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District nursing needs a lifeline

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Crystal Oldman Crystal Oldman

The challenges in delivering the district nursing service have been much debated in the last two weeks. On 1 September, the King’s Fund published a report in which the experiences of the district nursing service were explored, both from the patient perspective – including the patient’s family and carers – and that of the nursing teams within the provider organisations delivering the care.

It painted a picture of a service which is hugely committed to the patients it serves but which is, at times, overstretched in capacity to deliver the highest quality service. The report is strongly endorsed by the QNI.

The strength of the patients’ voice in the report is outstanding and their appreciation of the District Nursing service is summarised by the authors: “It is difficult to overstate the value that our interviewees placed on having health professionals visit them to provide the care that they needed, helping them to continue to live at home rather than to be compelled to move to a hospital or a care home”.

The King’s Fund report also reflects the views of many Queen’s Nurses and others who contact the QNI to share their experiences and anxieties about the District Nursing service. Significantly more attention needs to be given to ensure a sustainable service that can support the vision of more care being delivered in the home. This includes implementation of new digital technologies and improved service metrics at a national level.

Better and more consistent data are needed to describe the service and its needs; this is essential to the forward planning of the District Nursing service. Standardized data enabling comparisons to be applied as part of benchmarking of the service will assist in articulating variations in performance and the rationale for these.

The QNI’s own report, ‘Understanding Safe Caseloads in the District Nursing Service’ was released on 5 September with the intention of opening up the debate around the elements that need to be taken into consideration when managing safe caseloads. The report complements the King’s Fund report, reflecting the complexity in managing the district mursing service while ensuring that flexible, person-centred care is available for all, delivered by the right nurse with the right skills at the right time and place.

Crystal Oldman, chief executive,
Queen’s Nursing Institute

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