‘Neglected and invisible’: NHS chief on community nursing

Community nurses work in a neglected and sometimes invisible part of the health service, according to the head of the NHS in England.

NHS England chief executive Simon Stevens thanked nurses for their work and acknowledged pressures at the Queen's Nursing Institute healthcare in the community conference on Tuesday.

‘Schools, care homes, primary care – it really is such a diverse set of workplaces and patient groups you are serving in [what is] a neglected and sometimes invisible part of the health service,’ Mr Stevens told delegates.

‘The vast block of care is provided, not by GPs or consultants, but by nurses.’

System pressures

Discussing the NHS Five Year Forward View, Mr Stevens emphasised pressures across the health system from an ageing population and ‘crunch’ in funding growth.

Mr Stevens said historical fragmentation was hardwired into the NHS between community/primary and hospital services; health and social care; physical and mental health and must be overcome.

He added that – despite ongoing media focus on emergency departments (EDs) – these settings look after 25 million people, compared to 300 million people a year seen in primary care services.

‘Perhaps 27% of those do not necessarily need face to face GP services,’ Mr Stevens said, adding that community nurses, pharmacists and general therapists could take on these patients in the future.

Nurses must influence future 

‘We also have the increasing problem of people stuck in hospital when they could be ready to go home. Even today there are more than 5,000 older people [unnecessarily] in a hospital inpatient bed.’

‘We have got a pretty huge agenda in front of us: times are tight, services are under pressure and every one of you in clinical practice can see opportunities to do better,’ said Mr Stevens.

He added that community nurses were ‘impressive and influential leaders’ who could lead the challenge and ensure debates continued as services were redesigned around patients.