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EXCLUSIVE: Hundreds of district nursing posts lost since 2014

More than half of NHS trusts employing district nurses have seen a fall in their numbers since 2014/15.
district nurse visits patient

District nurse numbers are declining in more than half the trusts that employ them.

In 25 out of 46 NHS trusts in England, the number of district nurses has fallen since the start of the 2014/15, figures provided to Nursing Standard under freedom of information rules show.

The data reveal a loss of 460 nurses in the period, plus a further 286.46 full-time equivalent (FTE) posts. The information provided by the trusts does not specify whether these staff had district nursing qualifications or not.

Today, Leeds Community Healthcare NHS Trust has 32 band 6 district nurses in post, compared to 57 in 2014, although it said there had been a rise in band 6 nurses with no district nursing qualification, from 25 to 46.

Staff shortage

The organisation said the shift in balance of the roles was due to a reduced supply of district nurses, a lack of training placements, as well the volume of district nurses reaching retirement age.

Other reductions at trusts were attributed to the loss of contracts awarded to competing private providers or other NHS organisations, or service reorganisations.

RCN professional lead for primary, community and integrated care Kathryn Yates said: ‘These findings only add to the growing evidence of workforce issues in district nursing that we have been talking about for quite some time.

‘Two years ago the RCN warned that the district nurse role was in danger of extinction, yet the situation is at least as bad today because teams are stretched to the point that quality is at risk.

‘To meet the level of need for high-quality care, the long-term problem of staffing has to be tackled now.’

Lack of team leaders

Queen’s Nursing Institute chief executive Crystal Oldman said that in the past three years there had been an increase in universities offering the district nursing programme. However, she pointed out there is more demand for district nurse team leaders than there are qualified district nurses.

‘The demand in the service in terms of patient need for district nurses exceeds the supply,’ said Dr Oldman.

‘A full workforce analysis to project the numbers needed to train has not been undertaken. We have seen a reduction in the numbers of district nurses who are appropriately qualified to lead and manage teams caring for increasingly complex patients.’ 

National recruitment problems

At Cumbria Partnership NHS Foundation Trust, there are 74 fewer nurses – a 12.3% reduction – in its district nursing team since 2014/15.

A spokesperson said: ‘The fall in numbers is due to national recruitment challenges, including an ageing workforce, and new ways of working. We have a number of vacancies in our district nursing teams but new ways of working mean that as vacancies arise we consider how to provide the most appropriate skill mix. 

‘There has not been any reduction in district nursing service finance and we are actively recruiting to vacant posts.’

In September, health think tank the King’s Fund warned that district nursing was at breaking point following an analysis that highlighted unmanageable caseloads and staff shortages.

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