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District nurse shortage 'damaging reputation of nursing'

A decline in district nursing means vulnerable patients are being treated at home by inexperienced staff who have had just an hour of training, a conference heard on Friday.

This was the worrying picture painted by Royal College of Nursing chief executive and general secretary Peter Carter when he challenged the UK’s four chief nursing officers on the state of district nursing.

He said the number of district nurses across the UK had fallen dramatically from 12,000 in 2003 to 7,500.

More community nursing tasks were being performed by healthcare assistants, while the increased use of private firms to deliver home care meant some patients were being seen by completely inexperienced staff, he said.

“Providers are employing young people who are expected to go out after having an hour of training”

Peter Carter

Dr Carter raised the issue during a question and answer session with the CNOs at the Florence Nightingale Foundation’s annual conference in London last week.

He said not only was the situation damaging the quality of patient care but also “damaging the reputation of nursing”.

Nurse arrives at a patient's home

A nurse arrives at a patient’s home

“So many contracts are being out-sourced and providers are employing young people who after having an hour of training are expected to go out to people’s homes to nurse patients,” he said.

“A recent example that was given to me was that of an 18-year-old young woman who hadn’t had any training but was given a full caseload and her first home visit was to an elderly man with an internal catheter and she didn’t even know what this was,” he added.

CNO for England Jane Cumming said she was concerned about the reduction in qualified district nurses, despite the fact there had been an increase in community nursing staff as a whole.

She said there was a need for “better workforce planning” to ensure appropriate, quality care in the community in the future and England’s Community Nursing Programme was working on that.

“You have to have the right mix of staff and a variety of skills in community teams”

Jean White

Earlier, CNO for Wales Jean White told the session efforts to ensure community nursing met patient needs was not just about district nurses but the whole community team.

Jean White

“You have to have the right mix of staff and a variety of skills in community teams,” she said.

While district nursing in Wales had decreased, she said the different skill sets in community nursing had increased.

Readers' comments (7)

  • Ok then, what's your plan of action? Organise a march in London, a day of action even? Perhaps we can picket 10 Downing st. Just tell me what the hell you are going to do about it!

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  • That old chestnut of skill mix, which equates to a supposed money saving dilution of skills. News flash properly trained experienced nurses are better value for money. What's the point in delegating tasks to health care assistants and trained nurses to do others when both will then spend more time traveling as they both cover the same area to do their own tasks.

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  • Well I feel district nursing numbers are down because people are leaving for other roles, It's normal for a district nurse to be given 12 calls, now people may say, Well that's what one nurse on a ward looks after, well what if those 14 visits are all leg ulcer dressings that require compression, takes a lot of time to do, and your back pays for it.

    There also needs to be more training, all district nurses should have the same skills, one nurse shouldn't be able to do one thing and not be able to do another, vice versa. These are the tip of the ice berg, listen to the nurses who do the work and the numbers will go up.

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  • When you work on a ward your 12 patients are all in the same area, you have the back up of the rest of your team, the doctors and the AHPs during your shift. 12 patients in the community:-you see alone, you get frustrated trying to get GPs on the phone, you travel miles between the patients, dodge the dodgy pets and relatives and often the house bound patient (often refusing to go to the surgery) is out and not at the OPD seeing the consultant.
    More care is expected to be delivered in the community, the agenda from the government is to deliver more care at home where possible. However trusts are constantly restructuring, devaluing the highly trained hands on staff at all levels to the point where many who were born in the 1950s and early 1060s are now choosing to retire early and take those skils and knowledge away with them. We once had an enviable health care system. Most of us pay NI on all our salaries to suport the NHS. It's about time the government looked at extending the limit on paying NI to those who are in the very high earning bracket to increase revenue for the NHS to deliver quality care to all

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  • "We once had an enviable health care system. Most of us pay NI on all our salaries to suport the NHS. It's about time the government looked at extending the limit on paying NI to those who are in the very high earning bracket to increase revenue for the NHS to deliver quality care to all."

    ?????????????????????


    such individuals probably don't wish to use the NHS and prefer to subscribe to private insurance!

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  • michael stone

    I've written this before - if the 'plan' is better community care to lessen hospital admissions, it is ABSURD for there to be an inadequate number of DNs !!!

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  • But why should some of the population pay contributions on all their salary. The very rich also usethe A/E systems, theatrea, ITU, ambulance services and xray etc when they have accidents and MIs

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