Urgent investment in district nursing needed

New figures have shown that the number of district nurses working in the NHS in England has dropped by almost 43 per cent in the last 10 years.

A new report, jointly published by Queen’s Nursing Institute (QNI) and the Royal College of Nursing, has stressed that there are now only 4,000 district nurses providing care for a population of around 55.8 million people.

With the NHS aiming for more nursing care to be delivered in the community and in people’s homes, and the NHS Long Term Plan identifying district nursing services as crucial to delivering these aims, the report says urgent investment and training is needed to make that vision a reality and meet the challenges caused by simultaneous rising patient demand and falling numbers of highly-qualified district nursing staff.

The tow organisations also warn that district nurses are working to capacity and unable to provide consistent high-quality care due to pressures on their service. The profession faces serious recruitment and retention challenges with an older workforce and insufficient qualified nurses to replace those who retire.

Crystal Oldman, chief executive of the QNI, said: “This new joint report illustrates the central position of the District Nurse as the key professional in delivering outstanding healthcare to people in the home and the community. Working with GPs and other members of the multidisciplinary team, district nurses have the knowledge and skills to support people living with complex long term conditions to manage their own health and avoid unplanned hospital admissions.

“Conversely, lack of investment in the District Nursing service leads to greater strain on other parts of the health service, including GP practices and hospitals. With a rising and ageing population, many of whom are living with multiple long term conditions, we need a deliberate and intentional investment to support district nurses to continue to deliver complex care to the patients, families and communities that they serve. The success of the NHS Long Term Plan depends on the capacity and capability of district nursing teams and renewed investment in their education, recruitment and retention is urgently needed.”

Yinglen Butt, RCN Associate Director of Nursing, said: “Given the fundamental role district nurses play in delivering personalised care close to home, and in reducing the burden on hospital providers, the chronic underfunding of this service is an outrageous false economy. District nurses provide a lifeline for patients, many of them frail and elderly, who often can’t leave their own homes to get care elsewhere. It’s time ministers undertook a proper assessment of staffing needs based on the fundamental principle of patient safety, and enshrined explicit accountability for delivering this into law.”

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