"Crisis in community nursing"

For the past 35 years I have required the help of the District nurses at Meadway continuing on at Firsway Health Centre. I have been fortunate to have had

the same doctor and thus the district nurses attached to her for that length of time.

When I started using the service there were 2 sisters each with 2 staff nurses and an auxiliary each, 8 staff in total looking after the patients of 5 doctors.

The nursing management comprised of one nursing officer for South Manchester, today there are many levels of staff management. Today the same practice comprises of 1 Sister, 2 senior nurses and 1 health assistant, attending the needs of the patients for at least 12 doctors. In all those years the service has expanded beyond recognition, today it seems to me the hospitals are trying to release patients as soon as possible and they are then handed over to the district nurses.

Many changes have been made to try and improve the service, unfortunately I cannot remember any change that has helped either the staff or the patient.

2 years ago there was an established settled practice with sister, 3 experienced SEN's and health assistant, systematically the management has "cherry picked" each member of staff and moved each one to other practices within the community. I got the impression no-one wanted to go but they had no choice. In my view the busiest practice within Trafford has been decimated by a total lack of leadership . It is as though no-one cares, except the exceptionally hard working nursing staff doing their level best to try and visit up to 17 patients per day, as well as the added pressure of trying to maintain the computer work required. In my experience the nurses particularly dread Fridays as they get many referrals and discharges from hospital all these new discharges are just an extra burden to an already overloaded service. A nurse's hours are between 8am and 4pm, they never finish until 6pm or later. In what other occupation would it be acceptable to work up to 10 hours per week extra unpaid?

It has reached a point where nurses have broken down in tears, during a visit to me, after receiving yet another phone call giving them extra visits for that day.

In my opinion this practice desperately needs help.

I would like to give examples of two recent changes to the NHS service within Trafford.

To contact a nurse you once dialled their office and left a recorded message, today we ring a call centre aided by unqualified sometimes illiterate in my opinion personnel who have to fill in a form and dispatch it to the required centres only to be passed on to the nurse! What a total waste of NHS money.

Surely it would have been far more logical and economical to have a full time member of staff in the office to take calls, this would have been much more personal and reassuring to the patient.

The District Nursing Service aims to provide care to people with complex needs at or as close to home as possible in order to prevent avoidable admissions to hospital and to facilitate the earlier discharge of patients.

I have read that The fundamental approach of the District Nursing Service is based on the core values of the organisation, I always thought the service was to provide help and care to the community. Could some one please explain the difference!

Recently a large amount of money was spent on the formation of a new layer of nursing to provide care to people with complex needs at or as close to home as possible in order to prevent avoidable admissions to hospital and to facilitate the earlier discharge of patients. (Care closer to Home). This help would be provided for 72 hours and then forwarded to the already understaffed and over worked district nurses. I have given examples of 2 recent expensive changes to the NHS system within the Trafford area, unfortunately no-one ever thinks to consult the people who are left to pick up the pieces.........the district nurse!

This account is my own personal view of a service in crisis, these people have tended to my needs and I feel I should try and speak up for them before it is too late.