Why Our Community Nursing Will Change to Meet the Needs of Ageing Population; an Ageing Population and Rising Levels of Chronic Illnesses Is Placing an Unprecedented Demand on Our Health Service. Here, Chief Nursing Officer for Wales Professor Jean White Looks at Why Community Nursing Has to Change to Meet These Challenges

Article excerpt

Byline: Professor Jean White

WALES, along with most other European countries, has an ageing population which is something we all celebrate but this poses particular challenges for our health and social care systems.

As people live longer, often with complex and chronic conditions, services increasingly must focus on keeping people out of hospital, providing care in the community and helping people maintain their independence at home.

Community nursing has never been more important and, like the rest of our health services, it is changing in order to meet the demands in the health and wellbeing of the population. When most of us think of health services we tend to think of acute services in hospitals. However, in reality, more than 90% of healthcare interaction takes place in the community. Strengthening this part of the health system is vital and, to support this, earlier this year Welsh Government set out the Delivering Local Health Care report which is a three-year plan for NHS Wales.

A key aspect of this is ensuring locality network arrangements are fully embedded and designed around the local population's needs.

It recognises how critical integration of services is in assessing the health and wellbeing needs of older people with complex needs and using that assessment to plan and deliver integrated care.

The plan builds on the good progress made to date by health boards but aims to accelerate the pace and scale of the change that is needed.

To date the models of care that appear to work well include integrated health and social care teams with both specialist care of the elderly and GP clinical expertise, provided as part of a multi-disciplinary approach.

They support frail older people to be cared for at home and help provide access to diagnostics treatment and care provided in the home or as close to home as possible.

Community services typically have rapid response teams or enhanced care teams which are nurse led but often involve other professionals such as physiotherapists and occupational therapists. These teams bring care to the person at home, either to help facilitate early discharge from hospital or by providing a range of interventions that hopefully prevent hospital admission.

One way of supporting people with complex or chronic health conditions is the introduction of the concept of 'virtual wards' in the community.

The aim is to prevent an exacerbation of their condition and the resultant hospital admission, by providing care and other supportive services in the most appropriate setting, either in or close to their home, with the security and level of monitoring that they would typically get in hospital. …