Posted 16 January 2024 - 14:04
Posted 16 January 2024 - 14:04
News
Sepsis death: ‘district nurse shortage could cost more lives’
District nurse staffing found to be factor in death of woman with sacral ulcer, prompting coroner’s call on health and social care secretary Victoria Atkins to act to boost workforce
District nurse staffing found to be factor in death of woman with sacral ulcer, prompting coroner’s call on health and social care secretary Victoria Atkins to act to boost workforce
A coroner wrote to the health and social care secretary over avoidable deaths and the district nurse shortage, after an inquest found short-staffing had contributed to a patient’s death from sepsis.
Manchester South assistant coroner Lauren Costello wrote to the Department of Health and Social Care (DHSC) warning there is risk of further deaths unless action is taken to address concerns raised during the inquest into the death of Elizabeth Roberts, a patient of the district nursing service at Tameside and Glossop Integrated Care and NHS Foundation Trust.
Community nursing improvements ‘impossible’ in current staffing climate
In her prevention of future deaths report, Ms Costello outlined that improvements recommended after an investigation by the trust were not possible because of a nationwide shortage of district nurses.
The report said that Ms Roberts, who was frail and incontinent, developed a large sacral sore in April 2023. As a result, district nurse visits were increased to daily to ensure timely dressing changes. However, her family were told on several occasions the nursing team did not have time to change the dressings.
On 17 May 2023, no nurse attended because of other demands. The team instead offered an out-of-hours visit that would have disturbed Ms Roberts and her family’s sleep, so was not accepted. Two days later, Ms Roberts was admitted to Tameside General Hospital but later died from sepsis with congestive cardiac failure. She was 91.
The December inquest heard there were ongoing staffing issues in the district nursing team.
‘Risk of future deaths if national approach to district nursing doen’t change’
In her letter to health and social care secretary Victoria Atkins, the assistant coroner said: ‘In my opinion there is a risk that future deaths could occur unless action is taken.
‘Despite a number of measures being undertaken by Tameside and Glossop Integrated Care and NHS Foundation Trust, the inquest heard that there are residual staffing shortages in the district nursing service which the trust is unable to resolve without a change of approach nationally.’
District nurse numbers in England have almost halved in almost 15 years – in September 2009, there were 7,643 district nurses compared to just 4,208 in January 2023, a decline of 44.9%, according to NHS Digital.
Government’s plan to increase district nurse numbers
In the recently published NHS Long-Term Workforce Plan, the government pledged to increase numbers of district nurse training places by 41% by 2028-29, supporting an ambition to increase places by over 150% to nearly 1,800 by 2031-32.
When asked how patients and their families can be confident of safe care in the community in light of the coroner’s concerns, the DHSC said the NHS Long-Term Workforce Plan has a target to expand district nurse staffing and for a 150% increase in district nurse education places by by 2031/32.
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