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Review of community nursing launched to tackle training shortfalls

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The national workforce planning body Health Education England has begun a review of community nursing training, following problems filling places on programmes in recent years.

However, HEE also revealed it had increased the number of school nursing, district nursing and practice nursing training places it commissioned for the current academic year.

“It is essential that we better understand the reasons behind the reduction in uptake of these programmes”

HEE board papers

But the body was unable to confirm how many places have been filled in these specialties and has also not confirmed whether it boosted health visitor training places in 2017-18. 

HEE said at the start of 2017 it would set up the review of community nursing, after it found it was struggling to fill its post-registration courses.

Board papers from an HEE meeting last month show the review was officially launched in February 2018. Nursing Times understands it is looking at school, district and practice nursing, and also health visiting.

“It is essential that we better understand the reasons behind the reduction in uptake of these programmes and respond to HEE’s draft Integrated Workforce Strategy that signals the need to support a more flexible community nursing workforce,” stated the papers.

The body said it was working with NHS Elect, a membership organisation providing support and training, and wanted to enable “open discussion and constructive conversations among providers, practitioners and commissioners across the health and care system”.

HEE said it wanted to “better understand the skills and knowledge required within a contemporary community nursing workforce, both for now and into the future”.

“[We want to] better understand the skills and knowledge required within a contemporary community nursing workforce”

HEE board papers

A national steering group, chaired by HEE deputy chief nurse Liz Fenton, has been set up and includes representatives from organisations including the Royal College of Nursing, Nursing and Midwifery Council, Public Health England and directors of nursing in community services.

The papers reiterate that in 2016-17, 22% of school nursing course places, 16% of district nursing training places and 1% of practice nursing course places were left empty, according to HEE figures.

This was despite the number of commissioned places across all three specialties having been reduced or frozen from the year before.

In its recent board papers, HEE stated there was currently a “significant focus on community nursing and district nursing workforce”, in order to ensure there were enough nurses with the right skill “to meet health and care needs both now and into the future”.

It goes on to state that it has increased training commissions this year – by 4% for school nursing, from 285 places to 296, by 5% for district nursing, from 498 places to 522, and by 22% for practice nursing, from 359 places to 437 (see table below).

HEE’s director of workforce planning and intelligence, Rob Smith, told Nursing Times that the body would “rather have funded places subsequently go unfilled than risk having to turn people away because sufficient places had not been planned for in the first place”.

“Health Education England has been, and remains committed to, supporting community nursing”

Rob Smith

The most recent workforce figures published by NHS Digital show a continued drop in the number of school nurses working in the NHS, of around 9% in the past 12 months, and 4% in the year previous.

In December 2017, there were 2,337 whole-time equivalents, compared with 2,562 at the same point in 2016 and 2,675 at the end of 2015.

Similarly, there has been been a 2% decline in the number of district nurses working in the NHS in the past 12 months, following a 4% drop the year before. There were 4,210 WTE district nurses in December 2017, compared with 4,314 at the end of 2016 and 4,502 in December 2015.

Practice nurse numbers have also been decreasing, with the latest NHS Digital figures from September 2017 showing 11,390 WTEs in post, down from 11,770 in 2016 and 11,837 in 2015.

Meanwhile, health visitor numbers in the NHS have also dropped. They fell to 8,244 WTEs in December 2017, down from 9,278 the previous year and from 10,212 in 2015.

“Health Education England has been, and remains committed to, supporting community nursing,” said Mr Smith, who noted that community nurses often trained while employed by the NHS and “unfortunately providers have, for a variety of reasons, been unable to fill available places”.

“We will be working closely with a number of key stakeholders, including the Queen’s Nursing Institute”

Rob Smith

He said the review of the sector would be taking place “over the coming weeks and months” and involve other organisations. 

“We will be working closely with a number of key stakeholders, including the Queen’s Nursing Institute, to develop a detailed understanding of the current and future skills and knowledge needed to create and sustain the nursing team that helps people to remain in their own home and have as much independence as is possible,” he said.

“HEE’s plans reflect what local providers indicate they will need in the years ahead and we would rather have funded places subsequently go unfilled than risk having to turn people away because sufficient places had not been planned for in the first place,” he added.

HEE’s latest figures showing the annual post-reg training spaces available from 2013 to 2017

 Planned commissions 2013-14 Planned commissions 2014-15 Planned commissions 2015-16 Planned commissions 2016-17 Planned commissions 2017-18 

District nursing

402

431

502

498

522

 

School nursing

192

198

340

285

296

 

Practice nursing

49

218

359

359

437

 

  • 2 Comments

Readers' comments (2)

  • peter rolland

    This is excellent news for community services, and heaven knows they're needed to transform services, but return to practice numbers will not be enough to achieve sufficient numbers. The only place they can be drawn from is secondary care and in light of the NT 'spinning plates' article that is not exactly an over populated pool.

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  • I was a district nurse with what was south manchester trust . Two years ago following a car accident I sustained spinal compression then in November 2017 was diagnosed with fibromyalgia. During those two years my employer the trust treated me very badly I only had 7 months off sick when I was pushed into a corner to retire early . I was accused of the most unimaginable things not one patient complained about me I was the 60 th community nurse to be pushed out of this trust and what for my band 7 . So in reality I am not surprised that district nursing numbers have gone down . There was no one to support us as the unions went hand in hand with management I later found out . I suppose no one on here will believe me . I and many other district nurses where treated terribly and others where watching on as we where pushed into a corner interrogated investigated the investigating officer even came to my house knowing I was so highly distress . I also recently lost my car claim case due to the fact I had on going work issues which may have contributed to my illness of fibromyalgia. I am much better now but I have handed in my registration looking for another job non nursing if I can . Just remember not one patient complained about me or any other district nurse it was purely for us to surrender are band 7 get new band 6 staff nurses in to do district nurse jobs and to also cheat us out of 5 years pay protection due to many of us belonging to the old job description procedures and policies.

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