Can the NHS overcome the many challenges it faces in 2017, or are there yet more hurdles to come?
Another year is upon us, yet I don’t anticipate it being a particularly happy one for health services and, therefore for nursing. Let’s be honest. Healthcare in the UK has a poor reputation. Yes, I know it has sound statistics and some excellent outcomes that are trotted out by government bodies. But to Joe Public, there is a dwindling confidence that is being replaced by measurable anxiety.
Patients have first-hand experience of disjointed departments, the lack of GP appointments, cancelled operations, rescheduled consultations, A&E waits and, sadly, the errors of a service that is at breaking point. The cumulative voice of patients, carers and healthcare staff gives the media the fodder they need to investigate and expose just how dysfunctional their NHS has become.
No sector seems immune: ambulances, mental health, GP surgeries, emergency departments and residential nursing homes have all been affected – what was once shocking news has become the norm. Staffing shortages are a daily challenge, low staff morale is endemic and patient needs cannot be reliably met.
So when the Red Cross was criticised for stating that there was
a ‘humanitarian crisis’ in healthcare, many unfortunately did recognise that description – especially teams working in the community setting, where Red Cross volunteers have been required to prop up failing services.
Despite health receiving increased government funding, cuts to social care budgets mean many patients who are clinically appropriate to be discharged home are unable to function safely, with risks from cold homes and poor infrastructure. Increased age brings with it frailty, co-morbidities and basic living support.
The traditional division of social and health needs is incredibly blurred. Nursing cannot escape this chaos; nurses are involved in over 80% of healthcare episodes.
Community-based nurses can be forgiven for envying hospital colleagues who secure a discharge and can then concentrate on the next patient who takes the precious vacated bed. In the community, the hugely variable home environments, care service cutbacks, access to health and care staff, family and carers, finances and patient attitude can make for a risky, unstable mix to keep someone well and dignified in their own home.
So what do I wish for in 2017? Though I have a passionate loyalty, I do not want to spend my life, both work and personal time, debating and defending the state of the NHS when someone hears I’m a nurse. Yet I continually do so – and I bet many readers have absorbed criticisms and fears, reassured on and excused healthcare services, just because they too are nurses.
There is no clear solution. But my money is on some pilot projects that are attempting to break down boundaries between primary, secondary and community health, private and social care providers – so patients can access joined-up care, reducing wasted time and duplicated costs.
Nursing in Practice will be reporting on their findings, and the pivotal role of nursing in them. Watch this space this year.
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