Upload
emmeline-higgins
View
223
Download
7
Tags:
Embed Size (px)
Citation preview
Visible, Accessible and Integrated Care
Jane WalkerNursing Officer
‘My view you know is that the ultimate destination of all nursing is the nursing of the sick in their own homes…I look to the
abolition of all hospitals & workhouse infirmaries. But it is no use to talk about the
year 2,000.’
Florence Nightingale June 1867
Challenges facing UK health & social care system
Changes in population demography Changes in patterns of disease Changes in lifestyle Changes in public expectation Inequalities in health status Need to reconcile demand, need & access with safety
& quality
Ageing Population
Older people more likely to: Live alone, with consequent risks & need for support
services Have functional dependency & sensory impairment Have LTC’s & co-morbidities Require complex multi-medication regimes Have cognitive impairments & mental health problems Develop complications of acute illness
Population in <15 and 65+ age groups, Scotland: 1950-2042 (GAD projection)
Source: http://www.esrcsocietytoday.ac.uk/ESRCInfoCentre/Images/demography_seminar_tcm6-7919.pdf
Nursing, health and social care workforce issues
Age demographic of NHS Scotland Nursing Workforce (September 2005)
Total (WTE)
Aged under 30*
Aged 31-44
Aged 45-54
Aged 55+
N N % N % N % N % The entire NHS Scotland nursing, midwifery and health visiting workforce
55, 469 7,900 12 30,891 47 19133 29 7892 12
Acute registered nurses (G grade and above**)
2,924 (19% of
registered nurses in
acute sector)
5,930 16 18,684 51 9496 26 2824 7
Health Visitors (Grades G and above)
1,249 (84% of Health
Visitors)
13 0.9 600 40 648 43 240 16
District Nurses (Grades G and above)
1032 (50% of District Nurses)
9 0.7 474 39 535 44 192 16
* Figures reflect headcount ** Figures reflecting post Agenda for Change assimilation not available
Age distribution of the register
Age range in year ending 31 March
2002%
2003%
2004%
2005%
2006%
Under 25 years
2.24 2.10 2.02 1.94 1.87
25-29 years 8.86 8.54 8.44 8.29 8.04
30-39 years 30.63 29.37 28.30 27.35 26.72
40-49 years 32.32 33.26 33.94 34.42 64.52
50-54 years 11.46 11.46 11.62 11.91 12.42
55 years and over
14.50 15.27 15.68 16.09 16.40
DELIVERING FOR HEALTH
Current view Evolving model of care
Geared towards acute conditions
Hospital centred
Doctor dependent
Episodic care
Disjointed care
Reactive care
Patient as passive recipient
Self care infrequent
Carers undervalued
Low tech
Geared towards long-term conditions
Embedded in communities
Team based
Continuous care
Integrated care
Preventive care
Patient as partner
Self care encouraged / facilitated
Carers supported as partners
High tech
Implications of Delivering for Health
Existing focus on hospital care needs to change
Need to actively manage the most vulnerable in the community
Doing more of the same not the answer
Key Elements of Report
Generate strength from integration
Transformation through unity of purpose
Hold organisations charged with delivery accountable
Strong political, professional, public and union support
Nursing & AHP Response
Delivering Care, Enabling Health Visible, Accessible & Integrated Care Co-ordinated & fit for purpose Review Cancer Nursing National workforce project
How can Nurses make a difference?
Anticipatory care Increase support for self care & close working
with carers Early interventions to prevent hospital admissions Delivering on waiting times Increasing the range of locally available diagnostic
services
Thank you