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District nursing needs immediate action to prevent its rapid decline

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Serious investment is needed in district nursing Serious investment is needed in district nursing

Cuts to the district nursing workforce are impacting on patient care, a King’s Fund report has stated.

Understanding quality in district nursing services identified evidence of a growing gap between capacity and demand in district nursing services. The number of district nurses has declined at a time when the number of patients and the complexity of care has increased their needs.

The report concluded that this has resulted in staff feeling rushed and abrupt with patients, reductions in preventive care, visits being postponed and lack of continuity in care. This is in turn impacting on staff wellbeing, leading to stress, fatigue and ill-health.

‘District nurses and their teams are being stretched to the point where quality is at risk – and there is no sign
that the rise in demand will abate,’ said Kathryn Yates, the professional lead for primary and community nursing at the Royal College of Nursing (RCN).

The King’s Fund analysis also identified that district nursing shortages were impacting on general practice and social care caseloads and delayed hospital transfers.

‘There is a lack of expansion in the district nursing workforce at the moment. We are still working with community nurse staffing levels from years ago,’ said Vicki Smith, district nurse and integrated healthcare team leader in Staffordshire. ‘Since then the landscape of district nursing has changed and staffing levels have not adapted to reflect that. With education funding cuts, district nursing is really going to struggle.’

The report argued that NHS leaders should recognise the importance of district nurses in sustaining the healthcare system and to increase recruitment into district nursing by raising the profile and portraying it as an attractive career option. It also recommended developing robust mechanisms to look at staffing and resourcing of community care for older people.

‘We need to end the perception of district nursing as a quiet, gentle role, it is actually incredibly demanding and unpredictable. Nurses must be allowed to treat patients holistically and to stop becoming so task-orientated,’ said Ms Smith.

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Totally agree with all that has been identified . I have worked in the community for a number of years and seen the decline in staff numbers where staff are not replaced. Existing staff are expected to" manage time better" and absorb the extra work within an ever increasing caseload. Patients cope with frequent changes for which they complain of lack of continuity in care.
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I feel so sad that good services are failing. This service is a priority for people who are unable to use services like the more abled. I struggled as a parent to get the GP surgery to link a District nurse to my son who has Learning disabilities,AutismEplepsy and challenging behaviour. His health is poor and he needs regular blood tests and has a fear of visiting places so this became a problem n my point is I had to challenge and complain to get this recognised and now I myself had to overrule the system to get my sons needs addressed. The nurse now comes to the house to do this which is more settled for him. I am appalled how they can ignore the needs of a vulnerable person. I will support this service because it is a service that's needed. I feel a decline in approach to the systems and communication techniques is failing also. More joined up services approach is needed.
Posted by: ,
This article rings so a community nurse I see and feel everything the author and report findings say. I have worked in a hospital and now in the district....what a shock it was for me! I thought at first my time management been poor was causing me to not finish on time or complete my paperwork etc and felt that I was not giving the quality care that should be given to I realise that the fault does not lie with myself,I am a good nurse who wants to give the best that I can.....sadly as the article explains,this is not always possible due to the decline in district nurses and ever growing client caseload!!
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