The Queen’s Nursing Institute Scotland (QNIS) is a charity that supports, develops, and inspires Scotland’s community nurses and midwives to become agents for health improvement and catalysts for social change. For many remote island communities in Scotland, highly skilled nurses provide 24/7 healthcare cover. They are often advanced nurse practitioners working with remote clinical backup for unplanned and emergency care. These are challenging roles as there is an expectation that these isolated lone practitioners bring skilled primary care to the community as well as support unplanned and emergency care across mental and physical health and for all ages. In other remote and rural areas, nursing is provided by very small teams. 1.QNIS recommends that the Committee explores the challenges for remote lone practitioners, small teams, and community nursing and midwifery provision for non-doctor island communities, in particular: the preparation for these roles; the ongoing development of staff in these roles, staying up to date and skilled in providing routine care and specialist care for less frequently encountered conditions, where there are considerable challenges in maintaining skills and competence over time; the standardisation and grading of these posts commensurate with the level of responsibility, which will enable recruitment and retention; connecting island nurses and midwives for peer support and development through a Scotland wide network; arrangements for remote and rural practitioners working in areas of practice where they have few, or no local colleagues working in the same field - e.g., mental health nursing, learning disabilities, children's nursing etc. 2. Given the Scottish Government’s important focus on providing more care in the community while reducing pressure on hospitals, it is vital that measures that address the recruitment and retention of community nurses and midwives are considered by the inquiry, particularly in remote and rural areas, where these professionals are vital to the delivery of community care. 3.The benefits of enabling people to be cared for at home where possible have been well articulated, but this is particularly important for those who live hundreds of miles from a hospital. The committee may also wish to explore effective and innovative models of health and social care delivery in remote and rural communities to generate learning which can be shared across Scotland. One excellent example is the Home Teams model being developed in Dumfries and Galloway. There is a Queen's Nurse leading the team in Wigtownshire. We consulted with Queen’s Nurses ahead of making these suggestions.
they have already committed to a move from hospital care to more care in the community. In order for this to be successful they need to invest in the increased recruitment of community nurses and midwives. Further, they must look at the, often lone, practitioners working in these remote and rural positions, ensuring they have adequate support and professional networks they can rely upon. 👏
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