Community care 365 days of the year

baby and midwife

Over the festive period we are shining a light on some of the unsung heroes in community health. The physiotherapists, podiatrists, health visitors, district nurses, palliative care specialists, occupational therapists, community mental health practitioners, speech and language therapists, and other community-based health experts, who – in addition to the blue-light services – make sure the NHS continues to deliver safe, high quality care round the clock, keeping people safe in their own homes and communities.

Speech and language therapists
Sexual health services
Audiology services
Pulmonary rehabilitation services
Tissue viability specialists

Speech and language therapists 

For over nearly 80 years, the monarch has been taking to the airwaves on an annual basis to deliver a Christmas message to the people of Britain and the Commonwealth. The work of speech and language therapists (SLTs) goes far beyond ‘set piece’ speeches, and reaches much further into the community and individual’s lives than a televised speech on Christmas Day. 

Nearly one in five people may experience communication difficulties at some point in their lives. Speech and language therapists work with children, adults and older people in a wide range of disciplines. The Royal College of Speech and Language Therapists explains that this includes patients with communication or eating and swallowing problems, perhaps following neurological impairments and degenerative conditions, including stroke, head injury, Parkinson's disease and dementia, or children with autism or social interaction difficulties.

Every day of the year – including Christmas Day – individuals and families all over the country will be benefiting from SLTs’ specialist input. That’s why speech and language therapists are one of our #xmashealthheroes

Bradford Care Trust has filmed a range of interviews with SLTs who explain in their own words what speech and language therapy involves, how they work with patients, and the range of conditions that can benefit from specialist speech and language therapy input. View the videos online. 


Christmas parties can take their toll on your feet but podiatrists deal with far more complex conditions than blisters and bunions. Podiatrists provide specialist care for patients with a variety of foot health problems, including ulcer management for patients with diabetes (neuro-ischaemic ulcer management), laser therapy for chronic soft tissue problems (i.e. strains and sprains), prescribing and making orthotic supports or insoles to correct and improve foot and gait problems, as well as minor surgery, foot care and treatment.

The NHS in England spends more than £119 million each year on diabetes related amputations, according to a report by Diabetes UK, and only half of people with diabetes who have an amputation survive for two years. Working as part of a multi-disciplinary footcare team, podiatrists can have help massively reduce the need for costly and traumatic amputations, which is why podiatrists and chiropodists are one of our #xmashealthheroes.

Other foot problems which benefit from podiatrists’ specialist input range from corns, calluses and veruccae, to rheumatoid arthritis and sweaty feet. The College of Podiatry estimates that more than three quarters of the adult population in Britain have some form of foot problem. The College has produced a series of videos explaining more about what podiatrists do and the treatment they provide.

Sexual health services 

 Whether you need emergency contraception, want to talk through the best ways to protect yourself from sexually-transmitted infections, need syringes for safe slamming, or have some other sexual or reproductive health need, CaSH (contraception and sexual health) teams can be your #xmashealthheroes this year.

With specialised services tailored to teenagers, members of the LGBTQ community, people with HIV, men or women-only services, or help for people who have been sexually assaulted, NHS sexual health services based in your community can help you. And there’s nothing stuffy or fusty about their approach to sexual health issues or STIs – check out the video by Locala’s chlamydia screening team in West Yorkshire.

In London, a state-of-the-art clinic in Southwark offers sexual health services seven days a week, and is open on selected days over the Christmas and New Year period. You can find details of your nearest sexual health #xmashealthheroes on the SXT website.

Audiology services

The countdown to midnight on New Year’s Eve builds a tension that culminates in thousands of people tuning in to hear the ‘bongs’ of Big Ben, but for people with hearing difficulties, the New Year chimes can herald another year of communication difficulties.

There are more than 10 million people in the UK with some form of hearing loss, which is one in six of the population. One in ten adults has mild tinnitus, and one in 100 has it severely enough to impact on their quality of life, according to Action on Hearing Loss.  

NHS audiology services can help adults, children and older people who are affected by hearing loss, tinnitus, and balance disorders. Many audiology services which work with children are also involved in hearing screening programmes for new babies and school-age children. They definitely qualify as one of our #xmashealthheroes! 

Pulmonary rehabilitation services 

For many people, cold weather at this time of year can trigger or exacerbate breathing problems, but for people with a lung condition, such as chronic obstructive pulmonary disease (COPD), cold weather can be a double whammy. Even undertaking normal day-to-day activities can be difficult without getting breathless, and this can start a vicious spiral of anxiety, which then makes breathlessness even worse. For patients who then start to avoid activities which make them breathless, the path to reduced fitness, increased tiredness – and yet worse breathlessness – can lie ahead. 

So a community-based pulmonary rehabilitation programme can be lifeline, which is why staff in a pulmonary rehab team are among our #xmashealthheroes. A pulmonary rehabilitation programme can offer supervised exercise in a supportive environment, with education sessions on ways to control breathing or manage a flare-up of your lung condition.

Even so, for someone who hasn’t taken ‘formal’ exercise for many years, the idea of joining a programme can be intimidating. That’s why a team from Oxfordshire have put together a short video on how pulmonary rehabilitation can help you get your life back.


January 1st is the time of year when many people’s thoughts switch to thinking about their waistline and whether it would be a good to adopt a healthier approach to eating as the new year unfolds. But for NHS dietitians and nutritionists, using the latest developments in nutritional science to advise patients on optimal digestive and nutritional health is a 365-day-a-year passion, which is why they are one of our #xmashealthheroes. 

Dietitians work with both healthy and ill people, assessing, diagnosing and treating dietary and nutritional problems at an individual and wider public-health level, which means they can work with government, in the food industry, in schools or other organisations, or with patients on a one-to-one basis.

In England, dieticians must be qualified and registered with the Health Professions Council – you can’t call yourself a dietician if you’re not. 

The British Dietetics Association estimates that the average person in the UK could consume around 6,000 calories on Christmas day alone (versus the guideline daily amount of 2,000 calories for women and 2,500 calories for men)! The BDA has plenty of tips on how to take and maintain a healthy approach to eating – including celebrity diets to avoid! - but dietitians also do much more than just advise on eating or weight loss, including helping with preparations for surgery, managing allergies and treating digestive problems - see the BDA’s website for more information, including how to find a dietitian. 

Health visitors and school nurses 

Children and Christmas go together like Santa and his reindeers, but year round, clinicians like community midwives, health visitors and school nurses are working to help ensure all children get the healthy start in life which is the best present of all.

Health visitors are registered nurses who have a specialist qualification in community health and health promotion for families with young children. They can offer advice on your baby or toddler’s growth and development, give parenting support to mums, dads, carers and single parents, and help identify potential problems at an early stage, including emotional issues.

With more than 12,000 health visitors across England – and more being trained and recruited – who work in children’s centres, community clinics, GP practices and in families’ homes, one of these #xmashealthheroes will be near you.

School nurses pick up the baton when your child reaches school age, as this video from NHS Careers shows. School nurses do more than provide plasters for playground bumps and scrapes – as the school nurses’ association explains, its members provide specialist nursing input on child development, child protection issues, immunisation as well as helping manage the health of individual child patients, including young people with ongoing medical needs while they are attending school.

End of life care

It’s a topic which many people try to avoid talking about, particularly when it seems the rest of the country is focused on festivities and families. The fact is that everybody dies at some point and three quarters of people say that when the time comes, they would prefer to die at home. #xmashealthheroes who provide palliative care in the community are making this ‘dying wish’ a reality, by working closely with people in the last months, weeks or days of their lives to plan their end of life according to their individual wishes. 

In Derbyshire, the local community health provider has put together an end-of-life toolkit to help health professionals work through the kind of conversations and discussions which will ensure they can support their patients to have the end of life they want. 

More than half a million people die in the UK every year. It’s a fact of life. Palliative care professionals can help make sure that if you’re approaching the end of your life, you live as well as possible until you die, and that you get to die with dignity.

Mental health services

Christmas can be a time of heightened emotions and stressful situations even for people with good mental health, but for people living with a mental illness, the Christmas and New Year period can be a time of increased unwellness. 

The Mental Health Foundation has produced some useful tips for coping with Christmas if you have mental health issues, while #xmashealthheroes like community-based mental health practitioners can be a source of support and advice over the festive period, as they do all year round.

Working in clinics, GP surgeries, community centres, patients’ homes and other community spaces, community mental health workers can help provide emotional support, monitor and talk through any changes in your behaviour or mental state, and identify ways to help you recover or cope with your mental illness. Community psychiatric nurses, who are specially trained in mental health, can support people with depression, anxiety, dementia or psychotic illnesses.

With one in three people thought to experience a mental health problem at some point in their lives, and the vast majority receiving care and treatment in the community rather than in hospital, there are plenty of mental health #xmashealthheroes working over the festive period. If you need help or support for mental ill health over the period, the NHS Choices website can signpost you to lots of sources of support and advice.

Falls prevention teams 

Around one in three adults over 65 who live at home will have at least one fall a year, and for many people as they grow older or deal with physical ailments, fear about having a fall becomes a bigger and bigger worry, and can intrude on everyday life. 

But as Age UK explains, we shouldn’t see falls as a normal part of ageing, or something that ‘just happens’ as you get older. Across the country, falls prevention specialist staff work with patients in the community and their own homes to reduce the risk of falls, and reduce the worry, making them #xmashealthheroes to many people and their families.

In parts of London, falls prevention teams work in the community to support people at risk of falls by helping them to maintain active, independent lives by avoiding fall related injuries, unnecessary hospital admissions and premature transfer to long term care. With specialist input from occupational therapists and other clinical experts, community-based health teams can reduce the risk of patients falling, help them recover if they do, and reduce the ‘fear of falling’ which can prevent older people enjoying their life.

Bladder and bowel nurse specialists 

Approximately one in four people will experience bladder or bowel symptoms. It can affect children, men and women of all ages. Despite being a common problem it’s still something that we may feel embarrassed about, which is why #xmashealthheroes working in continence teams are so highly valued by their patients.
Bladder and bowel nurse specialists are qualified nurses who have had further training in promoting and managing continence.

They can assess issues which might be causing incontinence, using tools such as urinalysis, bladder scanning, assessment of pelvic floor tone and physical assessment, where appropriate. 

In The Wirral, the continence team provides treatment, products and support in the community which mean everyone can be helped to effectively manage, improve and in many cases even cure their incontinence.

Tissue viablitiy specialists 

‘Tissue viability’ can sound mysterious or even a bit sinister, but for patients with pressure ulcers, trauma injuries, abdominal wounds, tissue viability specialists can literally be life savers, which is why we think they are #xmashealtheroes

The NHS spends between £2-3 billion on caring for patients’ wounds each year. In Shropshire, members of the tissue team provide a specialist service to patients with a wide variety of complex wounds including pressure ulcer prevention and management, management of leg ulceration, management of traumatic injuries and complex non-healing wounds. 

Year-round, tissue viability specialists – also known as chronic wound management specialists – work in community settings and patients’ own homes to prevent and manage wounds. 

This is a look at just some of the many specialisms which fall under the ‘community healthcare’ umbrella and the people who provide vital services for their local communities. 

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