COMMUNITY nursing across Gwent is set to be overhauled during the next three years to meet the challenge of increasing levels of out-of-hospital care.

With Gwent's trailblazing Frailty Programme focusing on both preventing hospital admissions where appropriate, particularly for the vulnerable elderly, and ensuring such patients' discharge more quickly should the require a hospital stay, greater community nursing input is regarded as vital.

Wales-wide policies are also being geared increasingly toward the same aims, and a new community nursing strategy drawn up by Aneurin Bevan Health Board recognises that there need to be more community nurses and they need to be equipped with a wide range of skills.

Gwent-wide reviews of district nursing, midwifery, school nursing, health visiting, and mental health and learning disability services have been, or are about to be, carried out to determine what needs to be done.

District nursing, in terms of the way teams operate in Gwent and which other agencies, such as primary care, social services and the voluntary sector, they work with, will be reorganised to ensure the greater 'at home' treatment and care proposed through the likes of the Frailty Programme can be delivered.

In line with all-Wales policy, each secondary school in Gwent will have a school nurse available from later this year.

Health visitors will have new responsibilities, and community midwives are set to become the initial professional contact in maternity services, for mums-to-be.

The health board is also looking to develop education programmes for practice nurses.

The establishment of a system in which community hospital beds are largely nurse-led, with community nurses able to arrange health assessments and diagnostic tests for patients, is a key aim.

Some developments are already being tested, such as in Torfaen, a framework to support nurse-led assessment and discharge from hospital.