Elderly who fall at home unlikely to get an ambulance during strikes.

growstuff

Exactly! I didn't need social care! I needed nursing care! That's precisely the point I've been making. There weren't any district nurses. Funding for them has been cut, even in the context of general cuts to services - that's why I think there does need to be a change in strategy/direction.

I didn't need to take up any bed in an institution either. I was far happier to be in my own bed, but I did need nursing care for a few days. I was discharged the same day as my op, but that only happened because I had somebody who could drive me to hospital every day for the next week. If I hadn't have had that, I would have had to stay in hospital and been a "bed blocker" and would have cost the NHS far more - and I'm not the only one in that situation by any means.

Does there need to be a change in strategy/ direction for there to be more district nurses in your local team so that they are able to provide the level of nursing care required? I’d say no, there just need to be more district nurses so they can fulfil the requirements. I don’t think your local issues are necessarily replicated throughout England, because local choices are made about which services are prioritised.

Casdon I disagree with you that the situation isn't replicated. I know other areas where it's exactly the same. One of my sisters was a district nurse for years and latterly the manager of a big area in England. She was made redundant when the system was reorganised - as was the system in many other areas. That's how I have some insider knowledge of structural changes. She was offered another job, but the emphasis had changed to social care not nursing and she would have taken a drop in salary. The service was soon outsourced to a private company. My sister took the huge redundancy package instead.

As I wrote above, my mother needed nursing care in the weeks before she died. We knew exactly what was available - but there wasn't anything! Goodness knows how many phone calls my sister made, but got nowhere - and she did know what she was doing and still had contacts. My two sisters could cover most of my mother's needs, but they weren't allowed to do some of the serious stuff, which is why we ended up paying for a private nurse. It was expensive and there are many people who couldn't/wouldn't have paid. The alternative would have been for my mother to take up a hospital bed, which would have cost the NHS more, in addition to making my mother's last few weeks thoroughly miserable.

So please stop trying to lecture me about community care and systems and what you think is available.

Yes, there does need to be a change of strategy because it would involve reallocation of funding.

PS. There also needs to be a change towards funding mental health better.

The number of district nurses in England fell by 43 per cent in ten years between 2009 and 2019, with 7,055 reported in September 2009 compared to 4,031 in January 2019 - and that was despite increased demand.

www.hsj.co.uk/community-nursing-will-blow-as-discharge-threshold-is-reduced/7027384.article#:~:text=The%20number%20of%20district%20nurses,to%204%2C031%20in%20January%202019.