The main reason for this is that there has been no workforce planning to provide the right numbers of district nurses, health visitors, community mental health nurses or school nurses, for example, that we need to bring about this change.
If we are serious about building a ‘wellness’ service and one that is capable of tackling Northern Ireland’s profound health inequalities, as well as focusing on treating ill health, workforce planning needs to be addressed urgently. RCN members working in community nursing services tell us that they are feeling under unsustainable pressure and are short on staffing capacity, yet they are being asked to take on more and more. This includes increased support for nursing homes, and a spiralling workload due to the lack of hospital bed availability, escalating emergency care and ambulance response waiting times, and an emphasis upon quicker hospital discharges.
A major current concern for community nursing staff is the impact of rising fuel prices, with the cost of a full tank increasing by as much as £100 a month. Nurses are struggling to meet this additional cost. Community nursing staff often drive great distances to provide vital care. Recent measures taken by the Chancellor are not enough. Community nurses need immediate additional payments and an urgent review of the mileage rates.
Finally, whilst technology can never replace person-centred care, it can help community nursing staff to deliver better and safer care. However, RCN members, and particularly those who work in remote and rural areas, are often frustrated with the limitations of IT systems and connectivity. Community nursing staff are entitled to access support that will help to make their working lives more efficient and thereby improve patient care.