UK district nursing survey aims to provide true picture of the service

District nursing team leaders encouraged to complete the Queen's Nursing Institute survey 

A survey of district nursing team leaders by the Queen’s Nursing Institute aims to provide an authoritative picture of the service in the UK

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The NHS Long Term Plan, published earlier this year, provided probably the most concrete commitment to community health services of any national policy document since the creation of the NHS.

It coincided with a decision by the Queen’s Nursing Institute (QNI) to undertake a UK-wide study of the district nursing workforce. This study will be informed by the responses of team leaders to an online survey and will be the first one since 2014.

Previous QNI studies have described the challenges facing the district nursing service and have helped policymakers, service planners and nurses themselves to develop strategies to manage those challenges.

Undervalued and overlooked

Despite these studies, district nurses still find their specialism and the contribution they make to the nation’s health to be undervalued, misunderstood and overlooked. This is a consequence of the service being delivered mostly in peoples’ homes and not readily visible to the public. It is rarely covered in the media or by television and radio docudramas.

The number of district nurses in England has fallen steadily in the past decade, as shown in NHS Digital figures quoted in a QNI/RCN report published in May.

The NHS Interim People Plan, published by NHS Employers in June, aims to address the shortages in the nursing workforce – more than 40,000 vacancies in England alone – and the QNI looks forward to supporting them in expanding the number of district nurse specialist practitioners.

Changing demands

While investment in district nursing services has not kept pace with the increasing and changing demands placed on it, there are some positive indications that this has been recognised.

England’s new chief nursing officer Ruth May has made district nursing a priority, and chief nursing officer for Wales Jean White has doubled the number of district nurses in training. Northern Ireland is implementing a new framework that will result in a 24-hour neighbourhood district nursing service for the whole country. The Scottish Government has developed a district nursing CPD learning resource, based around the Pillars of Practice model, to support district nursing’s ongoing professional development.

The NHS Long Term Plan calls for more preventive healthcare, personalised healthcare and care delivered in people’s homes and communities, to reduce reliance on hospital care, particularly for the frail, older population. The district nursing service was designed and developed to address this need, even before the NHS.

Working harder for longer

Today’s district nurses say they are being asked to work harder for longer hours, delivering complex care to ever-expanding caseloads of patients. New technologies have helped improve efficiency, but workloads must be safe and workplaces fair to attract and retain the highly skilled staff needed for the future.

The results of the QNI survey will be analysed by its International Community Nursing Observatory and will be published at the formal launch of the observatory on 18 November.

The survey will provide the most accurate picture ever of the district nursing service, including how it is adapting to changing technology, using innovative approaches to care, and managing rising demand and increased complexity in care delivery.

I encourage all district nursing team leaders in all countries of the UK to complete the survey so that we can produce an authoritative, insightful and true report into the state of district nursing today, and thus influence the development and expansion of the service.

Click here to complete the district nursing team leaders’ survey, which is open until 15 July

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



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