Cynulliad Cenedlaethol Cymru	National Assembly for Wales
Y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon	Health, Social Care and Sport Committee
Ymchwiliad I wasanaethau Nyrsio Cymunedol a Nyrsio Adal	Inquiry into Community and District Nursing services
HSCS(5) CDN10
Ymateb gan Unigolyn	Evidence from an Individual

Data relating to Community Children’s Nursing Services scoping exercise August 2017

	ABM	AB	BC	C & V	Cwm Taf	Hywel Dda	Powys
Population - 0-15 yrs Wales: 557,079	92,476	108,637	123,619	90,282	55,708	2019 data 75000	2019 data 21,264
Number of children’s nurses within your CCN service (whole time equivalent - wte)	15.4 wte	28.55 wte	9.3 wte	26.57 wte	10.7 wte	15.3 WTE	5.51wte
RCN Recommendations 20 RN’s per 50,000	Require 37 In post 15.4 Deficit 21.6	Requires 43 In post 28.55 Deficit 14.45	Requires 49 In post 9.3 Deficit 39.7	Requires 36 In post 26.57 Deficit 9.43	Requires 22 In post 10.7 Deficit 11.3	Requires 30 In post 15.3 Deficit 14.7	Requires 8.5 In post 5.51 Deficit 2.99

1. Whether we have a clear picture of the district nursing and community nursing workforce in Wales, and the level of need for community nursing services (including future need). Do we have the evidence base to support effective workforce planning.

From this scoping exercise undertaken in August 2017, there is a very clear picture of the deficits in the children’s community nursing workforce. More often than not Children Community Nursing Services are the forgotten workforce when it comes to care in the community, yet they provide an essential and critical life line of support, education and clinical service to children and young people within the community setting. This is a serious omission, which requires urgent attention. We believe that because the numbers of children are small within each health board area (though increasing), a whole Wales planning strategy is required to address this need.

2. Whether there is clear strategy, at national and local levels, about the future direction for district nurse-led community nursing services. How well aligned is this with the development of the primary care cluster model for example, and with the vision for health and care services set out in A Healthier Wales.

There are concerns that as this demographic group is small and highly specialised they will remain under the care of community, secondary and tertiary paediatricians and so may become lost to the planning and funding opportunities within the clusters. However, the impact on GP services from family related stress and anxiety for this client group is substantial. The drive is for care closer to home from a welsh government perspective and children and young people should be no exception. There is a huge potential with the right education, training and investment in children community nursing services to limit admission to hospital with support from a children community nurse and GP, reduce length of stay in hospital , reduce stress and anxiety for families and associated costs of stays in hospital ( lost work days, child care, travel etc). directives from the RCPCH advocate in all standards care at home with support from a children community nurse.

3. How effectively community nursing teams are able to work with a range of professionals and agencies (including primary and secondary care services, social care services, and the voluntary sector) to deliver seamless, person-centred care.

The children’s community nursing teams across Wales work well and effectively for highly vulnerable children and young people. However, they struggle to be able to meet the demands for care in the community due to numbers of nurses and the ability to maintain competency due to the small numbers of children  in each area. A broader planning approach is required within the IMT’s or at an all-Wales level.