It’s a famous maxim that the definition of insanity is repeating the same action over and over while expecting a different result.

Reluctant as we are at JCN to accuse the government of succumbing to collective madness, it is hard to reconcile the deluge of policy documents stating that care needs to be moved away from hospitals and into the community, with the fact that primary care services still appear woefully underfunded. While health ministers talk endlessly about prevention and health promotion, community and district nurses leave in their droves through burn-out and lack of opportunity, and patients with complex needs continue to take up acute beds, leaving hospitals oversubscribed with chronically ill patients who can’t be discharged.