Almost all district nursing course providers have “major concerns” about the future funding and viability of their programmes, according to survey findings from a leading nursing charity.
The Queen’s Nursing Institute also said it was concerned that recent increases in the number of students on such courses appeared to have now “reached a plateau”.
“We are very concerned by the long-term trend of district nurse student numbers”
The QNI’s 2015-16 Report on District Nurse Education, which was published today to coincide with its annual conference in London, is based on survey findings and a detailed data audit.
As part of the research, the 44 UK universities approved to provide the Specialist Practitioner – District Nurse programme were asked about its future funding.
The QNI noted that, of the 39 university programme directors who responded to the question, only one “did not have concerns about the future funding of the course”.
Concerns included lack of long-term planning and uncertainty regarding future funding after the 2017-18 academic year, said the QNI’s report.
“If funding is lost how will we ensure the future of district nursing”
In addition, others were concerned that the structure of the programme would be affected as more district nursing service providers were moving from full-time sponsorship to part-time courses, due to staffing difficulties, despite the full-time option being preferred by students and the universities.
One survey respondent said: “I have concerns about the future of the specialist programme and if funding is lost how will we ensure the future of district nursing.”
Another said: “It is devastating that on the back of so much positivity in relation to district nursing that the funding issues should be capable of pulling the plug on so much hard work and energy.”
As revealed last year by Nursing Times, concerns have been raised that funding for nurses to train in postgraduate roles, including district nursing, will no longer be available in future.
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Currently, nurses who want to train in specialist roles can have their courses paid for by the government through workforce planning body Health Education England.
However, as part of the government’s plans to reform healthcare education funding, money provided for post-registration specialist nurse training could be removed.
It is understood that ministers are considering introducing a loans system, or using higher-level apprenticeships, in a similar move to its scrapping of bursaries for pre-registration education.
Meanwhile, the QNI said its findings also indicated that the increase in district nurse student numbers seen in recent years had slowed down.
Overall, 517 district nurse specialist practitioners qualified in 2016, compared to 479 in 2015 and 382 in 2014.
But the data collected by the QNI showed the numbers of new entrants to the programmes remained virtually the same between 2014-15 and 2015-16.
The number of entrants was 565 in 2015-16 and 566 in 2014-15, compared to 427 in 2013-14.
However, its survey data showed that 647 new entrants were predicted for 2015-16 but only 565 enrolled in 2015-16.
“This equates to a 13% decrease in the numbers expected by the universities,” said the QNI report.
In addition, there were only 554 new students enrolled in the academic year 2016-17.
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Given the numbers retiring annually, the institute said it was concerned that any slow-down would present a “major challenge” to current and future recruitment efforts to district nursing teams.
In addition, both the uncertainty over funding and lack of growth in numbers on courses posed a threat to the viability of district nurse education, the report warned.
For example, of the 40 universities that responded to the survey, two did not run the programme in 2015-16 and another was offering it for the final time with a small cohort of just two students.
A third of universities were running courses with less than 11 students and, as a result, any further cuts were “likely to impact on the economic viability of district nurse programmes”, said the QNI.
The QNI also highlighted figures published earlier this year by NHS Digital, which showed that the number of full-time district nurses fell from 7,716 in 2010 to 4,400 in September 2016.
In addition, it cited figures from a Health Education England investment plan that showed the number of district nurse student commissions in England fell from 502 in 2015-16 to 498 in 2016-17.
Dr Crystal Oldman, the QNI’s chief executive, said: “We are very concerned by the long-term trend of district nurse student numbers and of the number of universities that are able to offer a viable District Nurse Specialist Practitioner Qualification.
She highlighted that the value of the qualification to nurses and patient care had been demonstrated by the QNI’s own independent research, commissioned by the Department of Health in 2015.
“As more and more highly complex care is delivered and managed in the community, the more important it is that highly skilled district nurses are managing community teams – which are often large and have a high degree of skill mix,” said Dr Oldman.
She added: “The QNI plans to commission further work to show how specialist practitioner training leads to high quality, patient-centred care and enables people to be safely and sensitively cared for at home rather than in hospital.”
The report is the fourth annual assessment that the charity has published on district nurse education, with documents for previous years available on its website and Nursing Times coverage listed below: