Survival of the district nursing role in the hands of RCN congress

This year’s RCN congress will be one to watch for district and community nurses as safe staffing, staff well-being and survival of the district nursing role are debated

This year’s RCN congress will be one to watch for district and community nurses as safe staffing, staff well-being and survival of the district nursing role are debated. District nursing forum chair Julie Green sets out what is happening now to ensure their voices are heard

The RCN district nursing (DN) forum has in excess of 6,000 members and a forum Facebook page with more than 4,700 active members.

Julie Green speaking at the RCN forum. Picture: John Houlihan

As a forum, we engage with policy and provide a voice for our members at a range of local, regional and national events.

We support professional development and provide leadership, aiming to establish an active network of district and community nurses to promote and share best practice in district nursing.

When asked what the forum should focus attention on for the next two years, members suggested safe staffing, staff health and well-being, lobbying the government to ensure the DN role is not lost and investment in the role is increased, as well as supporting the development of a DN apprenticeship.

What has changed since 2016?

At RCN congress in 2016, our resolution calling for DN caseload holders to have a specialist practitioner qualification (SPQ) set the focus for the steering committee through the past two years.

Since then, we have held a roundtable event in London, carried out a survey of all members and, at congress last year, held a fringe event to shape our work throughout 2017-18.

The data we collected have given invaluable information about DNs across the UK. Survey respondents were predominantly female (94%) and 68% were over 40 years old. Responses demonstrated a wealth of experience in the DN community, with more than 25% having in excess of 20 years’ experience.

Only 6% of respondents planned to retire in the next year, with 28% retiring in the next ten years.

The survey also found:

  • 83% of respondents had not received any additional investment in their locality in response to workload challenges involved in delivering care closer to home. Some had seen a reduction in investment.
  • 73% of respondents reported unfilled vacancies in their teams.
  • 81% said they actively recruit newly qualified staff, but many highlighted that although this was positive, there was a need to support skills development – which put additional pressure on teams.
  • 67% of survey respondents thought the dirstrict nursing (DN) specialist practitioner qualification (SPQ) was essential for effective caseload management and indicated it embedded such skills as advanced health assessment, expert caseload management, enhanced knowledge to manage complexity, leadership and management skills, multidisciplinary team working, prescribing and workload priorities.
  • 87% of the respondents’ NHS trusts or boards continued to support staff to undertake the DN SPQ, usually on a full-time basis (80%), supported by a community practice educator (55%) or practice teacher (52%).
  • Where trusts or boards no longer supported the DN SPQ, single modules were most likely to be supported, including advanced health assessment (66%), leadership (70%), long term conditions (64%) or a prescribing qualification, either V150 (47%) or V300 (46%).
  • Where the SPQ was not supported, in 35% of cases, respondents reported that no alternative modules were offered.
  • 89% felt that it was important that the DN SPQ remains a recordable qualification with the Nursing and Midwifery Council.


The current forum work includes:

The development of a sketch animation to summarise the role of the DN and the community team. This resource will be applicable to all four countries and will be launched at Congress 2018. A fringe event at Congress 2018 on ‘District nursing: safer caseloads, acuity, demand and capacity’. To inform this session we recently undertook a Facebook survey to explore DN capacity and capability, and are summarising the findings.

A matter for discussion at congress in May: ‘That this meeting of RCN congress considers the need for funding and resource to follow the patient, therefore ensuring that community nursing capacity is able to meet increasing demand.’

The forum is involved in an application to become a trailblazer group to develop an apprenticeship standard for DN specialist practice.

Congress 2018 is a real opportunity to raise the profile of district nursing. Please join us for our fringe event and contribute your voice to the matter for discussion.

About the author

Julie Green is a Queen's Nurse, senior lecturer in nursing and director of postgraduate studies at Keele University, Stoke-on-Trent 

The RCN district nurse forum can be followed on twitter @RCNDNforum

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