Kelly Bishop, Head of Nursing at the NHS Transformation Unit, shares her thoughts on the role of nurses working in social care and why they should not be undervalued.
Much of the focus of strategic discussions within the NHS is understandably around the implementation of the long-term plan (LTP). The need to focus on the prevention and management of conditions such as cardiovascular disease, stroke care, diabetes and respiratory disease are without doubt the right thing to do. The LTP also talks about integrated community health teams and a focus on improving health outcomes for people with learning disabilities (LD) and autism. I can’t help thinking, however, that the role of healthcare professionals working outside of the NHS needs to be further highlighted and their development invested in.
The social care sector is an important part of the system and is central to the delivery of high-quality nursing care to people who are often very vulnerable and have a wide range of complex needs that significantly impact the NHS. The lack of recognition for nurses working within nursing homes (NH) and LD, both within the LTP and more widely, perplexes me.
It’s estimated that around 325,000 older people live in care homes in England, representing around four per cent of people aged 65 and over. Aside from social care needs, these residents also require healthcare. Data collected by the Care Quality Commission (CQC) and reported by the British Geriatrics Society (2011) estimated that over half of older people in care homes don’t have access to all the services and support they require from the NHS. These people are supported by nurses working in our social care sector, who are part of wider system that directly affects the delivery of the care they provide and results in high rates of emergency admissions.
While nurses in care homes do need to reflect on their own practice, they have little influence over the surrounding system. They receive low priority and little support with their professional development, even though they’re key clinicians within our local health and social care systems.
LD nurses also play a vital role in ensuring the uptake of screening and the promotion of well-being to a population we know have a much lower life expectancy than those without a learning disability – up to 18 years for females and 14 years less for males. They’re more likely to be obese and 25.2 times more likely to have epilepsy than their non-LD counterparts. With regards to the importance of LD nurses in reducing the need for people with LD to access acute NHS services, I think the data alone makes this point.
We need to ensure that we involve our social care nursing colleagues in system and service transformation, because to do so without them would be at the detriment to the NHS, and our patients. They’re part of our health and social care system and are therefore instrumental in our long term plan, or are they not?
I can’t help but think that future community nursing roles may look very different, requiring highly generalist nursing skills functioning within primary care networks and across the boundaries of health and social care providers. We talk a lot about ‘Place’ and how we deliver care in this context, but the NHS could learn a lot from our social care colleagues about delivering true compassionate care in place.
With 2019 celebrating the 100th year of LD nursing and looking ahead to Nurses’ Day on 12th May, the NHS Transformation Unit are discussing and supporting the important role that our colleagues working in social care bring to the delivery of high-quality care, not just today – but considering the important role they have in the future sustainability of the NHS.
We’re delighted that we‘ve linked up with Skills for Care this week. Skills for Care supports adult social care services to deliver what the people they support need and what commissioners and regulators expect. Throughout the week will we continue to promote the role of nurses working in social care and why on 12th May, Florence Nightingale’s birthday, they should be celebrated.