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Looking forward to what the new year brings!

This will be my last blog for 2007 and it has made me look back over the past year to reflect on the successes and challenges there have been within primary care.

As we approach Christmas it can be a stressful time - planning for the festivities, looking after the family, and trying to do a good job at work can seem overwhelming at times. It is important to take stock and time out for ourselves to maintain our own health and wellbeing. Often as nurses we put our own needs at the bottom of our list of priorities and only seek help and support when crisis hits or we become unwell ourselves.

There have been significant changes within primary care and I, like many of my colleagues, have risen to the challenges to improve patient care. With the recent reorganisation of PCTs, nursing modernisation and increased targets this hasn't been easy, and it would be all too easy to lose sight of the achievements made during this busy year. It is important that we reflect on the highs as well as the lows and celebrate these successes.

Following massive consultation, the document Our Health, Our Care, Our Say set out a new direction for community nurses and embraced what patients said they wanted:(1)

  • Choice.
  • Practice-based commissioning (PBC)
  • Health and social care integration.
  • Health education/prevention.
  • Reduced inequalities.

While this means increased capacity and demand for already stretched services, it is also an opportunity for healthcare to be provided in different ways. PBC has meant a shift in how finances are managed and will mean more services being transferred from the hospital to the community. Alongside this, new roles are emerging to meet the increasing demands and open up new ways of working. Consultation for Our Health, Our Care, Our Say clearly identified what the public said they wanted:(1)

  • 40% preferred nurses as the first point of contact.
  • They want integrated services and to "tell my story once".
  • They want expansion of walk-in centres and NHS direct.
  • 50% want to die at home; figures suggest that currently only 20% do!
  • They want care closer to home.
  • More long-term care to better manage their long-term conditions.

More long-term care is addressed in the names contract resulting in less fragmentation and better integration, and by 2010 everyone with a long-term condition is to have a care plan. With over 45% of community nurses in the current workforce aged over 45 years, how are we going to meet this huge agenda? Workforce development has never been more important.

As we come to the end of 2007 we need to reflect on our achievements and look at what has worked well and what still needs to be improved. 2008 will bring new challenges so it is important to plan ahead. Lord Darzi's interim report brings more opportunities for primary care to further improve and meet patient demands.

What are your three priorities for the coming year? Tell us at NiP and maybe someone else will be thinking the same so you can share your ideas and experiences.

Above all have a very merry Christmas and a prosperous, healthy new year.

1. Department of Health. Our health, our care, our say. London: DH; 2006.