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District nurses could take on the care of elderly patients

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District nurses may take on the care of elderly patients instead of GPs, health minister Dan Poulter has suggested.

In a parliamentary response, Dr Poulter denied that the role of health visitors would be extended to include the care of the elderly, because their work focuses on the early years and childhood. He said that a range of other professionals such as district nurses could play important roles in supporting the named GP for elderly and vulnerable patients.

It was originally suggested that GPs would take on the responsibility of caring for elderly patients in an attempt to move back to 'old-fashioned family doctors.' This was one of the responsibilities negotiated for the GP contract that will be introduced in April.

Tim Curry, the assistant head of nursing from the Royal College of Nursing, said that GPs are not in a position to delegate these tasks to district and community nurses.

'If GPs are going to 'delegate' these tasks, they need to be given the resources to do so. The numbers of district nurses are going down and they do not have enough time to do what is already a very complex job.

'There is no problem with having a named clinician for vulnerable patients but GPs should not be able to say that district nurses will take on this role. It also means that data would need to be shared between clinicians to improve the integration of care.'

Dr Poulter said: 'Named GPs will be expected to work with associated health and social care professionals to deliver a multidisciplinary care package that meets the needs of the patient. In some cases this may include working with colleagues such as district nurses, who are well placed to visit patients out in the community.

'Further to this, it will be the responsibility of the named GP to ensure that their patients have effective care coordination in place by the most appropriate professional for that individual's needs. GPs may be well placed to fulfill this role, but in most instances other professionals are likely to be better suited to take on the care coordination role.'

Crystal Oldman, the chief executive of the QNI, said that this recognised the important work that district nurses do.

'We think that it is a fantastic recognition of the importance of district nurses, and high time that the health minister singled them out in this way. It is a formal recognition of the clinical leadership and significant expertise that district nurses have in serving their patients, the community, and meeting the needs of the frail older person,' she said.

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