2. What is community health care?
• Community health care is provided in people’s own homes, health centres
and specialist clinics.
• A diverse group of professionals, agencies and independent sector
workers provide both general and specialised health care in these
settings.
• Nurses provide a range of services in the community, including:
Community or district nurses
Palliative care
Tissue viability
Public health specialist practitioners
Sexual health
Bladder & bowel care
Practice nurses
Community paediatric nurses
3. Primary Health Care
• Primary care describes community based health services
that are usually the first, and often the only, point of
contact that patients make with the health service
• General Practice will take the lead role in commissioning
the majority of care for patients. In the White Paper, Equity
and Excellence: Liberating the NHS (DH, 2010) the current
Primary Care Trusts (in England) will pass their provider and
commissioning roles over to collective groups of GP
practices, known as consortia.
• It is expected that nurses will be
represented within the consortia.
4. Who else will you expect to meet during
your community placement?
• In your placement you may liaise with general practitioners, community matrons,
practice nurses, school nurses, physiotherapists, speech therapists, dentists,
opticians, pharmacists and many more.
• You may be in contact with NHS walk-in centres, NHS Direct and community based
minor surgery clinics. You may learn more about community based screening or
keeping healthy initiatives.
Search for health initiatives in the area where you will undertake your
community placement e.g Adult Health & Social Care, Enfield,
http://www.enfield.gov.uk/info/100004/health_and_adult_social_care
• As you familiarise yourself with your clinical
area consider how the patient or individual
accesses services, how integrated you find
community care and the ways in which needs
are met.
5. What health care needs might you come
across in the community?
• Many people, living in the community, have multiple and chronic health
problems that we classify as long term conditions, e.g rheumatoid
arthritis, urinary incontinence and hypertension
• They may require care from many different services e.g GP, bladder &
bowel nurse specialists
• To co-ordinate these complex needs a case management approach has
been developed in the community supported by case managers and
community matrons (Cubby & Bowler, 2010).
• Read more about long term conditions on,
http://www.dh.gov.uk/en/Healthcare/Longtermconditions/index.htm
• On your placement explore who is caring for patients
with multiple needs, who is coordinating their care
and how does this approach benefit the patient.
6. Working in partnership with patients
• Health and social care staff in the community setting work in
partnership with patients to promote autonomy & self
management
• Self-care does not mean ‘no care’, but rather supporting
people to know when to contact services and ask for help and
when they should manage their own health needs (Beasley,
2009).
• Can you think of one health need that
patients can self manage and
one that they should seek help for?
7. Learning opportunities for pre-registration
students in community placements
• Spend time with your mentor identifying learning
opportunities
• With your mentor, decide on the skills you would like to
be assessed on
• Identify your own personal learning needs & work with
your mentor in meeting this need.
E.g Use your community placement to
work alongside a tissue viability specialist
nurses or to attend a bed wetting clinic.
8. Guidance on medicine administration
in the home
• You may not fill Dosette™ or similar medicine
containers.
• You may not give medicines of any kind by mouth
or injection unless directly supervised by a
qualified nurse.
• You may administer eye drops, apply
wound care products, skin preparations
and glycerine suppositories provided
that you have been briefed on their use.
9. Supplying and administrating medicines
• During your placement you will have the opportunity to observe
different methods of supplying and administrating medicines.
• You must never give medication unsupervised however, you will
have the opportunity to administer a variety of medications under
direct supervision of your mentor.
• You should note the different prescribing and supply strategies
available, including clinical management plans, patient group
directions and conventional prescriptions (FP10s).
• It is important that you are aware of the legal and professional
issues inherent in all aspects of medicine management and you
should refer to the NMC Standards for Medicines Management
(updated 2010) for in depth advice
•
http://www.nmc-uk.org/Documents/Standards/nmcStandardsForMedicin
10. Your responsibility
• Attendance
• The team leaders will submit a
record of attendance each week,
to the University
• Absence
• You should ensure that both the clinical
placement and the placement office her aware of
your absence. It may not always be possible to
make up the time you have been absent. All
queries should be referred to the link lecturer.
11. Final placement students
• Middlesex University students with a special interest in
developing their skills in the community setting will be
offered the chance to undertake their final placement
in one of the community placement areas.
• You will need to be assigned a ‘sign-off mentor’. That
is, an experienced mentor who has gained further
experience in mentoring
final placement students, as
stipulated by the NMC
(www.nmc-uk.org)
12. Link lecturer contact details
• Camden PCT
• Kate Brown, Institutional link; Archway
Campus; 020 8411 6930;
k.brown@mdx.ac.uk
• Carol Lincoln; Archway Campus; 020 8411
5961; c.lincoln@mdx.ac.uk
15. References
• Beasley C. (2009). Supported self care and care planning for patients with long-term
conditions. British Journal of Community Nursing . Vol 14, No 9; p394-7
• Cubby A & Bowler M. (2010). Community matrons and long-term
• conditions: an inside view. British Journal of Community Nursing . Vol 15, No 2, p71-76
• DH (updated 2011). Long Term Conditions. Available from:
http://www.dh.gov.uk/en/Healthcare/Longtermconditions/index.htm
• DH (2010). Equity and Excellence: Liberating the NHS. Crown. Available from
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH
• NMC. (2008). Standards to Support Assessment & Learning in Practice. Available from:
http://www.nmc-uk.org/Publications/Standards/
• NMC (2007; updated 2010). Standards for Medicines Management. Available from:
http://www.nmc-uk.org/Documents/Standards/nmcStandardsForMedicinesManagementBooklet.pd
