WORKFORCE: A major re-organisation of community nursing in East Kent has seen nursing teams aligned with GP practices, resulting in improved joint working.

The move involved the creation of smaller district nursing teams, a £1.5m investment in frontline nursing staff, and more district nurses based at GP surgeries.

It resulted from a Community Nursing Strategy devised by NHS Eastern and Coastal Kent and local GPs, working with the Eastern and Coastal Kent Community Health Trust.

“A key conclusion was that to get more effective and better quality community nursing outcomes, nurses and GPs needed to work together more closely,” said Ruth Brown, lead commissioner for community services at NHS Eastern and Coastal Kent.

“Over the years district nursing teams had moved away from working with GP practices, often ending up based in larger locality teams. The result was nurses were not in very good contact with GPs.”

The re-configuration, which began last summer, involved creating smaller primary care nursing teams aligned to one or more specific GP practices, depending on the size of GP lists.

In addition the community matron service was aligned with the new teams for work with patients with long-term conditions with a designated matron covering several teams.

Ms Brown said the change was designed to improve accountability and ensure better continuity of care.

The £1.5m went towards the equivalent of 32 new full-time posts and ensuring there were enough senior nurses to lead the new teams.

Ms Brown said it was still early days but the move had already led to more “shared working” between district nurses and community matrons.

“They’re helping with each other’s caseload,” she explained. “So if one team is visiting a patient then they might do a bit of basic nursing care for the other while they’re there. It means less replication and less stress for nurses. They feel they have more of a team around them now.”

It has also helped raise awareness among GPs of specialist services offered by nurses, such as respiratory care, led to more joint planning of services and discussion of local healthcare needs and improved communication.

“Before some GPs weren’t aware which of their patients were getting extra care from a community matron,” added Ms Brown.