The New Zealand Nurses Organisation (NZNO) says changes proposed to staffing for the CREST service proposed by Canterbury District Health Board (DHB) will reduce the quality of care available to older persons in Christchurch and surrounding areas.

The Community Rehabilitation Enablement Support Team (CREST) cares for the health of older persons when they are first discharged from hospital so they spend less time on return hospital visits and remain in their own homes longer - instead of in residential care.

NZNO Professional Nursing Adviser Marg Bigsby said NZNO members are very concerned the changes would disestablish 17FTE of experienced nurses (including two leadership roles), replacing them with just five ‘liaison staff’ and one clinical nurse specialist (CNS). Case management work would then be contracted to private community providers.

"Depending on who is appointed to the liaison and CNS positions, this represents a loss of 11-16 experienced nurses to CREST, which would have serious impacts on the care available to older persons in the region, especially when they are leaving hospital. This is something Canterbury older persons’ health services can ill-afford," Ms Bigsby said.

"Our members are also concerned about people being employed who were unfamiliar with the CREST service and the possible lack of case management expertise when work is given out to community providers.

"Many of these providers are already quite underfunded and short-staffed so they will struggle to provide care to the standard they would like and which currently exists. It will be a systemic problem."

NZNO is also concerned about the failure of the DHB to collaborate with or consult CREST staff.

"Case managers learned about the proposed changes from nurses in community providers before they had heard anything about them directly, which is a completely unacceptable violation of professional confidentiality," Ms Bigsby said.

NZNO made a submission today to Canterbury DHB opposing the changes, suggesting alternatives and calling for nursing expertise to remain in-house. Ms Bigsby said CREST nurses are invested in the service and that she hopes the DHB will listen to their voices.

At NZNO’s encouragement more than 160 health professionals around the region including doctors, nurses and allied health professionals, have sent letters to Canterbury DHB CEO David Meates opposing the changes and in support of the nurses’ call for a rethink.

Ms Bigsby said the CREST service supports elderly to regain independence and quality of life following a stay in hospital. Without its support the focus will inevitably fall on just the basics - and there is so much more to life than merely being able to wash and dress yourself or go to the toilet.

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