Celebrating Community Services: Q&A with Judith Douglas



Celebrating Community Services week is an annual celebration of the role, breadth and importance of community services. For 2024, we spoke to a selection of leaders from the community sector about what makes them proud to work in community services and why it is important they are empowered.

Judith Douglas is director of nursing, allied health professions and quality at CityCare in Nottingham.

Can you tell us about CityCare and what you do?

We are the biggest provider of NHS community health services in Nottingham.

As examples, we run services for people aged 0-19, and look after mums who are teenagers and just starting the journey to being a good mum. We have a community nursing service and provide stroke and rehabilitation services, such as Mosaic (our physiotherapy service).

We also have specialist services for palliative care, Huntington's disease and neurology conditions, as well as respiratory and cardiac services.

We have a full range of services geared up to keeping patients in their own homes. They also make sure that when patients are admitted to an acute hospital they come out as swiftly as possible. Discharge-to-assess services and integrated care home services provide support wherever those patients live and whatever their needs are. They make sure patients are safe, healthy and kept as well as they can be with the conditions they have.

What makes you proud to work in the community sector?

Community health is very special because you're actually invited into patients' homes and that is a privilege, as well as bringing levels of responsibility.

It's just lovely to see patients thrive and be as well as they can be and have the support they need to enable them to stay at home.

Some services like our homeless health service, which is very bespoke, makes sure that patients in very difficult situations can access healthcare that sometimes isn't readily available or known about.

We help the most vulnerable people in society to access the care they need at the time they need it.

Could you tell us about some of the positive impacts of your local community-led initiatives?

We have an urgent treatment centre to provide walk-in care and attention when that's required.

We work closely with hospitals to make sure patients are discharged with the packages of care they require and the help and support they need.

Working with teenage mums, our homeless health services and looking after really vulnerable members of society, that's what makes me proud.

The teams and staff we employ make a difference every day. They make sure patients are better off for having met us.

The care we provide is of the highest standard and has compassion. I'm very proud of our staff, I'm very proud of the complexity and breadth of services we offer, and I'm very proud of the way our staff go out and provide care in sometimes very difficult situations and scenarios.

We've come through Covid-19 and the recent riots, which really had an impact on our staff and our patients. It's not always easy, but staff keep coming into work and giving their best. That's what makes me proud.

Why do you think it's important that we empower community services?

It's really important that we empower community services because it's an opportunity in primary care and in our communities to actually see patients earlier and do that screening and have conversations about health and wellbeing and health promotion.

It's also about ensuring patients can stay at home or in their preferred place of care – whether that's a nursing home or a residential home – and actually getting the services they need at the time they need them.

We know the issues that hospitals are having in relation to discharge and capacity. So it's really important those patients that need to go into hospital are assessed and go into hospital, but those that don't can stay at home.

We provide really good integrated care and services and it's important for that to be recognised, so patients aren't kept in hospital when they could be at home or admitted when they don't need to be admitted.

We can provide care and support in their preferred place of care.

How do you think that community providers can be enabled to go further, faster to support Labour's ambitions to shift to a preventative community-based model of care?

It's certainly a challenge and preventative care always gets forgotten or stopped when finances are difficult, as we know they are. It's the bit that gets forgotten because the long-term benefits can take years to come to fruition.

That's always a challenge but it's about changing the infrastructure as much as changing personnel and processes.

It’s about putting the money in the right place and the staff in the right place to drive things forward.

What is the one key ask you have of the new government?

We are seeing an increase in the vulnerable and gaps getting wider between those that have and those that haven't. That's a challenge for us all.

My plea would be that the government focuses on the really vulnerable in society and that we actually start to close that gap.

This is always difficult when we're concentrating on finances and performance, but we need to step back and see the wider picture.