Community care for nurses and the caring professions

By Nigel Malin, Jill Manthorpe, David Race and Stephen WilmotOpen University Press 197 pages£15.99

This book meets the difficult challenge of making clear to the uninformed the business of community care. It is everybody's business, not simply those who belong to the caring professions, and much of this book should be of great interest to a vast array of different folk.

Even the well-informed and experienced struggle with the complexities of community care. Theories, concepts, philosophy, attitudes, policies and reforms all contribute towards the confusion felt every day by different community workers.

Community nurses and social care workers, in particular, found the social policies of the 1990s - in the form of Caring for People - quite chaotic, and they needed much energy and tenacity to provide decent integrated care to people who were meant to benefit from the changes. Yet despite this confusion many dependent people are now able to enjoy transformed lives as a direct result of skilled community workers and change in policy.

We are given a clear account of the meaning of community and its history from 1946 and the birth of the NHS and welfare state. The authors describe the work of Goffman and others, such as Morris, Robb (author of Sans Everything), Townsend and Tizzard, and illustrate the impact that the institutions of the day had on inmates and staff - a reminder of how, despite imperfections, progress has been achieved.

We learn of the serious planning during the 1970s to decant hospitals and institutions over 20 years old and develop a system aimed at enabling health and social services to work together.

Why has it taken us until the end of the century to put legislation and other systems in place which will make us confront local health needs and plan services accordingly?

Community care shows us how radical thinking can so easily become mere common sense a few years later. By 2005 health and social care workers will wonder how on earth they provided the services people want while working for non-integrated units.

This book will stimulate those new to community care and fascinate people who have been involved in the business for some years and wish to gain greater understanding and insight.

England now has health action zones, primary care groups with social service representation, and legislation in place which makes health and social services personnel plan services together. These initiatives, plus the government drive to help carers enjoy better lives, diminish social exclusion and develop healthy living centres in poor areas, make it easy to believe community care will improve.

New policies, fresh thinking, a sense of history and knowledgeable, caring professionals will help improve the future for people who need the very best of community care. This is an important book - it will help to ensure that the community is well served by professionals who fit the bill.

Lynn Young

Community health adviser, Royal College of Nursing.