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Working together to achieve positive change

Beverly Malone
General Secretary, Royal College of Nursing

As the new General Secretary of the RCN, and coming from the USA, my first impressions are of the obvious differences between the healthcare systems in the UK and America. However, similar problems and challenges exist, and there is also the same dedication and professionalism in nursing and other healthcare professions. What strikes me most forcibly is the principle of healthcare as a right, not a ­privilege, which is at the heart of the NHS.

This is a principle worth defending and developing. The field of primary care, where the majority of the population receive their healthcare, offers nurses more opportunities for showing leadership, developing specialties and working across disciplines to deliver high-quality healthcare in new ways than at any time since the NHS was formed.

Specialist nurses in primary care, be they practice or school nurses, health ­visitors, district nurses or mental health nurses, know that working across professional boundaries and collaborating with health ­colleagues delivers a better standard of care for patients. The old hierarchies of health no longer apply.

Health legislation later this year will start the process of devolving control of 75% of primary care budgets to Primary Care Trusts. Nurses, doctors and other health and social care professionals will be responsible for shaping healthcare for their communities. The better the collaboration, the communication and the ­consultation with the public, the better that healthcare will be.

Nurse-led projects have been winning awards - nurses across the country have been identifying needs, winning the budgets to meet them and displaying the management and leadership skills required to assemble the expertise to make new initiatives work for patients. From eating disorders to diabetes, minor injury treatment to services for children with brain injury, nurses have taken the lead.

Extending nurse prescribing is controversial in some quarters. Its scope currently is limited, and the RCN wants to see the formulary from which specialist trained nurses can prescribe further extended. The government took a positive first step in May of this year, but there is no sense, for instance, in a specialist pain control nurse who has managed the palliative care of a patient being unable to prescribe essential pain control such as diamorphine.

Walk-in centres have proved enormously popular with patients. They are so popular because they give patients choice and flexibility over how they access healthcare and provide nurse-led healthcare advice, information and treatment almost round the clock, every day of the year without an appointment. Walk-in centres, like NHS Direct, are additional services to doctors and accident and emergency departments, not replacements.

No-one wants to work in a fixed NHS, incapable of change. But we are all part of the change. Nurses, I know, ­relish the prospect. We look forward to working with our doctor colleagues to achieve it.