The Government’s urgent and emergency care recovery plan has been greeted with skepticism, and derided as unachievable in the current NHS staffing crisis. The two-year delivery plan includes proposals to expand care given in the community by treating people in their homes to reduce hospital admissions. This will be done through the increase of ‘virtual wards’, urgent community wards (UCR) teams and acute respiratory infection (ARI) hubs.
The plan has been slammed by Shadow Health Secretary Wes Streeting. ‘NHS care in the comfort of our own home can be better for patients, but unless it is supported by staff, it’s less hospital at home and more home alone,’ he said.
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Virtual wards are nurse-led services, but nursing leaders have raised concerns as to whether there are enough nurses to deliver them effectively. QNI chief executive, Dr Crystal Oldman highlights that district nurses are the key professionals responsible for most of the care that virtual wards describe, such as caring for frail elderly people with complex long term conditions.
‘District nursing services are already short of staff. Virtual wards need to be delivered in conjunction with district nursing service as an integrated properly resourced whole that does not drain resources from one part of the system to build another,’ warned Dr Oldman.
The Nuffield Trust reported late last year that there have been significant falls in the level of nursing staff in community health services over the last decade. The fall between March 2010 and March 2022 was equivalent to over two in five community matrons and district nurses.
RCN director of England, Patricia Marquis echoed the concerns of Dr Oldman, saying: ‘This plan relies on ramping up community services, which in the case of nursing have been decimated in recent years.’
The virtual wards will also be extended to children and young people to reduce A&E pressures.
But Alison Morton chief executive of the Institute of Health Visiting says that the reason there has been a 60% increase in children’s A&E attendances is because parents are unable to get help in their community. ‘Health services are flooded with increasing needs, to succeed this plan needs to look beyond ‘mopping the floor’ in NHS services and focus on ‘turning off the taps’ by investing in health visiting,’ she said.