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District nurses caring for discharged COVID-19 patients at breaking point

Queen’s Nursing Institute calls for more investment in district nursing service

Queen’s Nursing Institute calls for ‘significant’ district and community workforce recruitment

The Queen’s Nursing Institute says district nurses are under pressure caring for patients with long-COVID at home
The Queen’s Nursing Institute says district nurses are under pressure caring for patients with long-COVID at home, on top of their existing workload Picture: Alamy

Many district nursing teams caring for patients discharged from hospital recovering from COVID-19 are at ‘breaking point’, the Queen’s Nursing Institute (QNI) has warned.

The QNI says district nurses are coming under increased pressure caring for patients continuing their COVID-19 recovery at home, on top of their existing caseloads.

QNI chief executive Crystal Oldman has now called for ‘significant recruitment’ to bolster the existing district nursing workforce to cope with increased demand on services.

Investment needed to expand district nursing service

‘We have heard of one example of a London provider organisation that is delivering over 80% above its contracted workload,’ said Dr Oldman.

Crystal Oldman, chief executive of the Queen’s Nursing Institute
Crystal Oldman
Picture: Barney Newman

‘This is not sustainable. Investment is needed now to expand the district nursing service.’

Dr Oldman said community nursing teams were increasingly caring for patients with long-COVID symptoms defined as fatigue, chest pain and depression for four weeks or longer.

The Office for National Statistics (ONS) estimates one in five people continue to experience COVID-19 symptoms for five weeks or longer after a positive test, while for one in ten it lasts longer than 12 weeks.

The QNI recently published a resource on how to manage long-COVID in the community.

‘Hospitals are under pressure to discharge people who have often spent weeks in intensive care,’ added Dr Oldman.

‘Their recovery at home will be a long process, often involving the coordination of many specialists including speech and language therapists and physiotherapists as well as community nursing teams.’

A joint QNI and RCN report, published in 2019, found district nurse numbers in England had fallen 43% in a decade, from 7,055 in September 2009 down to 4,031 in January 2019.

QNI in discussions with NHS and Health Education England about community nursing recruitment

Dr Oldman said the QNI is now undertaking work to determine what additional capacity is needed in community nursing teams, and is contributing to discussions with NHS England, NHS Improvement and Health Education England around education, recruitment and retention issues.

A Department of Health and Social Care spokesperson said the government is investing nearly £52 billion this year to support health and care services, adding there were currently ‘record numbers’ of NHS staff, including 11,000 more nurses than this time last year.

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