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And this is progress?

This week I had an interesting meeting with the district nurses where we learned:

  • Intermediate care no longer exists.
  • There is a new service called Home First. Home First includes a clinician and offers diagnostic services too – ‘No it doesn’t…’ – ‘Yes it does…’ – ‘I’m sure it doesn’t…’ – ‘Let me check that and I will get back to you…’
  • There is a rapid-response team, but no one is sure what that is and how it differs from Home First – ‘Perhaps rapid response offers diagnostic services..?’ (See conversation above)
  • Home response can deal with three or four people a day. What happens after that?
  • A community matron is covering our practice to replace the community matron who stayed six months and who  came after a one-year gap to replace the community matron who stayed six months who… you get the picture.
  • The community matron cannot take referrals. The community matron will not visit the existing caseload. The community matron will call back patients on the existing caseload who left a message on her answer machine.
  • The district nurse team is at full strength… unless you count the fact that two full-time nurses are on long-term sick leave.
  • This replaces a system where you just spoke to someone on the phone.


From Dr Mike Ingram, Radlett, Hertfordshire