Improving NHS nursing care for older people

By Tina Donnelly, walesonline.co.uk

August 10, 2009 

United Kingdom

The Royal Ccollege of Nursing (RCN) presented its annual special recognition award to Welsh board member Jan Evans at our biennial conference in Cardiff last week.

Jan works at Park House Court Nursing Home in Tenby, and has worked tirelessly to improve the lives of older people in Wales and in the independent healthcare sector.

When people think of healthcare, they immediately think of the NHS (National Health Service), but continuous nursing care, particularly for older people, is almost wholly provided by the independent sector.

The RCN (Royal College of Nursing) in Wales wants to see reform in the system of providing continuing NHS care, as many people with serious health conditions may not realise they may be eligible for fully-funded NHS care.

And nurses are struggling to implement the two-stage process for assessing continuing care health needs in a way that is clear and fair.

It is imperative that all people are assessed for continuing NHS care in exactly the same way across Wales and the unfair postcode lottery is ended.

Regulatory standards and expectations are quite rightly rising, yet many nursing homes are struggling to finance staff training and continuous professional development.

The Welsh Assembly Government should ensure that health organisations accurately assess the needs of their community for nursing care beds and for care in people’s own homes from nurses who have knowledge of and experience in meeting the nursing needs of older people.

The limited and short-term nature of funding for nursing care beds in the independent sector results in pressures that may force care homes to close, creating a shortage of nursing care beds.

In turn this means that hospital patients are inappropriately transferred to a community setting or they are kept in hospital unnecessarily.

This is quite simply unacceptable and reflects a lack of care and consideration for the nursing care needs of the older person.

We believe that the Assembly Government should also support the provision of and access to appropriate training and development for both nurses and health care support workers involved in the delivery of continuing nursing care in the independent sector.

Furthermore we would like to see the Assembly Government invest in e-health solutions that help in providing nursing care outside an acute setting and the provision of flexible respite care to support carers in their caring role.

RCN Wales supports the Assembly Government’s proposed Social Care Charges (Wales) Measure, which will allow ministers to set out, in subordinate legislation and in guidance, the detail of a fairer and more consistent framework for councils to adopt when charging individual service users for non-residential social care services.

The UK Government recently published its Green Paper on improving social care in England and reforming the funding system for long-term care.

The Assembly Government has undertaken a range of consultations and engagement on paying for care, with a view to publishing a set of proposals this autumn.

Both of these are important developments in this area and have major implications for many people.

The RCN in Wales has responded to the Assembly Government consultation by outlining the key principles that we believe should underlie any future reformed system.

These include dignity for those cared for, a universal entitlement to care services funded by the Government, a nationally-set level of entitlement, integration between health and social care, appropriate planning for the provision of care, maintaining people’s independence in their own homes for as long as possible, investment in public transport to allow people to access services such as day centres and an educated care workforce.

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