Four out of five diabetes specialist nurses say their workload is impacting on patient safety and care, according to a report from a leading charity.
Urgent action needs to be taken to recruit and develop more diabetes specialist nurses to avert a crisis of care for people with diabetes, warned Diabetes UK.
“In many areas our health system is neglecting this highly skilled workforce”
The charity, which has conducted a survey of the profession, said that 78% of respondents voiced concerns that their workload was having an impact on patient care or safety and 39% considered their current caseload “unmanageable”.
Its online survey, carried out between March and June, was completed by 406 respondents – representing an estimated 29% of the UK’s total 1,400 specialist diabetes nurse workforce. Findings from the survey are detailed in a report (see attached PDF below)
Diabetes UK said the survey results painted a picture of a highly-committed workforce struggling to cope as demand for services continued to soar without a corresponding increase in staff numbers.
Almost 90% of nurses reported working above their contracted hours while several said their contracted hours had remained the same, but were working unpaid overtime to ensure good care.
The survey suggested the specialist nurse workforce numbers had not kept pace with increasing diabetes prevalence. In little over a decade, the number of people diagnosed with diabetes in the UK has increased by 72%, noted the charity.
“Diabetes specialist nurses should not be viewed as a luxury, they should be recognised as vital”
In contrast, 29% said there had been cuts to specialist nurse posts in their team over the past two years, suggesting NHS financial pressures were having a direct impact on diabetes care and safety.
Meanwhile, Diabetes UK predicted that workforce shortages were likely to worsen in coming years unless more diabetes specialist nurses entered the profession.
Worryingly, 57% of survey respondents were eligible to retire within 10 years or fewer, significantly higher figure than the 33% of registered nurses overall that will be retiring in the next 10 years.
In the same time period the number of people in the UK with diabetes is expected to increase by at least 700,000, taking the total number of people living with diabetes to 5.2 million by 2025.
The charity said it was calling for a national workforce strategy, as well as local action, to ensure sufficient appropriately skilled diabetes specialist nurses to meet current and future demand.
Diabetes UK added that it also wanted to see an end to inconsistencies in the diabetes specialist nurse role across the country via the introduction of “benchmark standards”.
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As a result, it has recommended a national system to accredit the specialist skills of diabetes specialist nurses and a “clear career pathways” from entry-level specialist through to senior roles.
Helen Atkins, lead diabetes specialist nurse at University Hospitals of Leicester NHS Trust, said: “Every day I see the positive impact my team has, often against the odds, supporting people with diabetes to manage their condition, avoid complications and keep them out of hospital.
“Yet in many areas our health system is neglecting this highly skilled workforce just when we need them most,” she said in the introduction to the charity’s report.
“No nurse wants to deliver anything but the best care possible but the diabetes specialist nurse workforce is being pushed to their limits,” said Ms Atkins.
She added: “If we are to rise to the challenge of increasing diabetes prevalence, we need urgent action at both a local and national level to tackle diabetes specialist nurse workforce shortages.”
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Bridget Turner, director of policy and care improvement at Diabetes UK, said “urgent action” was needed to recruit and develop more diabetes specialist nurses.
“Evidence shows that diabetes specialist nurses reduce length of stay in hospital, improve patient satisfaction and are cost effective. But as they are relatively more expensive than non-specialist staff DSNs are vulnerable to cost-cutting measures in times of austerity,” she noted.
She stated: “Diabetes specialist nurses should not be viewed as a luxury, they should be recognised as vital to delivering safe, quality care for people with diabetes.”
The survey was supported by pharmaceutical company Novo Nordisk.
Amanda Cheesley, the Royal College of Nursing’s professional lead for long-term conditions, said: “The diabetes specialist nurse is viewed by many people with diabetes as the lynchpin of their healthcare team.
“This [survey] is part of the bigger picture of underinvestment right across the nursing work force. This not only puts unsustainable pressure on the NHS, but does harm to the health and well-being of the nation,” she added.