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Letter: It's time to address the crisis in district nursing

Alexandra Murrell says we can learn from the Netherlands when it comes to district nursing

Your article highlighting problems in district nursing is well overdue (Nursing Standard September 14).

The 1990 Community Care Act downgraded district nursing by reducing the grading.
It also meant that personal care was transferred to social services, and reduced the time that district nurses have to provide care.

It is a shame the recommendations by the King's Fund quoted in the article are so vague, with no figures on the numbers of district nurses needed or suggested increase in pay to value the job.

District nursing was a very popular career path for many nurses in the 1980s and it was competitive to get a job in district nursing either as a qualified district nurse or as a staff nurse.

The article does not mention that Netherlands model for district nurses which was the subject of an RCN Policy and International Department Briefing (02/15 August 2015).

This model - the Buurtzorg community care programme - is non-hierarchical in structure, with nurses working in teams increasing autonomy. Another King’s Fund report, The Future is Now (2015), did mention the Buurtzorg model as providing good job satisfaction.

It is of course important to make the point that the lack of district nurses must have an impact on secondary care, with people going to A and E because they are not able to access district nurse care.


Alexandra Murrell MPH, M.Sc. RGN
 Nurse Practitioner

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