Expert advice

Workforce: collapse in district nurse numbers is happening now – action to halt it isn’t

Ministers’ ‘golden hellos’ plan to boost district nurse recruitment still hasn’t materialised

Ministers' 'golden hellos' plan to boost district nurse recruitment still hasn't materialised

Picture: iStock

The collapse in district nurse numbers has been much predicted. As I noted in my column in February, an ageing workforce, coupled with a lack of investment in educating replacements for those leaving, have been the underlying causes.

The ageing issue cannot be ‘solved’ but the inadequacy of funding is a self-imposed problem.

There are promises, but little action

The Queen's Nursing Institute (QNI), in response to a BBC report in November 2017, made it clear we were heading for a crash unless action was swift and focused. Almost a year later there has been little action, other than periodic promises.

A £10,000 ‘golden hello’ for postgraduate nursing students in the UK – specifically in the hard-to-recruit disciplines’ of mental health, learning disability and district nursing – was announced to parliament by health minister Stephen Barclay in May.  

Yet by August, Nursing Standard was highlighting how there had been no substantial progress in developing the scheme, with a spokesperson for the Department of Health and Social Care saying the ‘details would be released very soon, with the September recruitment in mind’.

In other words, details were still absent just weeks before the courses began, much too late to have a major incentive effect on those deciding which course, if any, to choose this year.

'Announcements appear better suited to chasing headlines than delivering real progress'

Nursing Standard also noted that the incentive was to be paid one year after qualifying from the two-year course, so less a ‘hello’ and more of an ‘are you still here?’

The promise of £10,000 for postgraduate students was repeated last month by care minister Caroline Dinenage at the QNI annual conference, but again with no detail.

So far, the government announcements about the scheme appear better suited to chasing headlines than delivering real progress. Not for the first time in the NHS, inadequate policy development and implementation capacity, insufficient resources, and political cynicism have combined to be a drag anchor on progress. 

Further reading

QNI response to BBC report on district nurse workforce pressures

James Buchan is professor in the faculty of health and social sciences at Queen Margaret University, Edinburgh

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