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Let's wish for a happy and trouble-free 2007

Lynn Young
Primary Helthcare Adviser for the RCN

I hope that you receive this copy of Nursing in Practice in time to wish you all a healthy, trouble-free 2007. Yes, I am growing more mature, maybe even a little wise in my older years, but these days a year seems like three months, and a week more like a rather long day. However, there are sound reasons why 2006 has sped by and left many of us gasping for breath - the government, in its infinite wisdom, insisted on imposing relentless reform upon the world of healthcare.
For the time being all eyes are focused on making financial savings and removing large deficits from the books. Our Chancellor of the Exchequer insists that we must have financial probity within the public sector, and oh yes, the rise in interest rates has just been announced, so savings have to be made both at home and at work.

2006 - a year of difficulties
2006 will be remembered as a most difficult year for healthcare. The RCN has been kept occupied collecting data on nurse redundancies, frozen posts, newly qualified nurses finding it impossible to get work, savage cuts in education budgets and the reduction of patient services. All this critical information has been sent directly to the Department of Health, ministers, journalists and all relevant personnel. 2006 could also be called the year of health select committee inquiries. The RCN has presented both written and oral evidence to the English health select committee on workforce planning, deficits, primary care trusts and the white paper Our Health, Our Care, Our Say.(1) On each occasion the RCN put great emphasis on the difficulties currently felt by both patients and staff and stated that the cuts in nurse education are likely to bring huge problems in terms of developing the future nurse workforce.
Of course, all eyes are now on the community, and it is a touch optimistic to anticipate that, in early 2007, with the new PCTs in place, work will take place aimed at achieving some of the aspirations described in Our Health, Our Care, Our Say.
The DH has recently circulated a press release announcing a number of demonstration sites, which will explore ways in which patients can be treated in the community rather than the local district general hospital. The scheme is to commence in six specialty areas - urology, ENT, dermatology, orthopaedics, gynaecology and general surgery - and will be set up in a number of localities, including, Bradford, Ipswich, Doncaster, Epsom, Cornwall, Hampshire, Leicester, Newcastle, Hartlepool, London, Kingston, Bolton, Middlesbrough, Essex and Nottingham.
There are currently 45 million outpatient appointments each year, and the target is to reduce these by half, which experts consider can be achieved if services are further developed in the community.

The "Care Closer to Home" concept
The "Care Closer To Home" concept will start once the new year has passed, and with it comes an extra £75m to invest in community services. The ambition is to not only radically improve the management of long-term conditions, but also to enable patients to have speedier access to medical tests, day surgery and out-of-hours GP services.
The hugely energetic drive to modernise the traditional NHS is clearly here to stay, but even with the current difficulties and problems the Pollyanna in me is looking forward to a time when primary care gets the attention, investment and resources it requires to keep people far away from hospital.

We can have a healthier population
The message is a difficult and indeed a complex one to get across to the public, health professionals and managers, but needs to be understood by one and all. The fact is that we can have a healthier population with fewer hospital beds. We simply need to have more effective public health measures in place, brilliant self-care plans for those people with long-term conditions, and the most marvellous primary care services in the world.
This is a long road to travel, but many of us - including Nursing In Practice readers - will happily join the journey heading towards good health and superb wellbeing.