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The challenges of caring for an island community

It is hard enough on the mainland to benchmark services and innovations against neighbouring providers

Last week a colleague and I had the privilege of visiting the Isle of Man and meeting with community and primary care staff to discuss the challenges and opportunities of serving this island community.

The environment was beautiful, with rolling hills and a coastline that combined the best of Devon and Cornwall.

The teams we met were committed, passionate and bursting with innovative ideas for the improvement of health and wellbeing in their communities.

It is hard enough on the mainland to benchmark services and innovations against neighbouring providers, but on an island, relative isolation from colleagues and services can be even more of a challenge.

However, the approach of community nursing services on the Isle of Man is very outward looking, forging links with other professionals, enabling comparisons with other services and focusing on innovation and improvement.

Conversations with nurses working in health visiting, school nursing, district nursing, community hospital, specialist community nursing and GP practices provided substantial evidence of this outward facing approach.

Staff members are given the opportunity to share ideas for innovations and improvement and the support to implement them, where there is evidence of patient benefit. A clear focus on evidence for change is supporting many innovations that are now being evaluated for their impact.

These included postnatal depression prevention for new mothers, health promotion within schools and colleges (which included healthy eating and exercise as well as sexual health) and dedicated expert clinical support for children with complex long term conditions.

I left with the overwhelming sense that nurses who work in the community in a whole variety of roles are the health professionals who are closest to their communities. They are working collaboratively with patients, families and carers every day, in the environments where they live.

Community nurses know their communities; with support of some external benchmarking and assessment, they know what good looks like, what needs to change and how to make those changes.

In the exceptionally well led community nursing teams on the Isle of Man, it was a joy to see this in action and to welcome three more Queen’s Nurses to the QNI family. We may have found one Man that is an island, but no nurse is.

Dr Crystal Oldman, chief executive, Queen’s Nursing Institute