Re: District nurses
Originally Posted by
AnnieS
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I don't agree about the cost. It's far more cost effective to increase district nursing services than to have more people turn up at A&E as Deylon does week after week. What is very expensive is a hospital admission and particularly a blue light to get there. The number of people needed to coordinate a hospital stay vs a district nurse visiting regularly just don't add up to any cost savings by expecting people who can't walk well to turn up at a gp surgery.
You have to remember the NHS isn't a charity that's free. It's funded handsomely by tax payers. There is no such thing as a free public service.
The NHS has money to fund district nurses and it would make great savings if they could expand them. The problem is that it is very difficult to recruit and retain them. PCTs are no more. The CCGs are meant to be run by GPs, that was the main change Andrew Lansley made in his reforms. So therefore GP groups do pay for district nurses and decide how to design that service.
I think that particularly in the older population, more access to services in the home should be made available. Studies have time again shown that's the best model rather than expensive hospital stays & bed blocking.
I don't disagree that hospital visits are expensive Annie and district nurses play an important role. I am sure you know that their services are largely used when a person has been discharged from hospital for such things as wound management, diabetic care, after surgery, etc. They are
not an emergency service.
Titles die hard and I am aware the PCT's have now become Clinical Care Commissioning Groups, (as they were before I retired from it all). See attached link. However, it it is not the GP's alone who hold the monies and make the decisions on how funds are allocated. The GP's do contract for the DN service collectively through the CCCG - unlike the practice nurses who are employed directly by GP practices themselves. There are many different specialists (not just district nurses) working in community and amongst them are some very skilled and highly qualified nurse specialists. As I understand it these professionals have an essential role in providing treatments at home (or in clinics) - and thereby minimising hospital admission if it is not essential. These treatments and procedures, only a few years ago, had to be provided in hospital. However, these types of nurses are too thin on the ground.
There might seem like a lot of money available, but there is never enough to go round, either for Acute or Community care. More complex procedures and surgeries become available yearly and, as you say people are living longer and they can have complex needs. The only way to provide them is to pay more in taxes IMO and even then there will be problems. The NHS is such a huge complex machine and there are many demands for services which get more expensive by the week. If not extra taxes to raise the finance, then individual private provision can step in, but that is not affordable for everybody and does not provide equity. We are not set up for insurance provision and as I said many can't afford it anyway. I hold the NHS dear and would gladly pay more in tax if I could be sure it would be spent within the NHS.
https://www.nhscc.org/ccgs/