Transforming Your Care: Evidence shows it's just not delivering
The Royal College of Nursing was initially supportive of the strategic direction for Transforming Your Care, refocusing care provision away from hospitals and other traditional institutional settings in favour of treating people, where appropriate, in their own homes and communities.
However, the gestational period for the policy has been a long and frustrating one. The review was announced in June 2011 and the report published in December of that year proposed a new model of care for the people of Northern Ireland.
A vision to action document was published for consultation in March 2013. In response, 97% of people said doing nothing was not an option and they believed that health and social care services needed to change. Those who responded sought assurances that investment would focus on making change happen and alternatives would be available before existing services changed. This has not happened.
Recent financial constraints and cuts have resulted in measures that are counter-intuitive - for example, a reduction in respite and domiciliary care and minor-injuries units. There is no doubt that there is much work ongoing within health and social care that has improved patient outcomes and experience. However, in the absence of a strategic or regional approach to delivering change, there exists a lack of consistency of approach.
TYC has failed to deliver the reform required to address social inequalities and meet the needs of a growing population, with growing numbers of ageing people, many of whom have long-term conditions. It strikes me that the evidence that TYC is being effectively implemented is clearly just not there.
- Janice Smyth is director of the Royal College of Nursing in NI