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Find a private nurse in your area for support at home for your medical condition. Whether you need the assistance of a home nurse to administer medicine or you’re looking for a private mental health nurse to provide emotional support, you’ll be able to find a qualified and experienced professional near you with My Health Assistant.

Need help finding a professional? Get in touch with us

What you need to know about private home nursing.

Nurses are one of the cornerstones of the healthcare system – with broad skills that can help people with all sorts of medical and mental health conditions. Nurses don’t just work in a hospital setting, though. For those who need nursing at home, private home nurses are available to provide flexible and adaptable support, assistance, and treatments.

Private nurses come in many different forms, from all-rounder generalists to specialists who are highly experienced in delivering support for patients with complex care needs. They are able to take on a broad range of roles, from administering medicines in a home setting to putting together comprehensive care plans and overseeing a broader care team.

There are many medical conditions that might necessitate a private nurse to provide care and support at home, including strokes, neurological conditions, severe diabetes, and multiple sclerosis. Home nurses can also be utilised to deliver support to patients who are recovering from an operation, require PEG feeding, are in need of palliative care , and much more.

Receiving support from a private nurse at home can be a liberating factor in the lives of people with health conditions, disabilities, and complex medical situations. It allows them to continue to live at home and maintain a level of independence that suits them, while also ensuring that they’re getting the care, attention, and treatment that they need.

If you’re looking for a private nurse to provide care at home, for you or a loved one, use My Health Assistant to find a suitable professional near you.

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London's Specialist Homecare Provider

Private Homecare in London

With over 20 years of experience, hp homecare is a leading provider of specialist private nursing and home care services in london and the surrounding areas. we are dedicated to delivering exceptional, tailored care right in the comfort of your own home. our commitment to providing bespoke care solutions ensures that each client feels respected, supported, and well-cared for, regardless of their specific needs., our team of skilled and experienced registered nurses and carers are ready to assist you and can be available within hours of your call. trust us to handle your home care needs with professionalism and compassion..

Michele Jogee

Introducing HP Homecare

"The best place to recover is at home... We are there to support you, not to control your life or take over completely... People live longer when they can stay in their own homes and have the practical help that they need."

Testimonials from London families, Private GPs and Consultants...

In March this year (2023) I underwent right knee replacement surgery in central London. Two days after the surgery I was brought home with no advice about physio or how to cope with the situation. I couldn’t walk, was in great pain & had no support so had to hobble around using one crutch. My brother in Sydney was very concerned; after some research he contacted HP Homecare & arranged for me to have the daily support of a carer. Melissa has been with me for initially 4 hours & now 3 every weekday since. She has been a wonderful support & soon will be coming 3 days a week as I have improved so much under her care. I thoroughly recommend HP Homecare to anyone who has similar needs.

Client Francesca Morrison

My expectations of your organisation were high from the moment that we spoke by phone and you assured me that arrangements would be made for round the clock home care to commence as soon as needed. Every aspect of your service, from the pristine uniforms and well-trained care personnel to the efficient office staff and careful record keeping, represents the benchmark for quality care. Thank you.

Dr Hughes, Retired Hospital Consultant (London, UK)

I have used HP Homecare for a number of years. My first point of contact is always Michele Jogee and I am always impressed by her diligence and professionalism. The standard of nursing is high: her nurses are skilled, professional, and caring. HP Homecare is particularly adept at managing patients who are being discharged from hospital back into the community, and Michele ensures that the care package is tailored to the individual's needs, keeping me informed of my patient’s clinical care throughout.

Dr Michael Barrie - Coombe Medical Practice, Kingston-upon-Thames

I have nothing but praise for the service provided by HP Homecare over the last 6 months. They have provided a professional, efficient and reliable home care service to one of my elderly patients. All communications with myself and the family have been timely and very professional. I would certainly recommend them and would use them again if required.

GP Dr Webster - Consultant Gastroenterologist and Hepatologist at University College London and Royal Free London Hospitals

The service provided by HP Homecare was extremely smooth. There were no areas of concern whatsoever, and my patient was extremely satisfied with the excellent standard of nursing care.

Professor Andrea Frilling - MD, PhD, FACS, FRCS, FEBS Professor of Surgery, Chair in Endocrine Surgery, Honorary Consultant Surgeon, Department of Surgery and Cancer, Imperial College London

Two years ago, we began support on a regular basis as my mother-in-law’s dementia, and thus, her vulnerability increased. Her two main carers Melissa and Patricia, along with others in the team, show great sensitivity, humanity, and practicality. H’s personal preferences, and her love of her home are respected, whilst through their companionship she has been able to retain her joy of life.

Relative of Client Mrs J Moss

Our Services

Explore our range of services to help you in your journey to better health and wellness.

Diabetes Management

Expert diabetes management at home, focusing on personalised care plans, education, and lifestyle support to manage diabetes effectively.

Parkinsons Disease

At HP Homecare, we provide comprehensive support tailored to the unique needs of Parkinson's Disease patients.

Post-Hospital Care

Comprehensive post-hospital care to support recovery and ensure a smooth transition back to daily life.

Post-Stroke Rehabilitation

Tailored homecare services for effective post-stroke rehabilitation, aiding in recovery and independence.

IV Treatment

Offering comprehensive intravenous (IV) treatments including standard IV drop and PICC line administration, tailored to patient needs in the comfort of their home.

Surgical Dressing

Professional surgical dressing changes and wound care, minimizing infection risk and supporting healing at home.

Discover more about HP Homecare's private care at home services in London and nearby areas:

TEL: +44 (0) 330 056 6000

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Specialist home care service provider, why nursing direct.

Nursing Direct knows that being in your own home and around the people you love and care about is an important part of a person’s well-being.

We are a service provider that specialises in providing bespoke specialist packages of care for adults, children and adolescents with complex needs or multiple diagnosis such as ASD, ADHD, PTSD, LAC, LD, physical illness, and disability, as well as complex mental health difficulties.

Nursing Directs services range from, but are not limited to, private nursing care, complex care, dementia care, palliative care, paediatric care, post-natal care, elderly care, respite care, post-operative care and live-in services. We also support case managers and insurance companies across the United Kingdom with care related requirements.

Our in-office team include experienced care consultants, operations managers, adult & paediatric nurse specialists, CAMHS, mental health nurses, and social workers. We have a desire to deliver high quality care wherever we work and encourage feedback from all our service users so that we can strive for continual improvement.

Nursing Direct considers clinical governance important to our long-term vision. We are committed to doing the right things in the right way and at the right time by the right person or team. We have fully trained staff and a comprehensive and transparent care service.

OUR SERVICES RANGE FROM:

PRIVATE NURSING

mental health Care

BESPOKE CARE

Choose nursing direct for:.

• Ongoing management of your Personal Health Budget (PHB)
• Rapid response services for local councils and CCG’s
•  Care packages tailored to your needs 
• Detailed initial conversations with one of our clinical nurse assessors.
• Fully staffed office team 365 days a year between 0530 to 2230.

Nursing Direct operates in accordance with The Care Act 2014 and are governed by the Care Quality Commission (CQC).

We would be happy to discuss your personal requirements at any time. Please call our dedicated team on +44 (0) 330 056 6000 or alternatively email [email protected]

REQUEST PRIVATE CARE

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NURSING DIRECT

Private nurses

What is a private nurse?

A private nurse is a clinician who will oversee the support your carers provide.

A private specialist nurse or clinical nurse is an experienced clinician who will have many years of expertise in the care and health industry. Private nurses will not care for you directly – they will oversee the clinical care you receive at home, which will be delivered by a Helping Hands visiting carer or live-in carer . Whilst Helping Hands don’t provide nurses in your home, often our carers work alongside NHS or private healthcare nurses.

Getting to know you and your requirements, your private nurse will work with you to ensure that your support plan is centred around you and your type of care – not just on a practical basis, but to support your emotional wellbeing too.

What are the benefits of private nursing care?

Private nursing care allows you to keep living independently, confidently and securely.

Having private nursing care at home gives you the opportunity to receive the additional help you need without having to leave the comfortable, familiar environment of your home. At Helping Hands, our person-centred approach offers a number of benefits, such as:

Personalised support

Private nursing care gives you the opportunity to receive a truly personalised care plan that is fully tailored to your particular needs and preferences

A holistic approach

We take a holistic approach to our support, which means we concern ourselves with your long-term wellbeing, as well as supporting the wider family

Stay in a familiar environment

An increasingly popular alternative to a residential care home, private nursing care allows you to remain in the home that you love

Spend more time with loved ones

You’ll be able to choose when your family and friends visit, and your carer can assist with hosting duties – including getting your home spick and span

One-to-one care

Care at home gives you the opportunity to receive personal one-to-one support from your own carer, meaning you’ll always have their full attention

Maintain your routines and hobbies

Private care allows you to continue living life on your own terms, which includes keeping up all your favourite hobbies, routines and activities

The conditions that we support

Our nurses and carers are equipped to support people living with a wide range of conditions.

Registered with the Nursing and Midwifery Council , our expert team of private nurses manage all of our complex care packages. They can provide support for a wide range of conditions, both complex and simple. When they meet you and your loved ones, they’ll take the time to fully understand all of the specific needs of your condition, and take your preferences into consideration.

We offer support for the following conditions:

An alternative to residential care.

At Helping Hands, we firmly believe that home is the best place to receive care. Our nursing support serves as a viable alternative to residential care, and here’s why:

What are the responsibilities of a private nurse?

For those with complex care needs, private nurses oversee your care from the very beginning of your time with us.

A private nurse’s responsibilities are wide-ranging, and revolve around ensuring you’re always getting the right type and level of care. Here are some of the things your private nurse will be doing to support your care requirements:

Initial carers assessment

Completing an initial carers assessment with you alongside a local live-in care manager

Checking up on you

Regular visits to check that your care plan is up to date and to see how you are

Working with medical experts

Working closely with other medical professionals involved in your care, such as social workers

Finding the right carer

Finding a private carer who has the relevant skills and experience in your care needs

Providing bespoke training

Providing bespoke training to a chosen carer if they need upskilling for your specific health condition

Contributing to your support plan

Contributing to a plan that includes medication, health condition(s), personal care and your hobbies

The types of private nursing we offer

We offer private nursing support on both a visiting and live-in basis, depending on your needs. Find out more about each type of support:

With a visiting carer, you’ll get dedicated support to suit your needs at the times that are convenient for you.

Care from 30 minutes a week

Flexible support, independence.

Live-in care offers round-the-clock support from a carer who will live with and care for you in your home at all hours.

Round-the-clock support

Companionship, carer chosen by you, expert-led support from the home care specialists.

We only hire the very best carers and nurses to our teams, because that’s what you deserve.

To provide the best home care, we only recruit the very best private nurse clinical leads to join our credible team. All of our private nurse clinical leads must have an up-to-date registration with the Nursing and Midwifery Council, as well as experience in training and upskilling staff in clinical practices.

Our private carers who deliver care to our customers are all provided with award-winning training , equipping them with the skills and knowledge they need. For complex care, carers who do not already have the required experience for that particular customer will have one-to-one, bespoke training delivered by one of our private nurses.

How to arrange private nursing care

At Helping Hands, we make it incredibly straightforward to arrange care so that we can focus on what really matters: your needs. Speak to our team today to begin your care journey.

Speak to our team

Call our team of experts to talk through your options and any questions you may have

Free home care assessment

Your local Helping Hands manager will visit you to discuss your care requirements

Find your carer

We’ll help to match you with a carer who meets your preferences and has the right skills

Why choose Helping Hands?

Stay in the home you love and receive personal nurse-led support from the home care experts.

We believe that everyone has the right to live within the comforts of their own home, regardless of their health care needs. With private care at home from Helping Hands, you can rest assured that all of your clinical needs will be taken care of without the need for moving into a nursing or care home – whether you need round-the-clock support with a live-in carer or regular visits to support you at home from your local care team.

30 + years’ experience

Fully managed service

Local, flexible support

Expert carers

Nurse-led care plans

Fully Regulated by the CQC / CIW

Here at Helping Hands, our live-in care service is fully managed and regulated by the Care Quality Commission (CQC).

From your very first phone call to our friendly team, every aspect of your home care service is independently monitored and regulated by the CQC and Care Inspectorate Wales (CIW).

Why is being a regulated company important?

What does regulation mean?

Regulation means that we offer a care service that is monitored and assessed independently

Why have we opted for regulation?

We choose to provide a regulated service because it gives our customers full peace of mind

How does regulation affect my care?

Regulation means your care will always meet industry standards and follow best practices

Private nursing care FAQs

Can nursing care be provided at home.

Nursing care can be provided in the comfort of your own home. It will be provided by a dedicated carer, with the support of an experienced nurse and our clinical team.

What services can nurses offer privately?

Our nursing care can support you in a wide range of ways, from light medical support and mobility assistance, to doing the housework and looking after your pets.

How can I arrange to get a private nurse?

You can arrange private nursing care today by calling our friendly customer support team, who are available seven days a week. You can also contact us via our website if you need us to call you back at a time that suits you.

How much will it cost for a private nurse in my home?

Our visiting care starts from £29.00 per hour, whilst live-in care is from £1,779 for a single person and £1,779 for a couple.

Emergency nursing care

If you’re in urgent need of nursing care, we’re here to help. Our local care experts will find out what your support needs are and will normally have someone in your home within 24 hours to provide the dedicated nursing care that you require, ensuring you’re not left feeling isolated or unsupported.

Can a private nurse help with my condition?

If you’re living with a medical condition, whether it be straightforward or complex, we can absolutely tailor your care to help you manage any symptoms you might be experiencing, as well as providing support for the wider family if required.

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Page reviewed by Rebecca Bennett , Regional Clinical Lead , on July 25, 2024.

How we wrote this page This page has been produced referencing key insights and data from external experts, trusted medical sources and our team of in-house specialists. We have worked hard to ensure that all information is as accurate as possible and reflects current consensus at the time of writing and reviewing.

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Private Nursing

Private at Home Nursing Care Services in London

At Cavendish Homecare, we know that people are happiest and most comfortable when in their own home. Receiving nursing care at home enables you to receive outstanding care, reduce the risk of infection and minimise hospitalisations to take the stress out of your recovery.

Whatever your circumstances and requirements, we work directly with you and your loved ones to ensure you receive the specialised and devoted care services that you need.

Why choose a Cavendish Homecare Private Nurse?

Choosing 1-2-1 private nursing care with Cavendish Homecare ensures you have a smooth recovery, peace of mind and have continued involvement of family and friends as you wish.  As one of the leading providers of private home nursing care in London and the UK, we take great pride in delivering superior levels of care and support to clients living with a range of medical conditions. Renowned for our clinical expertise and compassionate approach, our nurses are specialists in their field and work with you to improve your health, manage medical conditions, promote independence and enhance your wellbeing.

The key benefits:

• Individualised care from a dedicated nurse or team of nurses, catering to your care requirements, whether for a short visit, live in care, overnight cover or 24 hour support.
• Nursing visits (subject to location) for assessments, dressing changes, IVF injections and wound care.
• Support with medication management/administration, enteral feeding, pain management, tracheostomy, stoma and catheter care (please note we are unable to change catheters).
• Personalised care plans tailored to your unique needs, medical history and personal wishes.
• Specialist nurses in various fields including: cancer care, cardiovascular conditions, later living, diabetes management, lung conditions, palliative & end of life care, post operative recovery, neurological rehabilitation, check out our  full list of home care services here.
• Accompaniment to and from medical appointments, advice and liaison with medical professionals and post surgery support.
• Expert guidance, emotional support and continual reassurance.

Private nursing at home can be a lifeline

Cavendish Homecare’s private nurses serve as a lifeline for those looking to return home. Choosing private nursing care at home minimises the risk of infections, reduces stress and promotes your overall wellbeing with a holistic approach. Our highly skilled private nurses closely monitor your medical conditions, they can liaise with your clinicians, promptly address issues and prevent unnecessary hospital readmissions.

Hiring a private nurse

Selecting the right private nurse can be a complex undertaking, ensuring that the nurse has the right skills for your medical needs, that they align with your preferences, their availability and credentials are essential considerations when selecting the private nurse most suited to you. Our Nurse Managers will meticulously discuss your care requirements and provide indvidualised recommendations for the most suited private nurse for your needs.

Registered Private Nurses

Our commitment to delivering the highest quality care is embodied in the exceptional medical expertise and extensive experience of our registered nurses, all of whom are registered with the Nursing and Midwifery Council. Ongoing training and continuing professional development ensure we are consistently at the forefront of the most effective care practices.

Get in touch to find out more about our nursing home care services

Find out more about our key private nursing services, palliative care.

Private palliative care nurses at Cavendish Homecare can provide support and assistance to you and your family when facing the challenges of palliative and end-of-life care. Working in coordination with other healthcare professionals involved in your care, our approach revolves around enhancing our client’s quality of life with a meticulous focus on symptom management, pain control and empathetic consideration of their emotional and psychological needs.

Cancer care

Having a private cancer care nurse following a diagnosis or during treatment can provide expert guidance and reassurance, supporting you with medication management/administration, coping with side effects, understanding medical terminology, accompaniment to appointments and emotional support for both you and your loved ones.

Care after surgery

Whether you require accompaniment to and from surgery, overnight post-surgery assistance, nursing visits, or continuous care, our exceptionally skilled nurses and carers excel in providing post-operative care at home . Your dedicated care team will motivate and support you in regaining mobility and returning to your routine, ensuring these activities align with your stage of recovery while providing the necessary emotional support during this critical time.

Our fully qualified nurses are available to help with administering injections in your own home, saving you the time from travelling to your appointments and reducing the stress of self-administration. This ensures a professional and convenient experience, especially beneficial for those with busy schedules or living with mobility issues or chronic conditions

Dressings and wound care

With expertise in dressing changes and wound care, our private home care nurses provide attentive care for skin and wound management, for support with monitoring, promote the healing process and preventing infection. Our private nurses also provide guidance and recommendations for continued aftercare so that you can self manage.

Dementia care

We specialise in providing dementia care services in the comfort of your own home. This ensures that individuals living with dementia can benefit from the advantages of staying in their familiar surroundings with their support network. Understanding that the needs of clients will change over time as their dementia progresses, our skilled private dementia nurses can adapt to and address these changing requirements. Through close collaboration with clients and their families, our team provides peace of mind, normalcy, and calmness that is crucial for those living with dementia.

Paediatric care

Our specialist private paediatric nurses can meet a wide range of needs, from acute to chronic illnesses, working with children and their families to ensure the highest quality of life and minimising time spent away from the home at this critical time in a child’s life. Winning the ‘Excellence in Children’s Services’ award , demonstrates our dedication to delivering high-quality care for children and adolescents.

Mental health care

Private mental health nurses at Cavendish Homecare are trained to provide comprehensive care across various mental health diagnoses, focusing on holistic wellbeing and recovery. Support may include regular check-ins, assistance with medications, and ongoing care management to enhance our client’s wellbeing.

Our specialists in stoma nursing help our clients with their introduction to living with a stoma or their ongoing management. Our nurses provide expert advice, guidance and can assist with emptying and changing temporary or permanent stomas, reducing the risk of infections or complications.

Regulated by the CQC

Regulated by the Care Quality Commission (CQC), we proudly hold an ‘Outstanding’ rating in care and an overall ‘Good’ rating. This report recognises our commitment to providing exceptional care while maintaining the highest standards of quality and safety.

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Please note job applications submitted via this form will not be processed, please use the job vacancies form.

Frequently Asked Questions

Private nursing at home is care from a dedicated nurse or team of nurses, specifically tailored to your unique needs, medical history and personal wishes. Our team comprises specialist nurses in various fields, including palliative & end of life care, dementia care, cancer care, post-operative recovery, lung conditions, neurological rehabilitation, cardiovascular conditions and later living.

Visiting nurses (subject to location) provide short, scheduled visits, dedicated to specific needs, such as dressing changes, injections, IV infusions, wound care and assessments. Our day or night nurses typically work a 12 hour shift based on your needs and will be available throughout this time to cater to your needs.

Our live-in care services offer seamless, continuous support, the nurse lives within the client’s home, providing flexible support as you require, ideal for when you have varying or changeable care needs. Our expert nurse managers will be able to advise at enquiry stage what type of private nursing would be most suitable for your condition and needs.

Our nurses are available 24/7 whether you require a short visit, live-in care, overnight cover, or round-the-clock care. Our on call team is also available 24/7, should you need to get in touch.

Our home nurses receive thorough training, have regular compliance checks and uphold the highest care standards to guarantee the wellbeing and comfort of our clients. They are highly qualified, clinically trained professionals dedicated to providing compassionate and attentive support. Our ‘Outstanding’ care rating from the CQC, along with our case studies , further demonstrates our commitment to delivering exceptional care to our clients.

Hiring a private nurse ensures that they receive consistent care from the same nurse or team of nurses, who have a thorough understanding of their medical history. This type of nursing care plan empowers our clients, encourages active involvement from family and friends and streamlines communication with other healthcare providers, resulting in a comprehensive nursing care plan. The dedicated nurses and Cavendish Homecare team are wholly committed to our clients recovery and helping them achieve their health and wellbeing goals.

Care in a nursing home is provided by a team of nurses, caring for a group of clients at any one time. Nursing care at home allows clients to have a personal nurse who is familiar with their needs, invested in their care and able to support their independence and recovery.

What our clients say about us….

The enquiry process - what to expect.

Initial Enquiry

The prospective client or someone acting on their behalf makes an initial enquiry. This can be via a phone call, a call back request or submitting an enquiry form via email. The enquiry is picked up by the office team who will gather the required information and then pass it through to one of our nurse managers

Call Back from Nurse Manager

One of the experienced nurse managers will give you a call back to discuss the needs in more detail and to provide their expert recommendation on the care that may be required. They will then discuss with you, what Cavendish Homecare may be able to provide, what the cost is, and what timescale we would be able to commence your care.

Selection of Staff

Once an initial agreement is established, the nursing manager will start working with the bookings team to determine the most suitable nurse and/or carer are best matched with your needs.

Proposed Agreement

Following the tailored care recommendation and the selection of staff. We ensure you (the client) are happy with the proposed course of action and the care is able to commence. In some cases, an assessment visit may be required and this will be undertaken by one of our nurse managers.

Active Client

You will begin receiving outstanding homecare from our team, tailored to your needs. Your care plan will be under constant review to ensure the correct level of care is addressing your needs and being provided at all times.

CLIENT TESTIMONIALS

This is why we do. What we do.

Professional service

I am very grateful to Cavendish Homecare for the service they provided. I needed a registered nurse for an injection at short notice and during the weekend and this was done very swiftly. The registered nurse came the same day, and she was excellent. This level of professional service and flexibility is extremely useful and very reassuring. Thank you.

Outstanding Care

Thank you so very much for supporting Lynne through what has been an unprecedented time. Thank you for the outstanding care you all have continued to provide despite hugely difficult times brought about by the Covid virus. The excellent training, attention to detail, organisation, communication devotion and compassion of all of your team during this time and in fact since you agreed to care for Lynne, is an absolute credit to you and our family wish to say a huge thank you to you all. The challenges of late stage MS are huge without the added difficulties of the pandemic. As you are aware without the astute nature and excellent training of your team, the recent situation that occurred for Lynne may have led to a very different outcome. I am so relieved to see Lynne back home and looking more like herself.

“Our son's condition requires strong, ongoing support, and Cavendish Homecare reliably provides it to us."

“We have been with Cavendish since 2019 and have consistently experienced their five-star-rated services across all departments, including the care team, support and administration, management, accounts, etc. Our son’s condition requires strong, ongoing support, and Cavendish Homecare reliably provides it to us.”

Case studies

“your team of carers have provided an exemplary level of compassionate and professional care”, “heartfelt thank you to you and all the many wonderful nurses who looked after him over the years”, “i am so incredibly grateful to you and arrah for your kindness”.

Related Services

Other Services Available

Live-In Care

Respite Care

Palliative Care

Cancer Care

Holiday Care Support

Post Operative Care

Nurse Services

Appointments for our nurse-led services - our friendly nursing team can help with ear wax removal, stitch and suture removal, wound care, instant testing and more., book your nurse appointment online.

Fleet Street Clinic is not a VAT registered company

Fleet Street Clinic has a team of highly-qualified nurses, experienced in dealing with a wide range of medical conditions including wound care, stitch and staple removal following surgery or injury, and instant testing.

As well as being highly experienced, our nurses provide a safe, friendly and confidential environment where you are able to freely discuss any health concerns, with full on-site medical backup.

They will talk you through each procedure before undertaking any treatment, and can recommend any further treatment that may be necessary.

Any personal information shared will be held in confidence and all treatment will be carried out to the highest standards of care.

Nurse services at the Fleet St. Clinic

Wound Care and Dressing Change

If you have had a recent injury that has required a dressing, this may need frequent changing. Some wound dressings need to be changed every couple of days in order to maximise healing and prevent infections. This can be very hard to do correctly yourself. For slowly-healing wounds, we have a wide range of specialised non-adherent dressings available that can facilitate healing and reduce scarring. Our experienced nurses can change your dressing quickly and in a sterile environment. They will also monitor how the wound is healing, offer advice on care, check for signs of infection, and can arrange swabs, culture or referral if needed. (If needed, specialist dressings are at additional cost.)

Stitch Removal

If you have stitches that need to be removed following recent surgery in the UK or abroad, or following a recent injury, one of our nurses can painlessly remove the stitches for you. Our nurse will also check that the wound is properly healed and check for infection. If your needs are complex, please call us to discuss the details and we'll let you know if we can help.

Staple Removal

If you have staples that need to be removed following recent surgery in the UK or abroad, or following a recent injury, one of our nurses can painlessly remove the staples for you. Our nurse will also check that the wound is properly healed and check for infection. If your needs are complex, please call us to discuss the details and we'll let you know if we can help.

Ear Wax Removal

Ear wax causing ‘blocked ears’ can be uncomfortable and inconvenient. We offer ear syringing and microsuction to clean your ears. During your appointment, our Practice Nurse will advise which option is best for you. Please book a practice nurse appointment by calling our reception team.

Instant HbA1C Test

An instant HbA1C test can provide valuable information about your diabetes status, since its blood level gives an indication of the amount of glucose in the blood over the preceding 3-month period. Our rapid HbA1C test therefore helps with screening and monitoring of diabetes and pre-diabetes. A small blood sample is taken using a finger prick test, and your results are available within the same 15-minute nurse appointment. This is a quick, easy and accurate way to check for and monitor diabetes.

Instant HIV Testing

Testing for HIV is quick, simple, and requires only a small blood sample. Our rapid testing means you’ll know your HIV status within a 15 minute nurse appointment - all it takes is a finger prick test. Early diagnosis of HIV infection enables better treatment outcomes and reduces the risk of transmitting the infection to others, and a negative test offers great peace of mind if you have had any concerns. If you think you have been exposed to HIV or just want a general STI test, we strongly recommend booking an instant HIV test.

Instant Cholesterol Test

High cholesterol is very common and a serious risk factor for heart and vascular disease. An instant cholesterol test is a simple finger prick test. Understanding your cholesterol levels can guide potential necessary lifestyle changes and any possible need for treatment. High cholesterol is symptomless, so periodic testing can make a big difference to early diagnosis and protecting you future health and longevity.

I was dealt with promptly, professionally, with great care and sensitivity My NHS nurse had to cancel an appointment and was unable to re-dress a wound caused by a cat bite for a further week. I didn't want to leave it that long and was able to see Becky yesterday morning. I have not been to the Clinic before but will certainly call again if I need to. I was dealt with promptly, professionally, with great care and sensitivity. Thank you. - Stella Jackson

Our Practice Nurses

When it comes to your health, experience is everything.

“After a silly accident abroad, I needed some surgical staples removed from a wound. Booked online, and this clinic fitted me in, same day, no fuss for a small fee. Everyone I spoke to was bright, professional and caring. Great experience”

– Ben Mason via Google Review

“This was my second time at Fleet Street and each time my experience has been excellent, tailored to my needs and transparent in regards to pricing. The nurse practitioners are amazing, I felt well advised on my needs!”

– Sherrylynn Heise via Google Review

All Practice Nurses begin their careers as a registered nurse by doing an associated degree in nursing. To become a Practice Nurse, additional training is required. Practice nurses work in GP surgeries where they plan and provide nursing services and treatment to patients of all ages.

Generally speaking, whoever applied the original wound dressing should advise how frequently it will require changing. This is usually by a doctor or Practice Nurse. Thereafter, one of our nurses can advise how often your dressing should be changed depending on the type of wound and how well the wound is healing.

Wound dressings are designed to provide the most optimum conditions for wound healing, while protecting the wound from any further damage and infection. Changing the dressing properly will help the wound to heal faster and also help protect it and prevent possible infections. It is also an opportunity for one of our nurses to monitor how well the wound is healing.

Ideally the wound dressing must be kept dry. If the dressing becomes wet from any liquid or blood, it has to be changed. This is because, getting your dressing wet can help spread bacteria which might cause an infection.

People do have different pain thresholds and so this question can be quite tricky to answer. Depending on how the stitches have healed, how many you have and where they are on the body will influence how painful they are to remove. In general, the process for removing stitches is simple and shouldn’t hurt. You may feel a slight tugging sensation, but it should be relatively pain-free.

It is very important that you do not get your stitches removed until the wound has had sufficient time to heal. Our nurse will advise you on when you should have your stitches removed. Stitches on different parts of the body require different healing times

If there is any specific aftercare necessary for your particular wound, the nurse will advise you. Generally speaking, you should keep the area clean and protected. There is a possibility that a scar may form where the stitches were – in this case, you should take extra care in applying high factor suncream on the area as this can help prevent skin discolouration.

When we refer to instant testing, we are talking about a “point of care” test where you can have the test done and the results back all within the same 15 minute nurse appointment. Instant testing can be a standalone appointment to check your health, alternatively, your doctor may suggest you do one of these testing as part of their investigation.

High cholesterol can block your blood vessels, which makes you more susceptible to heart issues which can lead to heart attacks or strokes. Having high cholesterol doesn’t usually cause any physical symptoms and so it can silently get worse over time. It is vitally important to get tested in order to prevent life-threatening illnesses and start treatment as soon as possible.

There is no need to fast before an HbA1C test – you can eat and drink as normal.

A HbA1C test is used to diagnose diabetes and can also tell us your risk of developing type 2 diabetes including if you are pre-diabetic. Type 2 diabetes can cause serious health issues including heart disease, stroke, poor circulation and eye health issues.

Understanding your current risk is therefore very important in knowing where you need to make lifestyle changes or not. If your results indicate that you already have type 2 diabetes, medication may also be prescribed to help prevent further complications.

Yes, you can have a regular HbA1C test to see how well your diabetes has been recently managed. It would also give you the opportunity to have a conversation with a nurse of any concerns or issues you may have.

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Ana nursing – trusted home care in london.

ANA Nursing is a trusted home care provider that has been operating in London since 1994.

We provide the highest quality home care services and are proud to have a reputation for excellence. Our friendly, highly skilled, and professional carers are our most valuable assets, and we invest heavily in their training and development. Their dedicated approach enables people with health conditions or impairments to live fuller, happier, more independent lives in the comfort of their own homes.

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Become an ANA Nursing Care Assistant.  

Established in 1994, ANA Nursing is one of London’s most trustworthy and dependable home care providers. We offer a wide range of home care services to people living in the Greater London area, such as live-in care, respite care, palliative care, personal care and much more.  

Our home care services are tailored to provide you or your loved one with the support required to live as freely and independently as possible. Our services are customised to suit your individual circumstances, and regardless of how much support you need, whether it is an hour a week or twenty-four hours support, we will work closely with you and your family to ensure that the home care plan is exactly right for you.  

Our services are suited to people of all ages, including older people and young adults, as well as those with learning differences, health conditions or impairments including dementia and Parkinson’s disease.  

Our carers are all highly qualified and experienced professionals who are dedicated to providing the best possible care. They are all DBS checked and undergo regular training to ensure that they are always up-to-date with the latest care techniques.  

At ANA Nursing, we understand how important it is for you to have peace of mind when it comes to the care of your loved ones. We also know that finding the right care can be a difficult and daunting task. That is why we offer a free care assessment, during which one of our care experts will visit you at home to discuss your care needs and answer any questions you may have. We will then match you with the perfect carer, taking into account your unique circumstances.

If you would like to find out more about our home care services, please do not hesitate to get in touch. We are always happy to help, and we look forward to hearing from you. Our lines are open twenty-four hours a day, call us on 07392 170990

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We can provide home care within twenty-four hours of your initial enquiry. Call us now on 07392 170990

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Our dedicated support team, including a Care Manager, are available twenty-four hours a day to answer any questions or concerns you may have.

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You can choose how many hours you need, even if it is just one hour.

What Our Clients Say about Us

ANA Nursing has been the sole supplier of temporary nursing and carer staff for our nursing home over the last four years. They have developed an excellent rapport with us and they seem to genuinely care about the quality of service they offer us as one of their service users. We regularly offer placements for their candidates to train under our experienced staff as part of their recruitment process, so we see firsthand the efforts that they go to in order to select only the best people to work with them

We’ve been working with ANA Nursing for just over 2 years, and we are so comfortable with their understanding of our needs, and the quality of the staff that they supply us with, that we have appointed them as sole providers of all our agency staff. In our industry it’s so important to have confidence in those we work with, and we have found ANA Nursing to be reliable, efficient, flexible and genuinely interested in developing a strong long-term relationship. Because they train all their staff themselves the quality of their care is always excellent, and we know that with ANA Nursing our residents are in good hands.

At times, it feels like ANA carers are there for our whole family, not just my father. Without them popping in daily to check Dad’s taken his medication and to heat up a meal for him, he would be unable to continue living in his own home. ANA carers continue to give Dad the kind of care that is well beyond the call of duty. Truly, ANA put the ‘care’ into caring

I was apprehensive when I knew I had to arrange home care for Dad. However, ANA Nursing met Dad and I before his discharge from hospital and we discussed and arranged a comprehensive package. The carer was marvellous and I always felt that we were treated as real people rather than just another customer.

We are very happy with the care that we receive from ANA Nursing. Our carer Evan has been with us for almost a year, and we have found him to be kind and reliable, with a good sense of humour, and he always offers the very best of care. Looking back I don’t know how we would have got along without him.

I’ve been with ANA Nursing for almost four years, and I’ve found them to be great people to work for. They really care about my training with a very thorough induction, followed by training to support me through my NVQ2. My first assignments were in nursing homes, which gave me a great grounding in the care industry, but I get so much satisfaction now working to care for people in their own homes.

When I left university just over a year ago ANA Nursing offered me a job as a care assistant. With a finance degree I have to be honest I didn’t initially consider this as a long-term prospect but, after the training I was given and the incredible experience I’ve obtained looking after the service user I’ve cared for ever since, I am now convinced that my future lies in the care or medical sector. My intent is to do the best job I can do then hopefully to study for my NVQ in the near future

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At Consultus, we believe that live-in nursing is a better solution for the care needs of you or your loved ones compared to a care home - it is far more comforting and less disruptive, but it can also be a more affordable option and offers a more personal service.

We take pride in providing the right level of nursing and support to those who need it, in the comfort of their own home where they can enjoy the familiar surroundings and the peace of mind that comes with this.

We believe our fees are very competitive and there are no hidden costs. Our nursing rates are based on a fixed weekly charge or pro-rata per day with a minimum booking period.

Do nurses need their own room?

Yes, a live-in nurse will require their own bedroom while they stay with you. It is important that a nurse has their own space where they can relax and sleep while they are not working.

How do I book a live-in nurse?

Simply call us on 01732 770403 and speak with our Nurse Coordinators

How many hours per day do the nurses work?

During their bookings, our nurses work a 12-hour day or night, with a two-hour break, typically between 8am to 8pm or 8pm to 8am. However, these hours depend on your personal requirements. You will also have the reassurance that the nurse remains physically present beyond these hours.

Can we have nursing occasionally?

Yes, we can provide respite nursing. Please discuss your requirements with our Nurse Coordinators

Can you provide visiting nurses for an hour a day?

Unfortunately not; we specialise in 24/7 live-in care and nursing. If you decide you do not need a live-in nurse, we recommend that any visiting healthcare assistant bookings be made through a fellow member of the United Kingdom Home Care Association.

I'm unsure about having someone living in my home - will the nurse be unobtrusive?

Our clients tell us that while it sometimes feels a little odd initially to have a new person staying in their home, that feeling quickly fades away – and is infinitely preferable to moving to the institutional environment of a care home, which can be impersonal and unfamiliar.

Our nurses are reliable, discreet, friendly and committed to the physical and emotional wellbeing of their clients. They operate in a professional, polite, dependable and confidential manner, and always respect the homes and privacy of clients.

Can I interview the nurses?

It’s not possible to meet the nurse we assign face-to-face before your booking starts. However, once we have confirmed the booking there will be an opportunity to speak to your nurse – this is when arrival and changeover arrangements can also be discussed.

How do you vet your nurses?

All nurses have a telephone interview and then a face-to-face interview. We check all documentation, take professional references and process a Disclosure and Barring Service (DBS) Enhanced Disclosure. All professional references are followed up with police checks from the nurse's country of origin.

I would like to have the same nurses returning. Can you arrange this?

Yes, many of our clients have favourite nurses, and we try to arrange a rota of regular nurses wherever possible.

Is there funding available for private home nursing and is it available on the NHS?

You’ll find lots of information about funding live-in care and nursing on our dedicated funding page.

What happens if I book a nurse but need to cancel shortly before they arrive?

By the time the nurse arrives at their client's home, our team will have put in many hours of preparatory work and our nurse will have committed themself to the full length of the booking (typically 14 days or more). 

For these reasons, we charge a deposit. In the event of a cancellation before the booking starts, this is non-refundable. If the booking goes ahead, this is simply deducted from the first invoice. 

Can I postpone the start of nursing care or interrupt the service for a short time?

We know from experience that delays to hospital discharge can force postponements to confirmed bookings, which can mean delaying our nurse's arrival. Similarly, you may need to request a break in service because of a temporary hospital admission. In these instances, to avoid the disruption of an established rota, we try to arrange for the nurse to remain on paid standby.

Politics latest: Fears of 'all-out war' as foreign secretary heads to Israel for talks

David Lammy is heading to Israel for talks with senior ministers as the foreign secretary looks to help prevent "an all-out war" in the Middle East. Meanwhile, the Tories take credit for positive economic news - but A-level results day brings universities' financial strife to the fore.

Thursday 15 August 2024 22:35, UK

• Foreign secretary heading to Israel amid fears of 'all-out war'
• Chancellor 'fuming' at positive economic data, claim Tories
• Analysis: A good week the government can't take credit for
• Ukraine allowed to use British weapons in Russia | Follow war live
• Universities told they must 'manage budgets' | Results day catch-up
• Listen: Can universities make their sums work?
• Analysis: Politics at heart of fundamental threat facing universities

Things you might have missed

• Listen: How well did PM handle riots? | What's next for economy?
• Analysis: As support plummets, can Farage have his cake and eat it?
• Explained: Why it's so quiet in UK politics | What does 'two-tier policing' mean - and does it exist? | Robert Jenrick and the Allahu Akbar row

With those details in our previous post of David Lammy's imminent Middle East visit, notably to Israel, we're bringing the Politics Hub to a close for the time being.

Be sure to scroll back through the Hub to catch up on what was a busy day both domestically and internationally for British ministers.

We had a significant update on how the economy's doing, A-level results day was somewhat marred by fears about the future of our universities, confirmation reached us of Ukraine using British tanks in Russia, and we had that news of the foreign secretary heading to Israel.

Thanks for joining us - and we'll see you next time.

More details of the foreign secretary's trip to Israel have been released.

The Foreign Office has announced David Lammy will be heading to the Middle East with his French counterpart Stephane Sejourne in what is the first joint UK-France visit in more than a decade.

They will meet Israeli foreign minister Israel Katz and strategic affairs minister Ron Dermer, though there is no confirmation of whether they will also speak with Prime Minister Benjamin Netanyahu.

A diplomatic source told Sky News earlier today Mr Lammy's main objective was to try to prevent "all-out war" in the Middle East, and we understand a meeting with the Israeli leader is expected too ( see 16.27 post ).

It comes amid fears of an Iranian attack on Israel, possibly carried out with the help of Hezbollah in Lebanon.

Iran has warned of a response following the killing of Hamas's leader in Tehran last month.

Mr Lammy and Mr Sejourne will call for calm and also for a ceasefire in Gaza, with talks on that having begun in Qatar today.

Mr Lammy said it was a "dangerous moment" for the region and "all parties must engage seriously in negotiations".

By Alix Culbertson , political reporter

People living in areas at the highest risk of flooding face cuts to key services due to a sharp rise in flood defence costs, councils have warned.

The government is being urged to overhaul funding for the bodies overseeing flood alleviation as soaring costs have seen an average rise of 28% over the past two years, according to data from the District Councils' Network, which represents 169 English councils.

Higher energy and fuel prices - needed for pumping stations - increasingly extreme wet weather and wage increases are the main causes of the cost of flood defences being pushed up for the current 2024/25 financial year.

By Deborah Haynes , security and defence editor

Ukrainian troops have used British Challenger 2 tanks in their offensive inside Russia, Sky News understands.

It is believed to be the first time British tanks - operated by Ukrainian soldiers - have been used in combat on Russian territory.

The Ministry of Defence in London declined to comment on operational detail, but did tell Sky News there has been no change in policy.

Ukraine's armed forces did not offer a comment.

According to government policy, the UK has confirmed Ukraine is free to use British weapons on Russian territory.

A source said this included Challenger 2 tanks and signalled that they had been used during the Ukrainian incursion, which began on 6 August.

On what was A-level results day, the education secretary was asked about the controversial prospect of raising tuition fees as many universities grapple with serious financial challenges.

Our business correspondent Paul Kelso   says the picture across the sector right now is pretty negative.

And that's because, anecdotally at least, there's been a 30% fall in how many overseas students are applying for British universities.

 " That matters because overseas students underwrite the British university system," says Paul. "They may make up about 26% of the academic population, but provide 46% of the fees."

So why the drop in applications? Britain's top universities have long been extremely popular with international students.

Paul says the sector thinks it's being driven largely by visa rule changes the previous government introduced, which include preventing foreign students from bringing family members with them.

It was a bid by Rishi Sunak to bring down levels of immigration.

The change and subsequent drop in applicants "poses a fundamental threat to the financial health of the university sector", says Paul.

"Domestic fees simply do not cover the cost".

The Sky News Daily podcast looked into this further - watch a clip below and find the full episode at the top of this page.

As students receive their A-level results, many of the universities they'll enrol in are facing their own concerns.

Academics have warned years of underfunding and a lack of lucrative international students at British universities after visa changes risk the sector's ability to provide top-class education and, for some institutions, whether they'll be able to keep teaching at all.  

On this episode, Niall Paterson is joined by two university vice-chancellors, Professor Jane Harrington at Greenwich and Professor David Maguire at East Anglia, to hear the realities and challenges faced by universities across the country.  

Plus, our business correspondent Paul Kelso explains why higher education is facing the crisis it's in now. 

👉 Click to subscribe to the Sky News Daily wherever you get your podcasts 👈        

The Scottish first minster held talks with the deputy prime minister in Edinburgh today - and had a bone to pick.

John Swinney raised the UK government's decision to begin means testing the winter fuel payment, which means only those eligible for existing benefits will still receive it.

The SNP administration at Holyrood said yesterday it would have to adopt the same policy because the controversial move had left it with a £160m gap in spending power.

Mr Swinney has conceded it will impact "tens of thousands" of pensioners and "expressed concern" with Angela Rayner today.

He also reiterated his desire for an "injection of investment" in the country's public services.

But he's still hoping for a more positive relationship with the Labour government than his party had with the Tories, working together on "shared priorities" such as reaching net zero.

By Darren McCaffrey, political correspondent 

Make no two bones about it – it has been a good week on the economic news front.

Today's stellar GDP growth figures at 0.6% are in line with expectation but are also a reflection of a strong year of growth, with the UK the fastest growing in the G7 this year - although it has lagged slightly behind the US in Q2.

This - coupled with falling unemployment, wage growth and pretty stable inflation (listen to the podcast on this in the previous post) - means the macroeconomic situation has not looked this good in years.

Normally the government would be crowing from the rooftops about such good news.

Instead, the Treasury this morning continues to talk about the "scale of challenges" and being determined "to fix the foundations".

Why? Because they want to stop the Conservatives - who are unsurprisingly very frustrated - from being able to claim the last government left the country in a good state.

Politically, this is important for Labour – part of a wider strategy to thrash the Tory record, while cementing future credit for economic good news.

Despite the attempt to shape narratives, in the end voters will only really thank Labour if this stellar economic growth continues.

Inflation is up for the first time this year.   

Prices went up by 2.2% in the year to July – moving the rate above the Bank of England target of 2%.  

Experts had expected an up tick as energy prices are falling by less than they did a year ago, and the increase doesn't seem to change hope for further interest rate cuts in the months to come.

But what else can we expect from the economy this autumn as the new government continues to warn about the "challenges" it's inherited, and as the chancellor prepares her first budget in October?

Joining Niall Paterson  is our business correspondent Paul Kelso and political correspondent Darren McCaffrey . 

👉 Click to subscribe to the Sky News Daily wherever you get your podcasts 👈       

It's time for your evening bulletin from the Politics Hub - summing up the main things you need to know today:

• The foreign secretary , David Lammy, is heading to Israel for talks with the country's prime minister;
• A source described the meeting with Benjamin Netanyahu as "an attempt to prevent all-out war" in the Middle East , amid fears of an Iranian attack on Israel and talks over a ceasefire in Gaza;
• Mr Lammy described it as a "crucial moment for global security" .
• Sticking with foreign policy, and the Ministry of Defence has said it's  happy for Ukraine to be using British weapons inside Russia ;
• Sky News understands tanks supplied by the UK are also being deployed across the border  during Kyiv's surprise incursion.
• On the domestic front,  the Tories claim the chancellor will be "fuming"  after new figures showed  Britain's economy grew during the previous quarter ;
• Rachel Reeves has repeatedly bemoaned the government's economic inheritance from Rishi Sunak's administration, but  GDP is up 0.6% - higher than other major European countries ;
• And on A-level results day , the education secretary told Sky News it would be  "unpalatable" to raise tuition fees  despite the financial challenges facing Britain's universities.

That's all for now - we'll bring you any further political news and analysis over the next few hours.

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The essential guide to visiting London

Here’s what you need to know about England's capital city—when to go, where to stay, what to do, and how to get around.

Why you should visit London

Architectural landmarks such as the   Tower of London ,   Westminster Cathedral , and   Kensington Palace , as well as revived modern buildings like   Tate Modern   and the   Battersea Power Station . Some of the finest theaters in the world, from the   Old Vic   to the rebuilt   Globe . Brown ale, fish’n’chips and weekend markets from Greenwich to Camden.  

Best time to visit London

Spring : The Gulf Stream warms up the city early. Flowers start blooming in February and trees follow with their blossoms in March. The   Chelsea Flower Show   is a major draw in May.  

Summer : The tourist season peaks between mid-July and late August. Music festivals play out in   Somerset House ,   Hyde Park , and   Victoria Park .  

Autumn : Fall kicks off with the   London Design Festival , and the weather stays temperate into late October. Halloween is gaining importance throughout the city, though Guy Fawkes Night—a festival of fireworks and bonfires on November 5 – is more widely celebrated.   Battersea Park , by the Thames, has a great display.  

Winter :   Shopping streets   switch on their festive lights in early December. While some cultural life slows down during the dark, wet winter months,   Kew Gardens   launches its winter fair and skating rink. And Hyde Park hosts a   Winter Wonderland .    

Lay of the land

The Thames River, lined with grand public architecture like   St Paul’s Cathedral , the   London Eye ,   and Westminster (the seat of government), divides the city into north and south. The oldest enclaves lie to the east, around the   City of London , the old financial center also known as the “square mile.” Cultural energy revolves around   Soho ,   Covent Garden ,   Mayfair , Bloomsbury, and the   South Bank , a riverfront strip of modernist theaters and galleries.    

Historically, wealthy residents settled in West London communities like   Belgravia , Kensington, and Chelsea, gravitating to Holland Park and Notting Hill. The picturesque Georgian streets around   Hampstead Heath   have always been popular among literary types, with nature-lovers hiking up   Parliament Hill   for the city view. The neighborhood becomes more fashionable as you descend toward   Primrose Hill , with its pastel-colored townhouses and ivy-clad pub gardens.  

Younger Londoners congregate in East London, in gentrifying working-class neighborhoods like Dalston and Clapton. Postindustrial Hackney Wick has reinvented itself as a hub for live music, clubs, and inventive restaurants. Just over the River Lea is the former Olympic Park, a sports mecca that’s been rewilded and developed with museums and restaurants.  

( 11 must-do experiences in London. )

Getting around London

By public transport:   The   London Underground , or Tube, is an extensive subway network that reaches from Heathrow Airport in the west, to Greenwich, the Olympic Park, and northern suburbs. The system incorporates an above-ground network called the Overground, and the new inter-city Elizabeth Line. Fares start at £2.70 ($3.50) and rise according to distance.   London buses   follow more winding routes between neighborhoods and start at £1.75 ($2.25) with a daily cap at £5.25 ($6.75). Seniors and students 11 and over are eligible for discounts. Children 10 and under travel free. Riders can pay with any contactless card or device, but cash is no longer accepted.

By train:   Trains beyond London are found at larger stations like Paddington, Euston, Liverpool Street, London Bridge, Victoria, and Charing Cross. Riders must purchase tickets ahead of travel at the station or with an app like   Trainline .  

By taxi:   London’s famous   black cabs   can be hailed on the street or booked in advance. Typical fares start at about £7.60 ($9.75) for a mile-long journey. Minicabs, or privately run taxi services, can be booked in advance or hired from a licensed purveyor, found on most main streets. Uber operates throughout the city.    

By boat:   The   Thames Clipper   boat service, now operated by Uber, runs along the Thames between Putney, in southwest London, and Barking, in the east, stopping at Battersea, Westminster, Tate Modern, Tower Bridge, Greenwich, and other piers. Prices start at £5.60 ($7.20) one way, with discounts for children and families. Riders can pay with a contactless card or with the Uber app.

( Going underground: a subterranean tour of London's abandoned tube stations. )

By bike:   Transport for London operates the   Santander bikeshare program , with bike docks in place across the city. A day-pass costs £3 ($3.85) for unlimited 30-minute rides; payment can be made through the   app   or at a docking terminal.   Lime operates an e-bike- and scooter-share program. Vehicles are GPS-equipped and located via the   app ; prices vary.    

By car:   Only confident drivers familiar with England’s road laws should operate a private car in London. There is a daily £15 ($19.25)   Congestion Charge   in effect for most areas of central London, which must be paid on the day of travel. New   emissions rules   impose additional fees on non-compliant motor vehicles, and “ultra-low-emission zones”   (ULEZ)   make it tricky to enter some neighborhoods during the day.  

By foot:   London neighborhoods are highly walkable, but the distance between them can be vast. Most roads have sidewalks that are well populated into the night. Always look both ways before crossing, even at a green light. Traffic normally comes from the right.  

Know before you go

Diversity:   London is one of the world’s most ethnically diverse cities, with 37 percent of residents born outside London—many from South Asia, West and East Africa, Europe, and the Caribbean. Hundreds of languages are spoken here, and most neighborhoods have a mix of residents.    

LGBTQ+:   The most recent   Open For Business index   gave London a top AAA rating as a “stalwart supporter” of LGBTQ+ inclusion and equality, and its universities rank highly among gay students. Soho is, historically, the LGBTQ+ hub of the city, though gay bars pop up in several neighborhoods, notably in East London and Lambeth.  

( Best hotels for every type of travele r. )

What to read and watch

The most fascinating London-based books and films transport the reader to a specific neighborhood and historical period and focus on its rich diversity.    

Oliver Twist , by Charles Dickens. Tragic, romantic, and surprisingly funny, this classic exposed the underbelly of Victorian London and prevails on high school reading lists everywhere.  

Bridget Jones’s Diary , by Helen Fielding. The titular Jones is a sad, sardonic, desperately funny 20-something single woman working for a London publisher. The book centers on West London while the film adaptation transports most scenes to the southeast. Both will get you in the mood to explore.  

The Adventures of Sherlock Holmes , by Arthur Conan Doyle. The book series and the companion TV show Sherlock take place around Baker Street in central London but investigate further afield into Piccadilly, New Scotland Yard, and the Tower of London  

London: The Biography , by Peter Ackroyd. Possibly the greatest contemporary history of the city, the weighty tome reaches back with wisdom and wit through Victorian London to the Plague and the Great Fire.  

Brick Lane , by Monica Ali. This instant classic, published just after the millennium, is an evocative peek into the lives of Bangladeshi immigrants in East London, based firmly in reality.  

Notting Hill , written by Richard Curtis of Four Weddings and a Funeral (and others), this 1990s hit comedy capitalized on the vulnerable charm of Hugh Grant—and the undeniable charm of bohemian London—and inspired generations of tourists to seek out that blue door.  

Rye Lane . Set around the eponymous market in Peckham, South London, this post-Covid romance begins with a meet-cute in   an   gender-neutral   bathroom.  

My Beautiful Launderette . An enduring favorite that introduced a young Daniel Day-Lewis to the world, this romance by Hanif Kureishi was set in South London during the Thatcher years and emerged as one of the first “queer fairytales” to reach a wide audience.

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Rape and murder of doctor in hospital sparks protests in India

Early on Friday morning, a 31-year-old female trainee doctor retired to sleep in a seminar hall after a gruelling day at one of India’s oldest hospitals.

It was the last time she was seen alive.

The next morning, her colleagues discovered her half-naked body on the podium, bearing extensive injuries. Police later arrested a hospital volunteer worker in connection with what they say is a case of rape and murder at Kolkata’s 138-year-old RG Kar Medical College.

Tens of thousands of women in Kolkata and across West Bengal state are expected to participate in a 'Reclaim the Night' march at midnight on Wednesday, demanding the "independence to live in freedom and without fear". The march takes place just before India's Independence Day on Thursday. Outraged doctors have struck work both in the city and across India, demanding a strict federal law to protect them.

The tragic incident has again cast a spotlight on the violence against doctors and nurses in the country. Reports of doctors, regardless of gender, being assaulted by patients and their relatives have gained widespread attention. Women - who make up nearly 30% of India’s doctors and 80% of the nursing staff - are more vulnerable than their male colleagues.

The crime in the Kolkata hospital last week exposed the alarming security risks faced by the medical staff in many of India's state-run health facilities.

At RG Kar Hospital, which sees over 3,500 patients daily, the overworked trainee doctors - some working up to 36 hours straight - had no designated rest rooms, forcing them to seek rest in a third-floor seminar room.

Reports indicate that the arrested suspect, a volunteer worker with a troubled past, had unrestricted access to the ward and was captured on CCTV. Police allege that no background checks were conducted on the volunteer.

"The hospital has always been our first home; we only go home to rest. We never imagined it could be this unsafe. Now, after this incident, we're terrified," says Madhuparna Nandi, a junior doctor at Kolkata’s 76-year-old National Medical College.

Dr Nandi’s own journey highlights how female doctors in India's government hospitals have become resigned to working in conditions that compromise their security.

At her hospital, where she is a resident in gynaecology and obstetrics, there are no designated rest rooms and separate toilets for female doctors.

“I use the patients’ or the nurses' toilets if they allow me. When I work late, I sometimes sleep in an empty patient bed in the ward or in a cramped waiting room with a bed and basin,” Dr Nandi told me.

She says she feels insecure even in the room where she rests after 24-hour shifts that start with outpatient duty and continue through ward rounds and maternity rooms.

One night in 2021, during the peak of the Covid pandemic, some men barged into her room and woke her by touching her, demanding, “Get up, get up. See our patient.”

“I was completely shaken by the incident. But we never imagined it would come to a point where a doctor could be raped and murdered in the hospital,” Dr Nandi says.

What happened on Friday was not an isolated incident. The most shocking case remains that of Aruna Shanbaug , a nurse at a prominent Mumbai hospital, who was left in a persistent vegetative state after being raped and strangled by a ward attendant in 1973. She died in 2015, after 42 years of severe brain damage and paralysis. More recently, in Kerala, Vandana Das, a 23-year-old medical intern, was fatally stabbed with surgical scissors by a drunken patient last year.

In overcrowded government hospitals with unrestricted access, doctors often face mob fury from patients' relatives after a death or over demands for immediate treatment. Kamna Kakkar, an anaesthetist, remembers a harrowing incident during a night shift in an intensive care unit (ICU) during the pandemic in 2021 at her hospital in Haryana in northern India.

“I was the lone doctor in the ICU when three men, flaunting a politician’s name, forced their way in, demanding a much in-demand controlled drug. I gave in to protect myself, knowing the safety of my patients was at stake," Dr Kakkar told me.

Namrata Mitra, a Kolkata-based pathologist who studied at the RG Kar Medical College, says her doctor father would often accompany her to work because she felt unsafe.

“During my on-call duty, I took my father with me. Everyone laughed, but I had to sleep in a room tucked away in a long, dark corridor with a locked iron gate that only the nurse could open if a patient arrived,” Dr Mitra wrote in a Facebook post over the weekend.

“I’m not ashamed to admit I was scared. What if someone from the ward - an attendant, or even a patient - tried something? I took advantage of the fact that my father was a doctor, but not everyone has that privilege.”

When she was working in a public health centre in a district in West Bengal, Dr Mitra spent nights in a dilapidated one-storey building that served as the doctor’s hostel.

“From dusk, a group of boys would gather around the house, making lewd comments as we went in and out for emergencies. They would ask us to check their blood pressure as an excuse to touch us and they would peek through the broken bathroom windows,” she wrote.

Years later, during an emergency shift at a government hospital, “a group of drunk men passed by me, creating a ruckus, and one of them even groped me”, Dr Mitra said. “When I tried to complain, I found the police officers dozing off with their guns in hand.”

Things have worsened over the years, says Saraswati Datta Bodhak, a pharmacologist at a government hospital in West Bengal's Bankura district. "Both my daughters are young doctors and they tell me that hospital campuses in the state are overrun by anti-social elements, drunks and touts," she says. Dr Bodhak recalls seeing a man with a gun roaming around a top government hospital in Kolkata during a visit.

India lacks a stringent federal law to protect healthcare workers. Although 25 states have some laws to prevent violence against them, convictions are “almost non-existent”, RV Asokan, president of the Indian Medical Association (IMA), an organisation of doctors, told me. A 2015 survey by IMA found that 75% of doctors in India have faced some form of violence at work. “Security in hospitals is almost absent,” he says. “One reason is that nobody thinks of hospitals as conflict zones.”

Some states like Haryana have deployed private bouncers to strengthen security at government hospitals. In 2022, the federal government asked the states to deploy trained security forces for sensitive hospitals, install CCTV cameras, set up quick reaction teams, restrict entry to "undesirable individuals" and file complaints against offenders. Nothing much has happened, clearly.

Even the protesting doctors don't seem to be very hopeful. “Nothing will change... The expectation will be that doctors should work round the clock and endure abuse as a norm,” says Dr Mitra. It is a disheartening thought.

Inside India's first heat stroke emergency room

India's covid doctors demand action after attacks.

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‘Racism absolutely must not be tolerated’

STEVE FORD, EDITOR

• You are here: Leadership

New chief nurse for NHS London named

08 August, 2024 By Gemma Mitchell

Highly regarded nursing leader Karen Bonner has been appointed the new regional chief nurse for NHS London.

Ms Bonner, who is currently chief nurse at Buckinghamshire Healthcare NHS Trust, will take up the new post at the end of 2024.

"The chance to lead vital work to improve the health of the millions of people who live and work in this city is incredibly motivating" Karen Bonner

She is taking over from Jane Clegg, who is retiring at the end of the year after a 40-year career in nursing and health visiting.

A nurse for 30 years, Ms Bonner has spent most of her career in London, gradually working her way up through the nursing ranks over the past three decades.

She has worked for several trusts in the city including Chelsea and Westminster NHS Foundation Trust, Guys and St Thomas NHS Foundation Trust and Imperial College Healthcare NHS Trust.

As someone whose parents came to the UK as part of the Windrush generation, Ms Bonner has built a reputation for being a champion of diversity, equality and inclusion .

In 2023, to mark the 75 th anniversary of the NHS, Nursing Times recognised Ms Bonner as one of the 75 nurses who have made a significant positive impact on the health service since its creation .

Meanwhile, in the 2024 King's birthday honours , Ms Bonner was made a Member of the Order of the British Empire (MBE) for services to nursing.

Commenting on her new appointment, Ms Bonner said: “I live in London and was born in London – the chance to lead vital work to improve the health of the millions of people who live and work in this city is incredibly motivating.

“While the opportunities ahead of us to do this are huge, I’m also clear that this new role is an opportunity to really focus on the nursing and midwifery profession.

“I look forward to working with a broad range of partners and others across London to improve care, continue to develop our profession and champion the wonderful nurses, midwives and many other professionals in London.”

“Our vision is that London is the best global city in which to receive health and care services" Caroline Clarke

The chief nursing officer for England, Duncan Burton, is among those who have welcomed her selection.

Writing on social media platform X, Mr Burton said he was “delighted” about Ms Bonner’s appointment.

She was also publicly congratulated by Helpforce, an organisation which seeks to boost volunteering in health and social care, for which she is a trustee.

Caroline Clarke, regional director for NHS London, said: “We are thrilled to welcome Karen and know that her experience, focus on patients and collaborative approach will offer strong nursing leadership for the capital.

“Our vision is that London is the best global city in which to receive health and care services.”

Ms Clarke also paid tribute to outgoing regional chief nurse Ms Clegg.

She said: “I also want to take this opportunity to thank Jane Clegg for the expertise and passion she has brought to this role, working tirelessly to improve the health and healthcare of Londoners, including during the Covid pandemic.”

Related articles 

• NHS 75: Making an impact – Karen Bonner
• High profile diversity champion secures first nursing director job
• Minority ethnic nurses urged to consider chief nurse jobs
• Nursing director damehood among King’s birthday honours
• ‘I am proud to be a nurse working in the NHS’
• Other Nursing Times articles on nursing leadership
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Where to Stay in London: Our Editors' Favorite Neighborhoods

A London getaway is always exciting—take it from someone who has lived here for a decade—but first, you must decide the best area to stay in London for you. Do you want to be in the center of the capital, close to the action and the best things to do in London , or a little further out in a more peaceful location? Is it important to be close to public transport options, major train stations such as King's Cross, or iconic cultural landmarks like the Natural History Museum? Or perhaps you'd rather stay in one of the best neighborhoods in London to get under the skin of life like a local? Thankfully, whatever version of London you're interested in experiencing—foodie London, arty London, cultural London, or iconic London—there'll be world-class hotels to book as your base. But we get it—as one of Europe's biggest and busiest cities, it can be overwhelming when you need to decide where exactly to stay. Below we've listed our favourite areas of London for every type of traveler.

Where to stay in London at a glance

• For culture seekers
• For shoppers
• For foodies
• For families

Best for: culture seekers

Covent garden.

In London's West End, Covent Garden's central square was once a fruit and vegetable market. These days, it's home to shops and restaurants that draw in tourists every day of the week – but that's not the only draw here. This is the heart of theatreland, making it an ideal choice for those hoping to catch a show while in town, as well as where you'll find the Royal Opera House. Once a bit of a culinary wasteland, the food scene here is thriving these days—we especially like The Barbary, with its Mediterranean sharing plates concept, and Toklas, a bakery-meets-restaurant.

Why we like it:

• There's arguably no better location in London when it comes to getting around on foot
• Cultural icons such as the Royal Opera House and Covent Garden Market are right outside your hotel
• You're close to London's best theaters
• There's a buzz in this pretty neighborhood every day of the week

Where to stay

• NoMad London , New York swagger meets punchy period drama
• Henrietta Experimental , a cute boutique hotel
• The Savoy , one of the most iconic places to stay in London

Getting around

The best tube stations are Covent Garden and Leicester Square.

Best for: shoppers

Many come to London just to shop—if that's you, Mayfair is your best bet for a base. In this affluent neighborhood right in the centre of London, you're within walking distance of Bond Street, where you'll find all the big-name designers, as well as close to Regent Street and Oxford Street for a more casual shopping experience. Mayfair is home to some of London's best hotels, and, in recent years, restaurants too—book tables at Michelin-starred HUMO, Japanese spot KOYN or the arty Mount St. Restaurant to sample the best of it.

• Some of London's iconic places to stay are in this neighborhood
• Pretty architecture and well-groomed gardens abound
• You're right in the centre of central London, so getting around is a breeze
• Mayfair's restaurant scene is on a roll
• You're within walking distance of some of our favourite London areas such as Soho

• Claridge's , one of London's most legendary luxe hotels
• 1 Hotel Mayfair , an eco-focused modern stay
• The Twenty Two , Edwardian manor house turned 31-room hotel

The best tube stations in Mayfair are Green Park and Bond Street.

Best for: foodies

If you had to ask us which neighborhood in London had the best food and drink scene, it'd be a tough decision between Soho, in central London, and Shoreditch, out east. In this neighborhood, you'll find some of London's very best restaurants , such as Brat, The Clove Club, and Lyle's. We'd choose Shoreditch as a base not only because of its thriving restaurant scene but also because of the excellent hotel options and the cool, artsy vibe that the neighborhood has managed to retain despite years of gentrification.

• Being based in East London opens up some of London's best neighborhoods such as Hackney Wick, Dalston, and more
• You'll find some of London's best restaurants and bars here
• While no longer an edgy part of the capital, Shoreditch has a younger, cooler atmosphere – with street art, great bars and galleries – than many other top areas to stay in London
• One Hundred Shoreditch , with its cool rooftop bar and underground cocktail den
• The Hoxton , a cozy, chic stay for creatives
• Nobu Hotel London Shoreditch , a sleek hotel from the Japanese powerhouse group

Best for: families

If you're visiting with the whole family—whether you've got little kids or teenagers to entertain—access to London's (many) parks is vital. Hyde Park, one of London's royal parks, is right in the centre of London in Zone 1, set between well-heeled Knightsbridge and Green Park. Here, you're close to some of London's most iconic sites, like Buckingham Palace, as well as within touching distance of neighborhoods such as Mayfair, Belgravia, and Kensington. Plus, of course, you have the park itself to run riot in.

• Access to acres of green space, playgrounds and more within Hyde Park
• Close to central London for sight-seeing
• Great for families staying during events such as Winter Wonderland
• The Peninsula, London , a glassy, glossy new opening from the Hong Kong-based brand
• The Emory , London’s first all-suite hotel
• The Berkeley , a classic grand dame
• Mandarin Oriental Hyde Park , a hotel with historic charm that's undergone a modern makeover

The closest tube station to Hyde Park is Hyde Park Corner, on the Piccadilly line.

A version of this story originally appeared on Condé Nast Traveller.

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Russia: Insufficient Home Services for Older People

Gaps in Services Create Risks for Institutionalization, Violate Rights

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(Moscow) – The Russian government is not providing adequate resources for home-based services for older people , denying some of them the ability to live independent and dignified lives, Human Rights Watch said today.

Despite legislative reform to enhance these services, their funding and delivery appear to be inadequate to meet the needs of older people in Russia. Insufficient services may leave older people with little choice but to live in a nursing home or other institutional setting, rather than guaranteeing their right to live where and with whom they choose within their community.

“There are significant gaps in the services the Russian government provides to older people at home,” said Jane Buchanan , deputy disability rights director at Human Rights Watch. “When older people in Russia don’t get the support they need, they risk having to decide between living in an institution or in undignified conditions at home. This is a decision no one should have to make.”

With its aging population growing, Russia has taken positive steps toward reforming services for older people. In 2013, Russia passed a law to ensure that older people have access to a broader range of home services. Services can include personal support assistance such as delivery of groceries, payment of bills, food preparation, personal hygiene, or medical services, emergency services, or mental health services.

The law, which entered into force in 2015, says that services should be tailored to an individual’s needs with the goal of enabling older people “to remain in a familiar and positive living environment.”

However, Human Rights Watch’s interviews with 20 older people in Pskov and Sverdlovsk regions, as well as with experts and advocates in various parts of Russia, suggest that despite reform efforts, services often do not go far enough to meet the needs of older people to allow them to live at home with dignity.

Under the law, financing and delivery of home-based services is the responsibility of regional governments. Experts and advocates said that funds were often insufficient to cover the real need for home services, rendering the 2013 law ineffective. Social workers, whose jobs include delivering home-based services to older people, often have heavy caseloads that do not allow them to provide comprehensive services, even if provided for by regional or federal norms. In most cases Human Rights Watch examined, social workers were unable to carry out services beyond delivery of food and medicine.

A 93-year-old woman in Sverdlovsk region, who broke her leg two years ago has pain that makes walking or bending it difficult, said that a social service worker visits her twice a week, primarily to deliver groceries and tidy her apartment. But the woman said that she cannot get into the bathtub without help, rarely eats cooked meals, and receives few visits other than from the social worker.

“I don’t leave my apartment,” she said, crying. “I would love to… Two winters I have not been able to go anywhere. I sit here like I am in prison.” Three social workers interviewed said that they each assisted 16 to 19 people a week. Because of that workload, they said, they were unable to spend more than an hour two or three times per week with a client, and typically could only provide the least time-consuming services such as delivering groceries, firewood, water, or taking out the garbage and paying bills.

Social workers said that if a person had higher support needs and required more assistance, such as with cooking, eating, or personal hygiene, they could only ask relatives for help, pay for services, or move to an institution.

The law also requires older people or their legal representative to request services, meaning that unless older people get adequate information about entitlements, they may not be able to get the support that is available. According to Russian government statistics , Russia had 37.3 million people over the government pension age , 60 for women and 65 for men (approximately 25 percent of the population) as of January 2020, up from 20.4 percent increase in 2005. The percentage of older people is expected to continue growing in the coming years.

The Russian government spends significantly less for home-based support services than for institutional living costs: according to government statistics, average spending per person in a nursing home is 35,000 rubles (approximately US$472) a month and 34,095 rubles (US$460) in a psychoneurological institution (PNI), compared with an average of 5,889 rubles (US$79) for home-based services.

More than 278,000 people live in state-run residential institutions for older people and people with disabilities in Russia, but there is no publicly available government data on how many of them are older people. Journalists and advocates have reported extensively on the abuses in these institutions, including inappropriate use of psychotropic medication to control behavior, inadequate medical care, and denial of legal capacity.

The Russian government is collaborating with non-profit organizations to improve and expand the delivery of home-based services in pilot programs in 24 regions, with the goal of eventually expanding those reforms throughout the country. The federal government has allocated 1.8 billion rubles (US$24.8 million) from the federal budget for this and related initiatives each year from 2021 to 2023. Human Rights Watch did not assess the effectiveness of the pilot projects.

However, advocates said that the reform’s success in any given region still largely depends on the financial commitments and interest of regional governments, which means the availability of services varies across regions, sometimes significantly. They also said that longer-term federal funding and legislative reform were crucial to making reforms sustainable.

The Russian Constitution and national laws guarantee the right to health and social security to secure conditions for a dignified life. Russia also has obligations under international law to ensure the rights to an adequate standard of living and to physical and mental health. It should also protect the right of people with disabilities, including older people with disabilities, to live independently in the community with support.

The Russian government should ensure that all older people receive the support they need to live at home, if that is their choice, with dignity and autonomy. It should ensure that regional governments have sufficient funds to provide adequate support services on a long-term basis and improve and standardize training of social workers and other service providers where needed.

Federal and regional governments should improve and expand the types and availability of social services provided to older people and take measures necessary to ensure that sufficient numbers of social workers are available to provide support services for as much time as required. The government should also require service providers to do more outreach to older people to inform them about available services to ensure that those most in need of support can get them.

“Russia has taken important steps toward improving home-based support for older people, but there is a risk that those reforms will exist only on paper if they are not accompanied by better financing and more regulatory reform,” Buchanan said. “The Russian government should increase funding for reform efforts and ensure that older people can fully enjoy their right to live at home with dignity.”

For additional details and accounts by those interviewed, please see below.

Methodology

Between December 2019 and March 2020, Human Rights Watch conducted in-person interviews with 20 people between the ages of 60 and 93 in Pskov and Sverdlovsk. Human Rights Watch also interviewed three social workers and two relatives of older people in those regions. Between December 2019 and July 2021, Human Rights Watch conducted both in-person and remote interviews with 14 experts, advocates for the rights of older people, including those directly involved in reforming long-term care, and journalists.

Human Rights Watch also reviewed laws, regulations, statistics, and policies that pertain to older people and home-based services at both the federal and regional level. Older people and their relatives are identified with pseudonyms to protect their privacy. The research did not include documenting conditions in residential institutions.

On July 19, Human Rights Watch sent questions to the Ministry of Labor and Social Protection of the Russian Federation, the Pskov Regional Committee for Social Protection, and the Sverdlovsk Regional Ministry of Social Policy.

In a July 29 letter to Human Rights Watch, the Pskov Regional Committee provided its official website address and said that any information not published on it is “for internal use only and is not public.” The letter provided no further information. The other agencies have not yet responded.

Institutional Settings for Older People

Russia’s changing demographics have prompted the government to reform its policies for long-term care. The changes include increasing the support and services available to older people, increasing the participation of nongovernmental organizations in delivering services to people at home, and increasing access to medical services for older people.

As of January 2020, 278,900 people lived in the country’s 1,249 state-run residential institutions. Of these, 78,500 people live in residential institutions for older people and people with disabilities, nursing homes, while 157,500 live in psychoneurological institutions (PNIs) for people with psychosocial, developmental, and intellectual disabilities, and a smaller number in small group homes or gerontological centers.

Maria Sisneva, director of the advocacy group Stop PNI, said that the government does not publish data on ages of people living in residential institutions. She estimates that the average number of older people in PNIs has increased in recent years, typically making up 30 to 50 percent of residents. Advocates and experts told Human Rights Watch that older people in PNIs are most frequently segregated in so-called “mercy wards,” highly restricted parts of the facility for people who are deemed to have higher physical or psychosocial support needs.

Experts say that there is also a growing number of private nursing homes. While some are registered, registration is not required, and those that remain unregistered have virtually no government or independent oversight. In 2020, some experts estimated the number of beds in unregistered private nursing homes to be as high as 30,000. Media outlets have reported on numerous fires and other deadly incidents in private, unregistered nursing homes.

Media reports and advocates say that residential institutions for older people and people with disabilities in Russia are rife with human rights abuses. Psychoneurological institutes widely employ chemical restraint, the use of medication, particularly psychotropic drugs, to control behavior without a therapeutic purpose, and physical restraints, for example tying a person to a bed or other furniture to restrain them. And they provide poor quality medical treatment and very little physical or cognitive rehabilitation of any kind.

These institutions often lack sufficient transparency to allow more effective monitoring to prevent abuse. Organizations including Human Rights Watch have documented that many PNI residents have been stripped of their legal capacity by a court, in many cases without being in the courtroom, as Russian and international law require. In many cases, the institution itself assumes legal guardianship, making it even harder for residents to report abuse.

Staff ratios are typically extremely low, with advocates and journalists citing an approximate ratio of one staff person to 20 to 30 residents, many of whom have high support needs.

Advocates who have visited institutions said that older people in these institutions were rarely dressed in anything but a hospital gown, and typically remained in their beds all day, including for meals.

“[Staff] at least organize concerts and dances for the younger people, but older people [in the PNIs] are simply living out their days,” Sisneva said. “They are not given anything to do.”

Advocates and experts say that the situation in nursing homes, where most older adults are not under guardianship, was typically not as dire as in PNIs, but a lack of transparency and low staffing ratios often led to human rights violations, including the inappropriate use of psychotropic drugs to control behavior, inadequate or inappropriate medical treatment, and lack of sufficient support and engagement.

The Covid-19 pandemic highlighted the lack of transparency: the government did not publish regular and timely information about nursing home infections and deaths despite widespread accounts by media outlets and advocates about the spread of the virus.

A Human Rights Watch investigation into Russian institutions for children with disabilities in 2014 found numerous rights violations, including physical and psychological violence, neglect, poor nutrition, lack of health care, and the use of physical and chemical restraints, among other abuses.

Gaps in Home Services for Older People

Many older people Human Rights Watch interviewed said they did not want to live in a nursing home or PNI and preferred to live in their own homes. Two had lived in a nursing home but had decided instead to live in the community. But interviews with older people, advocates, and experts indicated that in some places, government-subsidized support services are insufficient to support older people living in the community, particularly those without relatives or others able to provide support.

The government began an effort to reform support services with Federal Law 442 On the Foundations of Social Services for Citizens of the Russian Federation . The law, which entered into force in 2015, applies to those who have “fully or partially lost the ability or opportunity to care for themselves, to move about independently, or to provide for their basic needs due to illness, injury, age, or disability.” In contrast with previous regulations, the new law called for both home and institutional service providers to create an “individualized program” to support the needs of older people and people with disabilities.

Under the law, home-based services include, among other things, personal assistance, emergency assistance, socio-medical assistance, such as administering medication or assisting with injections, and socio-psychological support, such as counseling or other psychological services. While all these services can be crucial to independent living, Human Rights Watch focused on access to personal assistance, which according to Russian government statistics is the service that older people use most frequently.

The legal framework for determining eligibility is based on financial means, which can be problematic, Human Rights Watch found. Under the law, the government must cover the costs of services for those who fall below a certain financial eligibility threshold, which differs among regions. People with incomes above that threshold must partially or fully pay for services. Income is calculated on a household basis, meaning the income of any family members living with the older person is taken into consideration. Government guidance encourages service providers to prioritize providing free services to older people who live alone.

But determining eligibility for free services based on family income assumes that the older person will have access to an adequate share of that income, which may not be the case. It can also reinforce or create situations in which older people are dependent on family members financially and for assistance, rather than treating the older people as individual, autonomous rights holders. Instead, the government should determine eligibility for free services based on individual income, Human Rights Watch said.

Older people, social workers, and advocates said that older people often do not receive home-based services that allow them to live in the community comfortably and with dignity. They said that social workers most frequently provide only very basic services such as delivering groceries and medicine and, in rural areas, firewood and water, or help with paying bills. But if an older person requires more support, such as with hygiene, cooking, eating, or assistance leaving the house, the government often does not provide these services.

“Nikolai P.,” 70, who lives alone in an apartment in Pskov region, had his first stroke in the late 1990s. He has limited use of his legs and one arm and can stand for only brief periods while using his stronger arm to support himself with a cane. A social worker visits him briefly three times per week to deliver groceries and firewood. But since he is over the regional income threshold, he has to partially pay for services. He said he was unable to afford some services that he needs, such as for preparing meals.

“I almost never [eat a cooked meal],” he said.” Sometimes I boil some pelmeni [dumplings], but it’s difficult to stand. How can I simultaneously stir the pot and hold myself up with one leg? If I were a tightrope-walker maybe I would be able to balance on one leg like that.”

He pays the social worker 1,400 rubles (US$19) monthly to deliver groceries, dispose of garbage, and help pay bills. “I need more services,” he said. But if he paid more out of his monthly pension of 19,000 rubles (US$257), he said, after he pays for utilities, food, and other necessary goods, he would have difficulty buying medicine, on which he spends 5,000 rubles (US$67) per month. “[The social worker] just told me to pay, or nothing. They told me to hire somebody myself, because ‘These are our rates.’”

“Elizaveta N.,” 84, who lives in Sverdlovsk region and is now blind, remained active until her late 70s and had sufficient eyesight to confidently leave her apartment by herself until 2018. Her daughter and son live in Moscow. Her grandson lives in the same city as she does and has three young children and a business, leaving him little time to help her. Her social worker visits twice a week to deliver groceries and medication, and to take out the garbage. The social worker vacuums twice a month.

“I could do with some walks [outside]... She [the social worker] doesn’t have time. She has to look after 18 people, that’s nine people per day,” she said. Responding to a question about how her life had changed due to the lack of sufficient services to support her, she said, “I’m socializing less, there are fewer calls, I rarely go out.”

The social workers told Human Rights Watch that if an older person required a higher level of support, they often were forced to go to a nursing home if they did not have relatives who could or would support them.

A social worker in Pskov region described one client who had had a stroke:

“She had difficulty moving around and she could talk, but [with difficulty]. She lived in a free-standing house and would have had to be visited every day so they could heat the stove, bring firewood, and bring water. She couldn’t even walk… If she at least was walking it would have been possible [to live independently at home]. But if a person is bedridden, there is no other option [than a nursing home].… They don’t want to go [to a nursing home] but need forces them to.”

Regional Disparities in Financing, Standards

Experts and advocates said that a major problem for expanding home-based services is the fact that they are largely financed and regulated by regional governments. The federal government creates a model list of personal assistance services that must be provided, including delivery of groceries, firewood, and other goods, help preparing food, help paying bills, and cleaning services. But regional governments are then responsible for determining the final list, and the rates, frequency, and duration, as well as oversight, setting staff workload, and funding.

Russia has high levels of regional inequality compared with countries with similar economies, and home-based services therefore may differ widely from region to region due to budgetary discrepancies. Experts said that regions cut back on spending by limiting the frequency or amount of time a social worker is allowed to spend on providing services.

“The trick is that the standards for delivering social services are set by the regions,” said one expert familiar with the home-based service system. “The standards establish the quality and frequency of the services. For example, they may say, ‘At most two times per week.’ But this means that vital needs are not covered. Regions do this because they do not have enough money.”

Regional regulations outlining caps on services indicate that it would most likely be difficult for an older person with high personal support needs to remain in their home, particularly without significant additional private or family assistance. In St. Petersburg , for example, regulations recommend that social workers can change a person’s diapers and feed them only 156 times a year.

In Pskov region , clients in houses without running water can receive only seven liters of water a month. In Khabarovsk region, social workers can support people unable to eat on their own to eat meals only twice a week. In contrast, in Moscow, city authorities said that eligible older people have a right to up to five hours of personal assistance at home per day.

Social Workers’ Workload, Training Needs

According to Russia’s state statistics office , the number of social workers in the country decreased from 172,526 in 2013 to 135,983 in 2017. The average number of clients a social worker serves increased, from 6.5 a day in 2011 to 8.4 in 2017. Social workers interviewed said that as a result, they had only limited ability to take on extra tasks for clients with higher support needs. This undermines their capacity to deliver on the federal law’s requirements for an individualized approach to supporting older people.

“[The individual plans] are more or less all the same,” said a social worker in the Pskov region. “It’s groceries, payment [for utilities], and other things like bringing them newspapers or medicine. In theory, there are a lot of services, but I just [can’t] do some things. I say right away that I can’t cook for them, wash floors, or clean. If they want that, they have to hire somebody or ask a neighbor. When would we have time for this?”

A social worker in Sverdlovsk region said, “I mostly bring groceries. Sometimes I cook for them but it’s not like I can spend three hours cooking meat, I can just boil them some [frozen] dumplings or make some tea. People can be visited twice per week, five times per week if they want. But never for more than an hour.”

“Social workers [in Russia] do not deliver support services, they primarily deliver groceries,” said Irina Grigorieva, a professor of sociology who researches aging at St. Petersburg State University. While federal statistics were not available on the quantity of each type of service distributed, some regional government data indicates that grocery delivery takes up most of social workers’ time. In Moscow , for example, delivering groceries and other key goods made up 60 percent of services.

Experts also pointed to the lack of federal training standards for social workers, which, when compounded with the large number of people they are expected to assist, meant they are often ill-equipped to take on the more complex support services.

“In Russia there is no system for training social workers, more than half of the regions don’t have access to social services training,” said another expert involved in long-term care reform. “Social workers have very low motivation. They need to reach as many people as possible and so they take ‘easy’ [cases], rather than more ‘challenging’ ones.”

The social worker in Sverdlovsk region echoed this in her comments about working with people with intellectual disabilities such as dementia: “We don’t take those [people]. … They should hire a home aide, there are no state home aides, that’s not our job.”

Asked what could be done to improve quality of assistance for people at home, she said, “We need fewer clients so that the quality of support would be higher, and also less paperwork… If the ‘lying down’ clients [those who cannot walk] had home aides, and I only had 12 clients, that would be quite manageable.”

Some regions appear to have taken positive steps toward ensuring that social workers have more capacity to support the needs of older people. According to the Moscow city government, all grocery delivery and utility payments were outsourced to professional companies as of January 2020, which allowed social workers more time for other tasks. A June 2020 news release said that “a number of services, previously provided only for a fee can now be provided free of charge (apartment cleaning, changing bed linens, accompanying [an older person] for a walk, etc.).”

Regions participating in the pilot programs to improve and expand at-home services have also passed relevant legislative amendments to, for example, increase cooperation between healthcare and social protection systems, tailor social service programs to individual needs, and expand the types of home-based services available.

Lack of Information for Older People and Family Members

Human Rights Watch interviewed older people and family members who seemed unaware of the existence of state-provided home services or believed they were ineligible, particularly if they lived in more remote rural areas. They expressed little trust in the government to provide such services and were wary of involving social workers rather than family members or neighbors in helping them.

Federal Law 442 states that social services should be delivered on a “declarative” basis, meaning a person in need of support (or their representative) must reach out to the local provider to request services. Advocates and experts have lobbied for an alternative system in which social workers, medical professionals, or others would identify or seek out those in need of support and connect them with the relevant services.

A social work expert said that in some cases social workers do reach out proactively to find in need of these services. The expert said this was typically related to the need to fill government quotas rather than an effort to comprehensively assess need in a given area: “Each locality has a quota, or a set number of clients whom social workers should be supporting, and for most part [this number] does not change. When people die, they [social workers] go looking for people to fill the rolls.”

“Alexander” and “Svetlana” O., 83 and 82, respectively, worked on a collective farm in a remote village of Pskov region until their retirement. Due to work-related injuries and arthritis, both can only walk for brief periods with the help of a cane. Walking and standing are painful. Their great-grandson, who is in the 10th grade, brings them firewood and water. They have never requested government assistance. When asked why, Svetlana said, “Who [would we ask]? You can’t get it. Who wants to travel out to us? [Look at] the road.”

“Anastasia F.,” 60, in Pskov region, has diabetes which has left her unable to walk without a cane. In 2019, she lived on a pension of 8,806 rubles (US$120) per month, which was the minimum pension in Pskov at that time, making her eligible to receive free services. However, she said that she feared involving the state in her life because she is currently responsible for her 15- and 16-year-old nephews while their father, her brother, is in prison, and she did not want to risk having social services remove them from her care. “I’m afraid to complain anywhere,” she said.

Relatives of older people similarly expressed disbelief that the government would provide adequate support services, or simply did not know that such services existed.

For example, “Agafya L.,” 60, supports her 95-year-old stepfather, who is blind, full-time. When asked if she had considered reaching out to the government social services provider for help, she said, “Older people, myself included, don’t know where to reach out to for help… I have been caring for him for five years, and these are blacked-out… years of my life. I can’t sleep. I don’t have any days off.”

“Lydia P.,” 50, in Pskov region, supports her 80-year-old father, who has dementia, limited mobility, and needs help with personal hygiene and eating. She also cares for two adopted children, including one with a disability. When asked whether she would consider reaching out for state support for her father, she said, “From where? Nobody is interested. I know that because of my own experience with social workers [for the adopted children] … I understand perfectly well that if they won’t help a child, why would they help an older person?”

Older people and their relatives also expressed a fear of stigma associated with seeking services, expressing a perception that those who received help from the state were often those whose children or relatives did not care sufficiently about them to help. The social worker in Pskov region said, “Let’s say their son doesn’t help them, they are embarrassed. They don’t want to admit that they need help.”

“Polina Z.,” 80, in Pskov region, has severe asthma and is limited in her ability to take care of her home. When asked whom she would ask for help, she said, “I would reach out to my children, there’s nobody else.”

International and Russian Law

Older people with disabilities have the right to live independently in the community and to home and community-based support under the Convention on the Rights of People with Disabilities (CRPD), which Russia ratified in 2012. Support includes “access to a range of in-home, residential, and other community support services, including personal assistance necessary to support living and inclusion in the community, and to prevent isolation or segregation.” These supports should be available to anyone with a disability on an equal basis, meaning it should not depend on the level of support a person requires.

The Russian Federation is also a party to the International Covenant on Economic, Social and Cultural Rights, by which it has undertaken to realize the right of everyone to social security; an adequate standard of living, including adequate food, clothing, and housing; and the highest attainable standard of physical and mental health. To realize these rights, governments should determine the nature and scope of problems, adopt properly designed policies, and ensure the relevant budget support.

The Russian Constitution provides for the right to “social security guarantees,” “state support to older people and people with disabilities,” and the right to health and medical assistance.

Under Federal Law 442 , social services should be “based on human rights and respect for individual dignity, humane, and not denigrate a person’s honor or dignity.” The law calls for services to be delivered without regard for sex, race, age, nationality, language, or place of residence. Services should be located near the users of the service; be sufficient to meet the needs of citizens; and have sufficient financial, technical, personnel, and other resources. The stated goal of the law is to allow for people “to remain in a familiar and positive living environment.”

Enabling people to live with dignity and as full members of society goes beyond meeting basic survival needs. While some regions are attempting to provide some support for older people’s access to social and public spaces and participation in the community, for example a companion when visiting theaters and organizing physical and cultural activities, these services are limited and not available across all regions.

To ensure that older people have access to support services that enable their participation in society on an equal basis with others, such services should be included on the federal government’s minimum list of services. Older people should be involved in the design of these services so they can determine what aspects of life and society they wish to participate in.

Federal Law 181 On Social Protection of People with Disabilities in Russia entitles people with disabilities who require assistance to medical and household services at home and in residential facilities. Under the law, social protection for people with disabilities is aimed at ensuring their equal participation in public life.

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