During a conversation with a group of nurses from the care home industry recently, a very interesting theme emerged from all of them. This group consisted of some hugely experienced people, who had devoted many years of service to the NHS before moving their careers into the private healthcare arena, their thoughts and feelings resonated very strongly with me as I had worked in both the NHS and care home sectors whilst also moving over to the ‘dark side’ of the commercial pharmaceutical/medical device business.

They had the impression that other clinicians perceive those that choose to work in the Care Home sector are ‘lesser clinicians’ than those who work in the NHS or those that operate on the acute side of healthcare.

This got me thinking – how much of this perception was accurate and how much of this was how they saw themselves. After researching this for a while, an article stood out to me ( https://www.carehome.co.uk/news/article.cfm/id/1567712/nurse-reveals-work-care-home-nhs ), whereby the author commented that other nurses often belittle the care home sector as a career path. However, is this a true reflection of reality?

Care Homes play a crucial role in caring for our ever-increasing elderly and incapacitated population. The service they provide not only reduces the potential for hospital admissions which could ‘block beds’ within an increasingly over stretched NHS, they can (and do regularly) provide holistic care for both the resident and the wider family.

In my personal experience, care homes have improved greatly over the past 15 years or so. Their commitment to investing in their staff has enabled them to attend more training than ever before – possibly more regularly than their compatriots within the NHS (I have often heard from NHS learning and development departments that one of the first things to suffer when there is a crisis is training). Speaking with nurses within the care home sector, the clinical skills that they require are far greater than they used to be as they now have to care for residents with tracheostomies, intravenous therapies, PEG feeding etc. with much less support than what they would get from an acute care setting.

Whilst Care Homes may still get a bad reputation within the media, it is key to realise that, according to the CQC, over 75% of care homes obtained a good or outstanding report between 2014 – 2017. One of the foundation stones that Care Homes are looking at in more depth to further improve the care they give (and therefore improve their CQC rating) is Clinical Governance. Clinical governance is a systematic approach to maintaining and improving the quality of patient care. It provides a framework for drawing together the different strands of quality improvement which includes clinical audit, clinical leadership, evidence-based practice and the dissemination of good practice, ideas and innovation and addressing poor clinical performance, and has been the benchmark for clinical excellence within the NHS for a number of years.

To conclude, I would argue strongly that choosing to work in a Care Home is most definitely NOT secondary to working in an acute setting. There is a huge commitment from those that I have spoken with to improve care and conditions for both the residents, their families and the employees that work with them. The skills required to work in this area are extensive and require regular updating which forms part of the organisations’ Clinical Governance Framework going forward. For those who work in this care sector, their role is hugely important now and will be increasingly so as the demands on the NHS increase exponentially over the coming years. Their work may well be the cornerstone to enable the NHS to continue in the UK in the future – let’s recognise and celebrate that work!