Nursing leaders have made clear their concern about the widespread downgrading of district nursing posts.
They warned that band 7 posts were increasingly being replaced with band 6 or even band 5 posts, despite the shift towards more complex care and procedures being provided in the community rather than acute settings.
Royal College of Nursing primary care and independent sector adviser for the Eastern region Kellie Norris said primary care trusts were “stripping out the band 7s in all sorts of ways”.
She said: “Downgrading staff gives the wrong message. You need highly trained, highly developed staff if you want to move services into the community. As people’s needs get more acute in the community, the specialisation needs to be higher.”
Nursing Times has found some district nursing teams are now mostly staffed by band 5 staff.
Half of NHS Peterborough’s 92-strong district nursing team are on band 5, 28 are healthcare assistants and six are band 6 community nursing sisters.
A Peterborough Community Services spokesman said two band 7 nurses had run the service before a reorganisation in 2005. It now has no band 7 district nurses. Staff were divided into 12 teams, each led by a band 6 nurse.
In February this year, community services in the South West had 45 more district nurses than they did last April. All but two of these new posts were on band 5.
Queen’s Nursing Institute director Rosemary Cook told Nursing Times: “This is part of the larger picture of what is happening to specialist nursing. Primary care trusts are going to have to look again at all this and make sure that their workforces are up to it.
“The provider can’t simply recruit a big workforce of healthcare assistants and a few nurses on a higher grade and say ‘they will manage it’ because they won’t have the skills.”