By continuing to use the site you agree to our Privacy & Cookies policy

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.

Readers' comments (5)

  • michael stone

    You should be able to find the document (and another) at:

    I might comment, after I've read it - I certainly think DN Services need more prominence if primary care is to be more prominent, as seems to be the plan.

    Unsuitable or offensive?

  • For those who would like to read it:

    Unsuitable or offensive?

  • I think this is it in a nutshell; copied from the document:

    The District Nursing Service Model
    District nurse led team providing care and support in the community,
    including people’s homes:
    Population and Case load management:
    Managing and accountable for an active caseload and providing population
    interventions to improve community health and wellbeing. Surveillance of
    caseload and local population needs. Working with a range of health and
    social care partners (including GPs, voluntary sector and community
    services) for health protection and improvement for adults and their carers,
    at home and in other community settings. For example, flu immunisation,
    falls screening and early intervention.
    Support and care for patients who are unwell, recovering at home and
    at end of life:
    Delivering a swift response from the district nursing service when specific
    expert health intervention is needed e.g. with short-term health issues, or
    sudden health crises or when patients are discharged from hospital, or
    have a sudden deterioration in a health condition. Providing interventions
    within the home including chemotherapy and intravenous therapy.
    Working with community specialist nurses including community matrons, to
    deliver specialist care including palliative and end of life care.
    Support and care for independence:
    Providing leadership and prioritisation of supportive care to help patients
    stay well and can manage their independence at home. For example,
    wound care management, advice on nutrition; help to avoid falls or to
    manage medicines, advice on ‘assistive technology’ such as telehealth and
    telecare, working with patients and their families to help them care for
    Leading and delivering ongoing support from the district nursing team and
    a range of local services (e.g. GP, voluntary and community organisations,
    or local authority). Working together with patients to deal with more
    complex issues over a period of time. For example, to meet continuing and
    long-term health needs.

    Isn't this what District Nursing Services already do???

    Unsuitable or offensive?

  • Is that a complete listing?

    if so the few remaing DN's must be very busy ! or perhaps that list is just a load of hogwash in which case the number of DN's will continue to reduce in favour of the much more useful CCA (community care assistant) who incidently is cheaper and provides excellent value for money !

    Unsuitable or offensive?

  • There is now a large increase in children with complex medical needs who will survive into adult hood. Lets not forget them its not just about the aged population and adult services needing community services.

    Unsuitable or offensive?

Have your say

You must sign in to make a comment.

Related Jobs

Sign in to see the latest jobs relevant to you!