’S

8. abcdefghijkl Review of Nursing in the Community AIMS  Identify the scope of nursing roles in community settings  Explore the future direction of nursing in community  Identify potentials for change & determine future requirements of service  Develop recommendations to provide a clear strategy & vision

9. abcdefghijkl Review of Nursing in the Community  Range of current nursing services  Current work  Interfaces  Patients & carers  Social Services  HEI’s etc etc

10. abcdefghijkl Review of Nursing in the Community Patients and carers want to leave behind… Patients and carers want to move towards… disjointed nursing servicesa principal nurse who helps them to co-ordinate care difficulty accessing care when they need itappropriate nursing services when they need them conflicting adviceconsistency of advice when they need it care provided by practitioners who do not know about them care provided by competent and appropriate practitioners who know about them and the communities in which they live nurses who do not consider them as partners in care nurses who support them by working with them lack of recognition by others of the importance of the relationships between nurses, patients and carers emphasis placed on the importance of communication and relationship skills

11. abcdefghijkl Review of Nursing in the Community Nurses in the community want to leave behind… Nurses in the community want to move towards… working in isolationworking as part of multi-disciplinary, multisectoral teams performing a series of disjointed tasks that do not necessarily require the expertise of registered nurses planning, providing, leading, delivering and evaluating holistic care programmes for individuals and communities performing unnecessary tasks for patients and creating dependency encouraging and supporting patients to self-manage their own care, working together in partnership, and supporting patients through rehabilitation programmes providing reactive services in response to deteriorations in patients’ conditions providing proactive services aimed at maintaining patients’ health status and avoiding health deterioration and crises

12. abcdefghijkl Review of Nursing in the Community Nurses in the community want to leave behind… Nurses in the community want to move towards… having minimal impacts on hospital admission ratesproviding a range of services aimed at reducing planed and unscheduled hospital admissions being restricted to working in just one or two environments working across a range of health and social care environments and settings being risk-averseengaging in effective risk assessments and management referring patients to other practitioners for medication amendments they have identified incorporating prescribing into their practice

13. abcdefghijkl Way Forward  Challenge the status quo  Consider the evidence  Ensure we recognise our leadership responsibilities as advocates for patients and the profession  Listen to patients & carers  Look forward

14. abcdefghijkl “Man cannot discover new oceans by keeping his eye on the shore” Anon