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Welsh community nurses identify as ‘invisible service’, report finds

Community nurses in Wales have described themselves as the ‘invisible service’ in a report released this week, even as expectations for them to meet multiple patient needs continue to grow.

The report on community and district nursing services released by the Health, Social Care and Sport Committee of the National Assembly for Wales presented 10 recommendations to the Welsh Government following its consultation with multiple stakeholders, including community nurses.

It was found that the single biggest issue raised by nurses working in the community as part of this inquiry is their inability to access the most appropriate technology to enable them to do their job effectively. The report states that when asked for their experiences of IT support, half of the nurses reported no access to a mobile device. They also reported that many employer-provided mobile phones had no software access to office calendar or e-mails.

‘It is unacceptable that nurses working in the community have limited access to patient information, appointments or e-mails via handheld devices and are instead reliant on paper-based systems and out-dated technology,’ the report states.

The responding recommendation calls for the Welsh Government to work with Health Boards to ensure proper investment in appropriate technology for community nursing. They insist that the use of hand-held mobile devices with instant access to patient information, appointments and e-mails should be standard across Wales.

The move to provide more care outside the traditional hospital setting has meant that the role of community nurses has become increasingly demanding with greater expectations now on community nurses to meet the emotional and mental health needs of their patients, as well as the physical. The report states that ‘it is, therefore, alarming to hear community nurses describe themselves as the “invisible service”’.

It found that in Wales there is no accurate picture of the number and skill mix of nursing teams, nor of the numbers and acuity level of patients receiving care in their own homes, and that this is likely to have an impact on the effectiveness of workforce planning.

In response, the report calls for the Welsh Government to ensure that the crucial role of community nursing, including children’s community nurses, in the future delivery of healthcare is properly recognised in its workforce planning, nurse recruitment and training.

Responding to the report, Nesta Lloyd-Jones, interim director of the Welsh NHS Confederation maintained that community nurses are an important part of the way health and social care services are delivered across Wales. ‘This report shows they are effective in preventing unnecessary hospital admissions, helping people who need our care stay active and healthy within their communities and maintaining their independence,’ she said.

She added that investment is being made to support community nurses in Wales with the technology they need and to develop a workforce strategy.

‘Advances in technology and public expectations are far out-pacing the change we’re seeing in the NHS. However, we are pleased the Welsh Government's long-term plan for health and social care, A Healthier Wales, commits to a fully integrated national digital architecture, supported by further investment, stronger national digital leadership and strengthened delivery arrangements.

‘Health Education and Improvement Wales and Social Care Wales are currently working with partners to develop a long-term workforce strategy for health and social care. The final strategy and subsequent plans will help support the delivery of more effective and efficient health and care services,’ Lloyd-Jones stated.