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District nurses' views build picture

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District nurse views can shape the workforce District nurse views can shape the workforce

The QNI has been running a 'Right Nurse, Right Skills' campaign for the past two years, seeking to influence the planning of an appropriate district nursing workforce to meet the increasingly challenging and complex needs of patients being cared for in their own homes.

In 2013 we created a survey for those nurses delivering care in people's homes, to provide an evidence-based picture of the reality of the district nursing service today. We were also seeking to understand how the challenges and issues had changed from a similar QNI survey reported in 2009 - 2020 Vision: Assessing the Future of District Nursing.

The results have been both heartening and disappointing equally. Heartening because we can clearly see the high levels of commitment, care, courage, communication, competence and compassion of those nurses who deliver care in people's homes. Disappointing because we have evidence of a service stretched to the limit, where morale is suffering and frustration is building over caseloads without boundaries and an inability to clearly articulate and predict an agreed level of capacity within district nursing teams.

Poor discharge planning continues to be a major impediment to the delivery of high quality patient experience at home. This is particularly disappointing when considering the potential of information technology to support clear communication between services in the home and community.

On a positive note,GPs were singled out for praise in partnership working. In the majority of areas GPs were seen as allies in providing high quality care in people's homes and this was predicated on respectful relationships built on the ground, often supported by co-location in the GP surgery.

The QNI will continue our mission to improve patient experience in the home by influencing policy and providing creative solutions to the challenges. We will report later in the year on the narrative data in the survey, which provides a rich picture of today's district nursing service and further insight into the current challenges.

The report of the survey can be found at: www.qni.org.uk.

Crystal Oldman, chief executive, Queen's Nursing Institute

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