Theresa Fyffe: Where is wisdom with age?

PICTURE:  Ian Georgeson

PICTURE: Ian Georgeson

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THE fact that people are living longer is a good thing, but many of our older people will be living with long-term conditions. We also know that the number of people with dementia is expected to double over the next 25 years.

Add the fact that the number of people over 75 is projected to expand by 84 per cent over the next 20 years and you can see the pressures we’re now starting to face.

Brian Houston, the new chairman of NHS Lothian, is correct to highlight the impact that demographic change will have on Scotland’s NHS.

There is also a rapidly-growing section of society which is being called the fourth generation, those in their mid-80s or over, many of whom are frail as well as elderly, and we don’t yet have enough evidence to truly understand their health needs. What we do know is that the severity of their illnesses means that it’s likely they will have to be cared for in hospital longer.

Across Scotland, although the overall workforce has grown, health boards still have gaps to plug and are facing spikes in demand.

When coupled with the pressures facing the NHS such as waiting times, demographic change, and unscheduled admissions, there continues to be a massive strain on the workforce across Scotland.

Some health boards have realised they’ve cut staff too far, too fast, and are recruiting nurses.

The Scottish Government and health boards need to look at the skills and experience of all disciplines in the workforce, including nursing, to make sure they are being employed in the places where they can make the biggest difference.

Prior to the emergence of the
current pressures, NHS Lothian based its workforce projections on a reduction in registered nurses.

It was then faced with having to deliver healthcare with a workforce below capacity when hit with
pressures such as those mentioned above.

NHS Lothian has recognised this as a problem and is recruiting more nurses, but the increase in the use of agency nurses is an indication of the pressures still facing NHS Lothian, and indeed other health boards.

We are in a period of transition. We all want to see more care delivered safely in the community so that more patients are treated in their own homes and fewer are admitted to hospital.

However, we need to see clear evidence of work to develop a workforce with the necessary skills to deal
with the increasingly complex conditions which used to require hospitalisation but are now presenting in the community, particularly among older people.

Furthermore, the integration of health and social care is an opportunity to help ensure a coherent delivery of services to patients in both hospital and community settings, and its success will be built upon respectful relationships and ensuring that people working across the health and social care spectrum work together in the interests of ensuring the best possible patient care.

• Theresa Fyffe is Scotland director of the Royal College of Nursing