Patient safety: we need action on community nursing's red flags

Red flags raised by community nurses can be ignored, but issues such as workload pressures and huge caseloads are urgent and complex, and affect patient care

Illustration of a nurse holding her face in her hands, with red flags on each side of her labelled intense workload, patient safety, unfinished care and pressure
Picture: Annette Taylor-Anderson

Could 2024 be the year when the concerns of nurses working across community, primary care and public health settings start to see some serious recognition and even action?

Our article Patient safety red flags: is unsafe care being normalised? highlighted the red flag issues to keep an eye on across the health spectrum.

These can remain unseen and unnoticed, with commentators often concentrating on what is happening in emergency departments and hospital corridors, but for the community nursing workforce they are just as urgent and complex.

Staffing and skill mix crises are behind the biggest red flags for safety

The ongoing staffing and skill mix crises in community nursing, which can lead to intense workload pressures, huge caseloads, and care being left undone or disjointed, are currently the cause of the biggest red flags for safety.

District nurses have been decimated, with numbers falling by almost 50% between 2009 and 2022, down to 3,749, RCN figures show. In the same period, the number of health visitors fell from 8,100 to 5,653.

In primary care, nurses are facing similar workload pressures and are bearing the brunt of the frustrations of patients waiting for treatment or being discharged early with unfinished care.

As well as logging, sharing and reporting your concerns to your managers and your union, what more can you do? How do you make public your concerns about safety red flags? We need to ensure the voices of community nurses are heard loud and clear in what will almost certainly be a general election year.

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