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District nurse shortages leaving thousands of older people in hospital

Loss and lack of recruitment of district and community nurses resulting in rise in avoidable hospital admissions and delayed discharge of old patients
District nurse checking the blood pressure of an older female patient at her home

Loss and lack of recruitment of district and community nurses resulting in rise in avoidable hospital admissions and delayed discharge of old patients

District nurse checking the blood pressure of an older female patient at her home
Picture: iStock

A ‘vicious cycle’ of district nurse recruitment and retention issues is resulting in an increase in hospital admissions of older people, a report warns.

Age UK said an insufficient number of district and community nurses was leading to increases in hospital admissions and readmissions, as well as delayed discharge of older patients.

The charity’s report – The State of Health and Care of Older People in England 2023 – revealed there were 855,000 emergency admissions of older people in 2019-20 that could have been avoided.

Care sector is ‘haemorrhaging’ experienced staff

It concludes this is due a lack of NHS resources, such as district nurses, to care for people at home.

Between 2015 and 2020 there was a 24% reduction in the number of nursing posts in social care and a 12% reduction in the number of district nursing posts, according to Age UK.

Age UK charity director Caroline Abrahams said the care sector was ‘haemorrhaging’ experienced staff.

She said: ‘Many of these people are worn out and fed up, and are quitting for better terms and conditions in hospitality, retail or indeed the NHS. They are the backbone of the social care workforce and they play a crucial role in setting and maintaining good standards of care.’

It comes as the Queen’s Nursing Institute (QNI) launched its first major national survey of the district nursing workforce since 2019, warning that a lack of investment in the sector has led to increased pressure in recent years.

The survey will look at the work undertaken by district nurses, how it is organised, what support nurses receive and where additional support is needed.

A district nurse treating an older male patient at his home
Picture: Neil O’Connor

Vital to understand and evidence the pressure on the district nursing workforce

The survey is being led by professor of healthcare and workforce modelling at London South Bank University Alison Leary, who said it will provide vital intelligence on the state of the workforce.

‘We know from our recent work, for example the district nursing workforce standards, that the district nursing workforce is under even more pressure and it is vital to understand and evidence this,’ she said.

QNI chief executive Crystal Oldman said: ‘The number of district nurses has been falling in recent years, despite an increase in demand led by a growing and ageing population who are living with multiple complex health conditions.

‘To help us create the evidence needed to argue for greater investment in the district nursing workforce we need nurses to give us the numbers and the intelligence about how services are delivered by their teams, in their area.

The QNI survey can be accessed here.


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