Transforming your Care response

Published: 17 January 2013

Careful consideration needed before changes to health care

The current health and social care system is not sustainable, however, changes to the provision of health and social care in Northern Ireland requires careful consideration and needs to engage frontline staff– this is the message coming from members of the Royal College of Nursing (RCN) at meetings held across Northern Ireland.

In its response to the consultation Transforming your Care (TyC), the review of health and social care in Northern Ireland, the RCN has stated that while nurses support the general direction of travel outlined in the consultation, they are not convinced that some of the steps outlined are the most effective way to improve care.

Janice Smyth, Director of the RCN in Northern Ireland said: "Nurses in Northern Ireland are ready for change, as long as it is done in the right way and for the right reasons. TyC aims to refocus services away from hospitals and other institutional settings towards caring for people in their own homes and communities. The RCN has said consistently that this shift towards more care in the community will only come about if it is properly planned, well-resourced and underpinned by good workforce planning.

"RCN members have told us that they are disappointed to date at the lack of consultation from employers and commissioners, particularly as nurses have a key role in making these changes happen."

Nurses want TyC to speed up the transition to a 24/7 model of care. However, one RCN member said: "At the moment, the service is just not there to support care at home. That is why patients end up dying on hospital trolleys. If we are serious about keeping people out of hospital, we need full 24/7 community services."

At the heart of the reforms is the Integrated Care Partnership (ICP) model. The RCN does not believe that this model offers the most effective or appropriate way to deliver this shift in strategy, and that it contradicts the multi-professional ethos of care provision under the new proposals.

The RCN also raises concerns about proposals for funding the care of older people, the appropriateness of resettlement of all people with mental health problems or learning disabilities, the availability and quality of information technology and the confused nature of some acute hospital networking proposals.

Janice Smyth continues: "Above all the RCN is deeply concerned about the impact of the TyC proposals on the number of nurses working on the ground. The consultation document states that 1620 whole-time equivalent posts will be lost over the next three to five years.

"This could mean the loss of 600 nursing posts. We demand to know where this figure has come from and what assessment has been made of its impact on patient safety. It is crucial that these reforms are underpinned by robust workforce planning to ensure we have the right numbers of community practitioners to deliver care.

"Nurses in Northern Ireland endorse the overall aim of TyC, however, there are several issues we believe must be addressed before any changes to the system are put into place and we urge the Minister to consider carefully what we and others have said before moving forward."

Read the RCN response to the Transforming your Care consultation (PDF 253KB)