For the last decade in Wales, Health Boards have been reconfiguring acute hospital services, reducing bed numbers, encouraging shorter patient stays and enabling more complex treatments and care to be delivered at home.
All of these services mean we need more nurses and nursing staff in the community. The good news is the numbers of community nurses and nursing staff are rising in Wales! However, investment in modern technology is urgently needed – many of our community nurse are still carrying around large suitcases of paper notes and writing these up for hours at the end of the day. We need investment in independent non-medical prescribing to provide timelier infection control and pain relief to the patient and prevent unnecessary referrals
Wales urgently needs more District nurses (which have a specialist practitioner qualification) or community nurses with a community master’s level degree. These senior nurses are the ones who are the leaders and deputies of community nursing teams. They provide clinical supervision to the nurses and support workers in the team and make critical decisions to support vulnerable people who need complex care. Without this level of leadership patients are likely to be readmitted unnecessarily and serious health issues are less likely to be spotted and dealt with in a timely fashion.
The numbers of District nurses and community nurses have been falling for many years in Wales. The Welsh Government has consistently failed to commission more postgraduate education in this area and Health Boards often block any attempt to increase it. The main reason for this failure is that Health Boards will need to backfill the vacancy on the frontline while a nurse undertakes studies. This perpetual short-term thinking has created a crisis for Wales by severely undermining community healthcare provision.