District nurse

New report calls for change in nursing

The Queen’s Nursing Institute (QNI) has called for sustainable investment and renewed digital technology for district nurses, after a major new report revealed that team leaders are carrying more responsibility than ever before.

The QNI research features the views of more than 1,500 UK district nurse team leaders and found that — reflecting their increased responsibility — more are being paid at Band 7 on the Agenda for Change scale since 2019, while the number in Band 5 and Band 6 has decreased.

Nurses are also continuing to develop their knowledge and qualifications, as more team leaders have the District Nurse Specialist Practitioner Qualification than five years ago — more people also have a prescribing qualification and an Advanced Clinical Assessment qualification.

“We have a growing and ageing population and this is having a profound impact on how health and social care must be planned and delivered: District Nurses are increasingly responsible for people living with very complex healthcare needs,” explained Dr Crystal Oldman, CEO at the QNI.

“The next government must work to boost the District Nursing services that deliver essential individual and population health in communities everywhere.”

The report also suggested:

  • More teams are carrying bigger caseloads — those in the 101-200 range have fallen (20% in 2023 from 24.8% in 2019) while those in 600+ territory have increased (16.2% in 2023 from 11.5% in 2019)
  • More people have refused referrals due to capacity or workload issues — 56.6% did not have to do so in 2023, while 61.7% did not have to in 2019
  • Unpaid overtime was common — 43% are carrying out 4-7 hours per week, 33.3% 1-3 hours, 15% 7-10 hours, and 8.7% at 10+ hours
  • Virtual wards and remote monitoring are having an increased impact — 46.2% said they made no difference to workload, 28% said they increased it, and 4.5% said they decreased workload

In light of its report, the QNI has made a number of key recommendations, including to enable sustainable financial investment in the current and future district nursing workforce, along with the removal of recruitment and retention barriers.

Support for the District Nursing Specialist Practitioner Qualification, including financial aid to those wishing to take the qualification

Coordinated efforts to address issues hindering district nursing, including poor IT systems, outdated technology, as well as disjointed communication and referral.

Final recommendations feature the possibility of a national campaign to raise the profile of district nurses and the role they play in the NHS, more explicit recognition of the value district nurses have within the NHS, and a strategy to deliver more care in or closer to people’s homes.

Dr Oldman added: “District Nursing is a highly valued, universal community service which is provided in every village, town and city. District Nurses, and by extension the individuals, families and communities they care for, are at the centre of the QNI’s mission and values.

“They are also a core part of the National Health Service in the UK.”

Image credit: iStock

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NHE May/June 2024

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