Providing care closer to home

I recently had the privilege of spending time with a local community in Gloucestershire.

I was finding out how organisations and communities are actively working together to break down boundaries and provide seamless health services.

Not only do I value spending time with those who are passionate about developing health and care services locally, I also enjoy meeting patients, their families and carers and understanding the importance of local care services in helping them go about their daily lives.

Together with Sarah Harkness, a Non-Executive Director at NHS Improvement and Bren McInerney, a local community volunteer, I experienced some wonderful examples of how local communities can work together to support and improve people’s health and wellbeing.

A community discussion with around 35 people celebrated a wide range of community led initiatives. I am a great believer in self-care and the power of managing your own health, and the determination I witnessed of the community working together to empower people was impressive.

We also met with Imam Hassan, from a local mosque at Barton and Tredworth, and Gary Thompson, the Assistant Chief Constable for Gloucestershire Police, who spoke passionately about the work they do in partnership with the local community to improve and strengthen local services.

We went to St. James’ City Farm; a fantastic local resource, managed and run entirely by local volunteers, and we met mounted police officers who talked about how the horses helped engage the police more closely with children and the local community.

I spoke with two co-chairs of the local Learning Disability Partnership Board, both of whom have a learning disability themselves. As national lead for the Learning Disability Programme, it was heartening to see local services being shaped by individuals who also value and need such services.

We also met four local Directors of Nursing who work together across Gloucestershire to shape and lead a number of vital services across local communities. I was introduced to four trainee nursing associates working across acute, community and primary care. Their passion and motivation was fantastic to see and they were excited about developing their skills, knowledge and future career opportunities.

The NHS needs to continue to look forward to ensure it has staff that aren’t constrained by organisational boundaries and the Gloucestershire example of the nursing associate pilot highlights how this can work for the benefit of patients and staff.

Across England, commissioners and providers across the NHS and local government need to work closely together – to improve the health and wellbeing of their local population and make best use of available funding. Services that are planned and provided by local government, with the support of local communities, including housing, leisure and transport as well and public health and social care, impact on the health and wellbeing of local people.

Other areas of my visit to Gloucestershire, including the Butterfly garden, Kingfisher treasure seekers and the Anglo Asian Cultural Centre highlighted the importance of how services and local communities can work together to improve health and well-being for all.

Addressing the wider elements of health affects demand for primary and acute services. Local health and care systems only work smoothly to provide effective services and minimise delays when there are good relationships and clear joint plans in place.

One way in which this approach has come to fruition is through the new care models programme. Over the past 18-24 months, 50 areas around England serving more than five million people have been working to redesign care, focusing on better integrating the various strands of community services. This includes GPs, community nursing, mental health and social care; moving specialist care out of hospitals into the community; joining up GP, hospital, community and mental health services; linking local hospitals together to improve their clinical and financial viability; reducing variation in care and efficiency and offering older people better, joined up health, care and rehabilitation services.

The drive to support and care for people closer to home is also linked to Leading Change, Adding Value – a framework for nursing, midwifery and care staff. LCAV supports 545,000 registered nurses and midwives in England but also 1.1 million unregistered staff who provide vital care and support to individuals in local communities across England.

Bren McInerney, a Community Volunteer said: “I wanted the day to be focused in the neighbourhood and at a local community level. As well as celebrating the wonderful assets of the area, including people, venues and activities that help support people to manage their health in an area of greater need, I also wanted the day to be about celebrating the many diverse areas of work and achievement both in health and care and beyond.”

I know many communities across England are doing similar fantastic things like Gloucestershire to transform services. But if you are inspired by examples like this, please talk to your CCG and Trust to find out how you can work more closely with your local community to truly transform the delivery of care, or contact Bren McInerney at:

Jane Cummings

Professor Jane Cummings is the Chief Nursing Officer for England and Executive Director at NHS England.

Jane specialised in emergency care and has held a wide variety of roles across the NHS including Director of Commissioning, Director of Nursing and Deputy Chief Executive.

In February 2004, she became the national lead for emergency care agreeing and implementing the 98% operational standard. She has also worked as the nursing advisor for emergency care. In January 2005, she was appointed as the National Implementation Director for ‘Choice’ and ‘Choose and Book’.

Jane moved to NHS North West in November 2007 where she held executive responsibility for the professional leadership of nursing, quality, performance as well as QIPP, commissioning and for a time Deputy Chief Executive Officer. In October 2011, she was appointed to the role of Chief Nurse for the North of England SHA Cluster.

She was appointed as Chief Nursing Officer for England in March 2012 and started full time in June 2012. Jane is the professional lead for all nurses and midwives in England (with the exception of public health) and published the ‘6Cs’ and ‘Compassion in Practice’ in December 2012, followed by publishing the ‘Leading Change, Adding Value’ framework in May 2016.

Jane has executive oversight of maternity, patient experience, learning disability and, in January 2016, became executive lead for Patient and Public Participation.

She was awarded Doctorates by Edge Hill University and by Bucks New University, and she is a visiting professor at Kingston University and St George’s University, London.

She is also Director and trustee for Macmillan Cancer Support and a clinical Ambassador for the Over the Wall Children’s Charity where she volunteers as a nurse providing care for children affected by serious illnesses.

Follow Jane on Twitter: @JaneMCummings.