Investment in district nurses needed as a matter of urgency – report

District nursing is key to success of NHS Long Term Plan – yet the workforce is shrinking

District nursing is key to success of NHS Long Term Plan – yet the workforce is shrinking

Picture: Alamy

District nursing needs urgent investment in resources and training, say leading nursing organisations.

Yinglen Butt, RCN associate director.
Picture: Barney Newman

A report by the Queen’s Nursing Institute (QNI) and RCN highlights a 43% decline in NHS district nurse numbers in England in the past decade, from 7,055 to 4,031.

This is despite district nursing being identified in the recent NHS Long Term Plan as essential to the delivery of more nursing care in the community.

‘Underfunding is an outrageous false economy’

RCN associate director Yinglen Butt said chronic underfunding of the district nurse service in England was an 'outrageous false economy'.

‘It’s time ministers undertook a proper assessment of staffing needs based on the fundamental principle of patient safety, and enshrined explicit accountability for delivering this in law,' she said.

Report recommendations

The NHS should:

  • Urgently increase investment in the district nursing service
  • Maintain the post-qualifying district nurse specialist practice qualification
  • Develop a strategy to expand commissioners, providers and the public’s understanding of the district nurse role
  • Develop a national standardised data collection system and data set in England on district nursing
  • Develop a national standardised approach to measure district nurse effectiveness in England


    Crystal Oldman, chief executive of
    the Queen's Nursing Institute.

    District nurses’ key role

    An estimated 4,000 district nurses provide care for a population of 55.8 million in England – a ratio of one district nurse for every 14,000 people.

    QNI chief executive Crystal Oldman said the district nurse was the ‘key professional’ in delivering outstanding care at home and the community.

    Dr Oldman added: 'Working with GPs and other members of the multidisciplinary team, district nurses have the knowledge and skills to support people living with complex long-term conditions to manage their own health and avoid unplanned hospital admissions.’

    Responding to the report, a Department of Health and Social Care spokesperson said: 'We are committed to maintaining the number of district nurses to continue their vital work.

    'We are working with Health Education England on funding for the specialist practice qualification for district nursing, expanding routes into the profession by developing an apprenticeship annd will consider them in the upcoming NHS People Plan.'

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    Further information

    Read the full report

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