Northern Ireland’s health department has launched a plan designed to make provision by the country’s district nursing teams 24-hours-a-day, seven-days-a-week.
The new framework, published today, noted that currently Northern Ireland “does not have a fully regional 24-hour district nursing service”.
“This framework sets the way forward for all of us to work together to deliver a world class district nursing service”
This was despite the fact that, increasingly, care and treatment, including end of life care, was being delivered in settings outside of hospitals and closer to or in the home.
To meet the country’s changing health needs, the “district nursing service must provide a 24-hour-a-day, seven-day-a-week service”, said the new document.
It stated that the new framework would provide the “strategic direction” for the district nursing service for the next 10 years and ensure nurses have the “right technological support which will enhance their practice and not distract them from delivering care”.
It said commissioners would invest in technology to ensure district nurses are supported to work in mobile ways and enable the use of technology enabled care such as remote monitoring and video consultation.
For example, it said 100% of district nurses would have a mobile phone by March this year, 100% would have access to Northern Ireland’s electronic care record by June and all would be able to work remotely using mobile devices by 2019.
In addition, the plan – titled A District Nursing Framework 2018-26: 24 Hour District Nursing Care No Matter Where You Live – set out four principles that should underpin district nursing services.
These are to provide care that is “person centred”, “efficient and effective”, “expert” and “integrated and population based around general practice”.
As previously reported by Nursing Times, the framework reiterated that new community nurse-led models of care, similar to Holland’s Buurtzorg type models, would be “tested and developed”.
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Such care models would ensure a population health focus where district nurses lead the assessment, planning and co-ordination of care in self-managed nursing teams, stated the framework.
It promised a regional caseload weighting tool “task and finish group will be established and report by March 2019, with a regional community nurse-led model of care prototype agreed regionally by March 2018 and a prototype “scaled and spread” throughout each trust by December 2020.
Meanwhile, it said district nursing teams would be “practice aligned”, with a named nurse acting as the “link” between each general practice in Northern Ireland and broader integrated teams.
It said 100% of practices would ”know who their district nurse is and will know how to contact them in a timely fashion and vice versa by March 2018”.
District nursing would also be “underpinned by a robust workforce plan and educational framework” to enable the goals set out in the framework to be “realised”, said the document.
“The title district nurse and community nurse are often used interchangeably”
District nursing framework
Pre-registration educational programmes “must continue to develop and offer appropriate learning opportunities for the district nurse”, highlighted the framework. It said district nursing placements for pre reg nurses would increase by 20% annually.
It also indicated protection for the district nurse title, following years of warnings from the Queen’s Nursing Institute and others that it was being diluted among more general community roles.
“The title district nurse and community nurse are often used interchangeably, however they are distinctly different and it is important to define exactly what their titles mean,” said the framework.
It stated that a district nurse was registered with a graduate level education possessing a district nursing specialist practitioner qualification recordable with the Nursing and Midwifery Council. In contrast, it defined a community nurse as a registered nurse working in the community within the district nursing team.
Announcing the framework today, the Northern Ireland Department of Health said the district nursing service was a “well respected and a highly valued part” of the health and social care system.
It said the plan “paves the way for developing a world class service that is innovative, collaborative and transformed, available 24-hours-a-day, seven-days-a-week, no matter where the patient lives”.
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The framework has been co-produced and developed after “extensive engagement” with all key stakeholders and a comprehensive review of policy directions, said the department.
The document was launched at the District Nursing Conference held at Mossley Mill, which was organised by the Department of Health and Public Health Agency.
Charlotte McArdle, chief nursing officer for Northern Ireland, said: “I believe this framework sets the way forward for all of us to work together to deliver a world class district nursing service.
“I am confident that the implementation of the framework will have a valuable impact on delivering safe and effective person centre care by district nurses and their teams in community settings,” she said.
She added: “Moving forward district nurses will have more focus on population health management. There will be an emphasis on improving clinical and care outcomes and people’s experience of that care, whilst supporting staff and optimising the resources available.”
The framework was launched to coincide with the start of a separate campaign to raise the status and profile of nursing.
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The Nursing Now campaign is being run in collaboration by the Burdett Trust for Nursing, the World Health Organization and the International Council for Nurses.
The Duchess of Cambridge both launched and become patron of the new global campaign at an event in London.
Earlier this month, it was announced that healthcare assistants in Northern Ireland would be known in future as nursing assistants, at the same time that new standards were unveiled for the support role.