New guidance for district nurse teams in Wales launched

Eight new guiding principles for establishing district nursing teams have been introduced in Wales.
District nurses

Eight new guiding principles for establishing district nursing teams have been launched in Wales.

Wales has launched eight new guiding principles for district nursing teams. Picture: Bubbles

It is hoped the interim measures will help employers when planning the size and skill mix of district nursing teams.

Welsh Government cabinet secretary for health, well-being and sport, Vaughan Gething unveiled the principles during a keynote speech at the All Wales Staffing Conference in Cardiff on Thursday.

Planning tools

Last year the government created working groups to develop evidence-based workforce planning tools to fully comply with the country’s new Nurse Staffing Levels (Wales) Act.

The act, which requires health boards to ensure they are providing 'sufficient nurses to allow time to care for patients sensitively’, became law in March 2016 and currently applies only to adult acute and surgical inpatient wards.

The new district nursing principles have been drawn up by All Wales District Nursing Workload and Workforce Calculation Tool Working Group. The group includes representatives from the RCN and Queen's Nursing Institute and reports direct to chief nursing officer for Wales Jean White.

Interim principles

The working group estimates it will take at least three years to develop a workforce planning tool specifically for district nursing, and has called on employers to adopt the interim principles to be adopted to meet the Act’s requirements in the meantime.

The eight principles are:

  • Nurses should always use professional judgement.
  • Teams should have ‘a distinct and identifiable geographical zone’ within their catchment cluster.
  • Skill mix should be predominantly registered nurse supported by healthcare support workers.
  • Each team should have a clinical lead district nurse who holds a recordable specialist practice qualification (SPQ) and leadership training.
  • There should be at least one deputy team leader also holding a SPQ.
  • Each team should have a compliment of no greater than 15 staff/12 whole time equivalents.
  • When planning workforce numbers, a 27% allowance (uplift) should be made to cover unplanned absences such as sickness, maternity leave and jury service.
  • Teams should have access to 15 hours admin support a week.


Senior district nurse Paul Crank, who attended the conference, welcomed the principles.

He said: ‘I feel they give a voice to our service.

‘This is the first time the Welsh government has given such an endorsement to what we do. It’s a massive piece of work and many of us are sure to experience some level of redesign of the service we provide.’

Work stream lead

Aneurin Bevan Health Board divisional nurse Richard Desir is the work stream lead for the district nursing working group.

He added: ‘We are making real progress.

‘I’m particularly impressed that the nurses we’re working with are focused on the benefits of these changes to patients, they are thinking of them first and themselves second.’

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