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Out of the hospitals and into communities

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Investment is needed into primary care Investment is needed into primary care

The government's gaze has been fixed on secondary care since the publication of Robert Francis' report into care failings at Mid Staffordshire Hospital. But like the fiery eye of Tolkien's Sauron on top of Mount Doom, the all-seeing eye has now moved its focus to primary care; apparently a focus of blame.

Two weeks ago health secretary Jeremy Hunt said he wanted to 'rethink' primary care, saying it was time community health professionals stopped acting simply as 'a gateway to hospitals'. He urged the primary care system to be proactive rather than 'reactive'; he described it as 'inaccessible' and added that too often people with long-term conditions were left to their own devices without the help, care and guidance of local providers.

Fast-forward a week and care services minister Norman Lamb echoed the rhetoric. He said there was a 'failure' of care in the community, resulting in too many elderly people with complex needs, such as dementia, in hospitals. So, are we to believe that nursing colleagues in hospitals are struggling to care (and to cope), because health professionals in primary care are causing too many elderly people to end up on wards?

The Royal College of GPs' chairwoman Clare Gerada, defended her members, saying there is no evidence to prove that any increase in demand in A&E admissions was due to GPs and they were being used as scapegoats. But IN readers could have predicted the government announcements.

Our poll in March revealed a massive 98% of primary and community nurses said that care in their work settings could be improved. Chairman of the CQC, David Prior summed up the blame game best last week, stating that while half of care in hospitals was either poor or 'not terribly good', due to the growing numbers of admissions, the way to alleviate this would be to close hospital beds and invest in the community. Investment, and a shift in resources, rather than blame, is needed.

David Woods, deputy editor, Independent Nurse

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