It’s no secret that the NHS, as it nears the end of its seventh decade, is under unprecedented pressure. Growing financial problems, a nursing shortage and the junior doctor contract dispute are just the tip of the iceberg; as a population we’re rightly concerned about this most treasured of institutions. Many have argued that one solution to these concerns is to alleviate some of the strain hospitals are currently shouldering by shifting more responsibility to primary care providers. Local community surgeries then, and the doctors and nurses that staff them, are once again on the frontline. Across the board, NHS trusts, politicians and medical professionals seem to agree that by focussing on illness prevention in the community at a primary care level, rather than on hospital care, and by improving the way that services are integrated, money can be saved and a more person-centred care delivered.
But what does this mean for those nurses who take their place in community healthcare? As patients are encouraged to avoid using emergency services in any but the direst of circumstances, the first thing it means is a simple but significant increase in patient numbers. The increased burden on primary care also means that nurses will increasingly have to adopt more specialist roles. While a few decades ago, the role of practice nurse was the most common, in coming years, this job will split off into a number of areas. Already, community nursing has expanded with nurses studying to specialise in topics such as women’s health, diabetes, asthma and mental health.
Once, nursing was a regarded as a one-size-fits-all job, with only matrons and sisters perceived as holding any more power than the lowly nurses themselves. By contrast, nursing today is a complex and multifaceted role and two nurses at similar stages in their careers can have incredibly different working lives and areas of expertise. The modern nurse also has a much wider pay scale and his /her level of seniority is now something that requires visual demonstration; the colour of nurses’ uniforms reflect their level of achievement.
These are uncertain times for the nursing profession, particularly for those functioning in primary care. There are some challenges ahead that will clearly be difficult to overcome, for example the ageing workforce and resulting skills gap, as well as a complex set of educational routes into and through the profession. However, there’s also reason for community-based nurses to be optimistic. Increasingly they are taking on leadership roles that once fell automatically to doctors and other managers, proving themselves very capable of overseeing the work of inter-disciplinary teams.
Ultimately, more community nurses are needed to fill the gaps our evolving NHS is creating for them, and only time will tell what part these men and women will play in the protection and enhancement of our nation’s future health.