A business case for district nurse resources no one should ignore

If action were undertaken nationally, the result will be a consistently high-quality, UK-wide district nursing service that focusses on patient safety

District nursing workload has increased significantly
Picture: Alamy

Every week I receive emails asking the Queen’s Nursing Institute (QNI) to point to the national guidance on how to configure the district nursing service locally. Questions are focused on patient safety and ensuring that the communities served have the right nurse with the right skills – at the right time and place.

Timeless guidance tool in all district nursing services

So when asked: ‘How many district nurse team leaders do I need in my service?’ and: ‘What should the skill mix be?’, I usually reply with a reference to the 2016 King’s Fund report, Understanding Quality in District Nursing Services, where the measures of quality are brilliantly researched and described.

Why hasn’t this timeless guidance been adopted as a national quality benchmarking tool in all district nursing services, not just a few?

The QNI recently published the long anticipated Workforce Standards for the District Nursing Service and the response from community service providers has been entirely positive.

Based on six years of research by Professor Alison Leary, the QNI’s International Community Nursing Observatory director, the Standards can be used at the team and whole service levels. In one area of England, they are being used now to benchmark across all the district nursing services of an integrated care system.

Standards focus on patient safety

This is excellent news and shows how practical and immediately relevant to patient safety these Standards are.

And this is their purpose – for all practitioners, managers and executives to be able to assess the capacity and capability of the service to manage the unremitting district nurse workloads, and create the business case for increased resources where demand exceeds capacity, with a focus on patient safety.  

If this is action were undertaken nationally, the result will be a consistently high-quality district nursing service across the UK, that responds to the increased demands, new policy initiatives and digital technologies.

Crystal Oldman, chief executive of the Queen’s Nursing Institute

Crystal Oldman is chief executive of the Queen’s Nursing Institute



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