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Integrated care vital for those with long-term conditions, says RCN lead

Integrated care vital for those with long-term conditions, says RCN lead

Action must be taken to ‘unblock’ the social care system so that patients with long-term conditions have ‘somewhere safe’ to be looked after, a senior nursing leader has told.

Louise Parker, Royal College of Nursing (RCN) professional lead for long-term conditions, told Nursing in Practice that more funding was required to help better integrate primary and secondary care services, to ensure patients received appropriate care and support.

She suggested that a rise in people with multiple long-term conditions, as well as the fact that people are now living longer, meant a more joined up health service was vital, and that key to this was increased digital integration and more senior specialist nursing posts.

Issues around bed capacity in the community meant people with long-term conditions are often stuck in hospital beds, Ms Parker explained.

‘At the forefront at the moment is the fact that patients often have more than one long-term condition, so they have multifaceted problems that are not easy to fix,’ she told Nursing in Practice.

‘They end up staying in beds that are needed in acute care and they can’t get out into a nursing home or care home because there aren’t enough beds but they are too unwell to go home.’

Ms Parker said this had given rise to a ‘symbiotic understanding that we need to unblock the social care system to get our patients that have a long-term condition somewhere safe’.

This required increased digital integration between services in the community such as district nursing and general practice, and secondary care services such as specialist nursing and virtual wards. Ms Parker said these digital services are ‘the future’ of the health service.

While the coronavirus pandemic had ‘shunted forward’ digital ways of working, such as virtual wards, online appointments and patient records, Ms Parker said since different services use different digital platforms, data sharing and communication between services can be slow.

Ms Parker stressed: ‘[Secondary care] services need to be joined up with the community because lines of communication need to be kept open about how stable patients are or whether they are getting their prescriptions on time. But the blocker is whether there is money to do that.

‘There are many different digital systems that already function in the NHS and primary care and none of them talk to one another.’

According to Ms Parker, the NHS in England had attempted to invest in a ‘digital spine’ to unify the various digital health platforms, but the project was ‘so prohibitively expensive’ that it was abandoned.

Ms Parker also argued that ‘a lack of career progression, and a lack of development and training’ were leading to difficulties recruiting and retaining senior nurses, which also needed addressing for integration purposes.

‘We need to be able to recruit and retain senior people,’ said Ms Parker. ‘It costs a lot of money to train a nurse and they cost of lot of money to take courses. We need to make sure that we’ve got senior people in leadership roles that can help and train others in turn so that there is succession planning throughout.’

The government was contacted for response.


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