Vision for future of district nursing unveiled
A new model for district nursing has been launched in response to concerns about whether the dwindling workforce will be able to meet the challenges of an aging population.
Care in local communities: a new vision and model for district nursing, sets out ambitions to modernise the service and reduce variation between different parts of the country.
The plans have been personally backed by the prime minister.
Viv Bennett, Department of Health director of nursing and lead nurse for Public Health England, told Nursing Times there was a “great deal of concern” about whether England had a district nursing workforce able to “meet the challenges coming down the line” in terms of an aging population with increasing number of co-morbidities.
The number of district nurses working in England has fallen from 10,526 full time equivalent district nurses in 2001 to 6,937 in 2011. At the same time the number of staff nurses working in the community increased from 15,600 to 27,289.
However, the strategy sets no targets to increase the number of district nurses, such as that set by the government to increase the number of health visitors by 50% in five years.
Professor Bennett said “workforce input targets” were not part of how the new system works, following the passing of the Health Act. Instead of setting process targets the government preferred to set outcome measures and leave it to providers and commissioners to decide how they will achieve them, she said.
However, she said the strategy was important as it would set out the potential of district nursing to “new players” involved in delivering and commissioning community services, in the wake of the reforms and the transforming community services programme. The programme saw services transferred from primary care trusts to a range of organisations including acute trusts, social enterprises and the private sector.
She said: “The view from the profession and others was that the visibility of what they do or the scope and potential of what they do was not understood by some of the new providers.
“They knew they had a tendency when asked to give a list of things that they do rather than a real description of what the service was, what patient experience was and how it related to outcomes.
“In moving from a list of tasks to a robust service model, it’s much clearer why we need qualified district nurses leading the team,” she added.
Professor Bennett said the introduction of the new GP led clinical commissioning groups, which are “informed commissioners about delivering care in the community”, would also help.
“I think the time is right. Part of doing this is to get some of these ideas into the public mind to demonstrate we can deliver very good care in different ways,” she said.
The strategy was also included in an announcement today by prime minister David Cameron as part of a package of measures to improve support for nurses.
Crystal Oldman, chief executive of the Queen’s Nursing Institute, described the strategy as “both timely and welcome”.
“This document will help raise the profile of district nurses and the increasingly important role that they are playing in primary and community healthcare,” she said.