To ask Her Majesty’s Government what is the current and planned trend for the reduction of (1) district nurses, (2) midwife services, and (3) meals on wheels to elderly and sick people in their homes; and how this is affecting the ability of National Health Service hospitals to return patients to their homes and community care.
The Government is committed to making real changes to the quality and availability of all NHS services and has no plans to reduce services in the areas specified.
The Department published Care in local communities: A new vision and model for district nursing, in January 2013, to provide best practice guidance to be used locally to support the provision of the district nursing services that make a real difference to the patient's experience of health and wellbeing. Community nursing teams are usually led by district nurses, and are made up of an appropriate skill mix to meet local needs and this includes specialist nurses and staff nurses, with support from healthcare assistants. Local areas are using a wider skill mix within their community nursing teams, including extending the role of health care support workers. To ensure an adequate supply of skilled district nurses in the future Health Education England has increased the number of training places for district nurses for 2015-16 by 16.5%.
The Government is committed to improving choice of place of birth, continuity of care and women’s experience of care. There are more than 1,900 full-time equivalent midwives than in May 2010 and a record number, in excess of 5,000 in training. Women can expect a range of choices over maternity services, as set out in the NHS Choice Framework for 2013-14, although these will depend on what is best for them and their baby, as well as what is available locally. Women can choose to receive antenatal care from a midwife or a team of maternity health professionals, including midwives and obstetricians. They can choose to give birth either at home, in a local midwifery facility or in hospital. Postnatal care can also be received at home or in a community setting, such as a Sure Start Children’s Centre.
Meals are provided by the 152 individual councils with adult social services responsibilities on the basis of assessed eligible need. Provision of social care services is a matter for local decision. The Department is unable to provide data on planned trends in provision. The Government has just issued a ring-fenced grant for £25 million to councils that have hard-pressed hospitals in their areas to facilitate faster discharge through additional reablement packages.
In addition, the Government has implemented a number of initiatives to minimise cases of hospital-delayed discharges. The Government has given a record £700 million this winter for 700 more doctors, nearly 4,500 more nurses and 5,000 more beds, including in social care and community settings. This money has been allocated through System Resilience Groups (SRGs), who bring together partners across the health and social care system, including acute and community providers and local authorities. Plans developed by SRGs before the funds were released, were required to include processes of good practice on reducing delayed discharges.
The vast majority of the £5.3 billion Better Care Fund, which begins on 1 April 2015, is being spent on social care and community health services. The aim is to encourage joint working between local authorities and the National Health Service to keep people out of hospital in the first place, as well as helping them to return home as soon as it is safe to do so. The national conditions in the Better Care Fund include the protection of social care and improvements in seven day working across health and social care to help quicker, more appropriate discharge from hospital. All plans must meet these conditions before being approved.