Deborah Sturdy RN MSc (Econ) Honorary Nurse Advisor Care England

Director Health & Well Being Royal Hospital Chelsea

Deborah Sturdy RN MSc (Econ) Honorary Nurse Advisor Care England

Director Health & Well Being Royal Hospital Chelsea

• 400,000 +older people live in care

• 20,000 Care Homes in UK

• Average stay 19 months

• Average age 85 years at entry

• 70% Cognitive impairment

• 40% depression

• 75% classified “severely disabled” (OFT 2005)

• Massive increase in dependency levels in last 2 decades

• Generally unable to remain in the community

Care Quality Commission England- regulator

Care costs

Wage costs

Funding / Commissioning

Poor image

Instability – Economic landscape

Quality concerns

In the next 8 years 71,000 more places needed – who’s going to care?

Few leaders and national role models Few senior nursing posts amongst providers & no requirement for them 50% of the market is operated by single or small group providers Communication nightmare! Poor integration with NHS in the main – NHS Vanguards making some headway

•Scandals

•Poor quality

•Money-grabbing

•Undesirable

•Less relevant

•In decline

• ½ million employed in care homes • Lack of funding for training • Un registered workforce paid less than

those looking after our rubbish • 66% NVQ2 • 39% feel unappreciated by public (Skills for

Care) • Closures and de registrations due to lack of

RN’s

Brexit and impact on RN’s

National Minimum wage increases

Lack of investment in infrastructure

No long term planning and solutions being sought in a systematic way

Head in the sand will not resolve the impact this is and will continue to have on the NHS and statutory services

NHS Plan- Decentralisation agenda

Announcement Jeremy Hunt 19/6/15 more nurses, more primary care support including care homes ?

Integration push to put pilots in place

Funding of Long Term Care not addressed

Little innovation

Poor recruitment & retention

Inability to recruit RN’s

8-40% staff turnover

Poor training & CPD opportunities

Poor peer support

Unable to access HEE funded programmes in the main

47,545 shortfall in staff in Care Homes

Meeting CQC regulations / commissioners

creates anxiety in sector

Lack of consistency of roles & CPD

Need for “register” or legislation for a code of conduct for care workers

Poorly regarded area of practice

Poor information systems

Underinvestment in innovation

Teaching Care Home pilots – Foundation of Nursing Studies

Inequality of access to information

Poor tech infrastructure

Lack of confidence

Innovation

Care is good in parts

Developing partnerships with others

Growth of commissioned teams to support care

Use of tele medicine

GP Case management

Consultant lead rounds

Changing expectations

Changing needs – societal picture of ageing

Needs innovation & clinical leadership

Communal living more acceptable ?

Are providers keeping up with the demand

Changes in needs e.g. Learning Disability, autism provision

Requires highly skilled workforce

Requires acknowledgement of complexity & acuity of need

Regulation changes & attitude - flexibility

Peer respect

Policy Focus on upstream intervention & service partnerships

It’s a little bit about £

5 Pilots

Led by Foundation of Nursing Studies

Caring Culture – Development Set

Learning for all

Change image

Home based projects

5 more pilots funded 17/18

Needs a new narrative

Nurse Led Units

Need to reengage with the fundamentals of the art of nursing

Long Term Care the emergent go to speciality

Chair in Long Term Nursing – UK first

•Change of use

•Vital part of care spectrum

•Demand increasing 40,000 beds needed in next decade

•Greater specialism – sub specialism emerging new market

•Reducing pressure on NHS – creating partnerships

THE ROYAL HOSPITAL CHELSEA ROYAL HOSPITAL ROAD LONDON SW3 4SR

VISIT CHELSEA-PENSIONERS.CO.UK CALL 020 7881 5200