Replies to LegCo questions
LCQ20: Community nursing service
Following is a question by the Dr Hon Joseph Lee and a written reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (June 14):
Question:
It has been reported that the Hospital Authority (HA) will employ additional
community nurses next year. In this connection, will the Government inform this
Council:
(a) of the expenditure on community nursing services in each of the past three
years;
(b) whether it has assessed the effectiveness of community nursing services over
the past three years; if it has, of the assessment results;
(c) of the respective numbers of community nurses in the general and psychiatric
streams and the ratio of community nurses to patients in each hospital cluster
at present;
(d) of the criteria adopted by HA for working out the demand for community
nursing services, and whether HA has set a target ratio of community nurses to
patients and regularly reviews the ratio;
(e) of the expenditure involved in HA's plan to employ additional community
nurses; and
(f) whether it has made any prediction on how the quality and development of
community nursing services will be enhanced as a result of employing additional
community nurses?
Reply :
Madam President,
The Hospital Authority (HA) provides a range of inpatient and ambulatory care
services to meet the health care needs of the community. The provision of
community nursing service is part of the community-based health care delivery
approach to support the care of those who need such services in the community.
The aim is to empower such persons in self-care, improve health and reduce
hospital dependency. Provision of community nurses and community nursing service
in a particular geographical area or hospital cluster depends on a number of
factors such as the care delivery model, the make up of a health care team, the
availability of local community resources such as volunteer carers,
non-governmental organisations and primary care providers, as well as provision
of old age homes in the area.
My answers to the questions asked are as follows -
(a) Expenditure on community nursing service in each of the past three years is
shown in Table 1.
The reduction in the expenditure between 2003-04 and 2005-06 was due to the pay
cut exercise in line with that in the civil service.
(b) In line with the strategy for a community-based health care delivery
approach, the HA hospital clusters assess the need for community-based services
based on specific patient needs and programmes. A range of outcome indicators
are being used and continuously refined for measuring the effectiveness of
community-based services, such as early discharge of patients, as well as
reduction in hospital readmission and accident and emergency attendance. An
example illustrating the effectiveness of the services is that the average
length of stay for mastectomy patients in some hospitals has been shortened from
8-9 days to 4-5 days.
(c) & (d) The total numbers of community nurses and community psychiatric nurses
in the HA as at the end of March 2006 are 385 and 110 respectively. Breakdown of
their numbers in each hospital cluster is shown in Table 2.
Community nurses in the HA have made a total of 792 810 homes visits in 2005-06
to provide services to those in need in the community. Since the community
psychiatric nursing service has been integrated with the community psychiatric
team to form the community psychiatric service, there are no separate visit
statistics for community psychiatric nurses.
The community nursing service in the HA provides care to an average of some 10
000 persons in need of such service in the community at any one time. These
persons have diverse needs. The service volume, service location, care
complexity and intensity for these persons vary because of their health
conditions, nature of their social background and availability of family support
and community resources. It would not be meaningful to interpret or devise any
target ratio of nurses to patients on its own without reference to the
aforementioned factors. The assessment of demand for community nursing service
is an evolving and dynamic process. As such, the HA has empowered the hospital
clusters to flexibly deploy resources to serve those in need of such service in
the community based on the different social environment and to encourage the use
of available community services in the local community.
(e) The HA estimates that $242 million will be allocated for running community
nursing service in 2006-07, representing an additional provision of $2 million
as compared with that of the 2005-06. Hospital clusters may employ additional
community nurses taking into account the availability of resources and relevant
services within their catchment areas as well as the service needs.
(f) The HA values the contributions of community nurses in empowering patients
in self-care, improving health and reducing hospital dependency. Additional
community nurses will further enhance the quality and service volume of the
community nursing service, which has a definite role in the community-based
health care service model, particularly in addressing the ageing population
problem.
Ends/Wednesday, June 14, 2006
Issued at HKT 15:21
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Attachment:
Tables on LCQ20