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QNI Launches Major New Report on Nursing in the Home
22 Nov 2011
The QNI has launched a major new report on the current state of nursing in the home, which shows that what patients value most are the attributes of skilled and experienced community nurses: the ability to assess unexpected situations, coordinate services, and answer questions about treatment.
‘Nursing People at Home: the issues, the stories, the actions’, was launched on 21st November at the House of Lords at a reception hosted by Baroness Julia Cumberlege, and attended by leading representatives from patient and carer organisations, Government and the healthcare professions.
The report follows the QNI’s Right Nurse, Right Skills campaign, which received hundreds of stories from the public describing the impact that the dilution of skills in community nursing teams can have on the quality of care. While 70% of experiences of nursing in the home described by patients and carers in a QNI survey were very positive, there were many examples of poor care. Fewer than half the people who responded knew whether they were treated by a registered nurse.
At the launch, Baroness Cumberlege welcomed the report, commenting, ‘Home is best. Home is where people want to be. But community nurses care for some people living in very challenging and inadequate living places. Nowadays nurses do very sophisticated things in the home, but professional compassion remains at the core of what they do.
‘We have an ageing population and a shrinking healthcare workforce. This report is a springboard for the workforce and a springboard for action. It is well-researched, succinct and containing startling figures. What is the most common question asked in hospital? It is, ‘When can I go home?’ 65% of people want to die at home; only 20% do die at home. This has to change.’
Professor Dickon Weir-Hughes, Chief Registrar of the NMC added, ‘The key to home nursing is not the task, it is the context. We have to think about delegation and problem-solving in a more sophisticated way. Yes, we all work as teams nowadays but a patient has the right to know who is a registered nurse. This excellent and insightful report will be of major benefit to policy-makers and those who plan healthcare workforces.’
Jill Fraser, co-founder of the charity ‘Kissing it Better’, spoke for patients’ families and carers. She said, ‘We are inspired by the work of the QNI. We have great faith in the specialised nurses and we rely on their care. We need to work with people in the community, with families and with volunteers, to improve care for those who cannot take care of themselves.’
Commenting on the report, Rosemary Cook CBE, Director of the QNI said, ‘People were very clear about what they wanted from community nursing. They wanted competence, confidence and caring. But sometimes they encountered nurses who were rushed, who lacked knowledge or seemed disinterested. Fewer than half the people who responded to the survey knew if they had been seen by a registered nurse or a health assistant.
‘The answer to this is not more inspection or regulation. Nobody can visit every patient’s home to observe care there. We have to rely on the individual practitioners to maintain high quality care. The solutions are person-based, not system-based. That’s why the QNI puts so much emphasis on identifying committed Queen’s Nurses who make change happen and are role models for others. It is why education and professional development are so important. Get the practitioner right and you will get the care right.’
The report highlights several reasons for the loss of skills in the community, including the decline in commissions of district nurse training, an increased reliance on less experienced nurses and a growing trend to replace nurses with health care assistants.
Ms Cook added: ‘Now is the time when everyone – nurses, managers, commissioners and policy makers - must take action to prevent the loss of one of the most precious assets in our health care system: expert nursing in the home.’
A printed version of the report is available and can be requested by calling our office 020 7549 1400 or emailing mail@qni.org.uk.
Ends
Notes for Editors:
The QNI’s Right Nurse, Right Skills campaign was launched in October 2010, to draw attention to the loss of community nursing skills at a time when more care, and more complex care, is moving out of hospitals and into people’s homes. The campaign has gathered more than 3,000 supporters, and hundreds of patients, relatives and carers have left stories on our website about their experiences of care, good and bad. The publication of the report marks the end of the 2nd phase of our Right Nurse, Right Skills campaign. In phase 1 we collected stories and information from nurses and from national sources about nursing workforce numbers. In phase 2 we offered the general public the chance to tell us about their care and their nurses.
Some key findings:
The report findings show what matters to people in their experiences of nursing care and their nurses:
Nursing in the home is highly valued by the people who receive it, and 70% of those who responded to our survey said they had good or excellent care.
Patients are clear about the skills they value: the ability to assess unexpected situations and take appropriate action (69% of respondents); the ability to coordinate other people and services to help with care (60%); the knowledge to keep people informed, answer questions and give advice about treatment (57%).
Patients expect ‘confident, competent and caring’ practitioners, but sometimes get practitioners who lack knowledge about their condition and treatment, have difficulty with communication, lack professional confidence, are rushing to complete a task, are disinterested in the patient and the job, lack compassion and do not listen to the patient.
Fewer than half of people who responded to our survey knew whether the person who provided their care at home was a registered nurse.
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