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'With funding, district nurses can train HCAs to support them'

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With appropriate funding, we should be able to train healthcare assistants to support district nursing services, says Neesha Oozageer

I have been asking myself whether effective district nursing is practical in the current financial climate and whether patients feel adequately supported in the community rather than in hospital. We currently have an evolving NHS system, with a shift from hospital care provision to a community care focus. The frequency and extent of changes in the health service often frightens health professionals let alone patients. Speaking to service users and colleagues I have found them questioning whether community services can provide suitable care for acutely ill patients.

Those providing care in the community, particularly that offered by district nursing services, have recognised the growing importance of listening to patients. As a result, services have developed over the years to suit patients’ practical needs. The district nursing service understands that looking after the community is not a “one size fits all” approach and works alongside other health professionals to provide care that is fit for each individual. To help serve a larger population, more community nurses, associate practitioners and healthcare assistants are working in the community to support a district nursing service in providing individualised care.

Being a health professional is not only about providing a service but also communicating and promoting that service. Identifying the strong points of a service can not only encourage use but also draw recognition and financial support. This can help boost staff morale and create a happier team. Recent publications have identified the need for a shift towards a community-led service due to economic challenges. However, it could be argued that, aside from economic pressures, we are finally listening to our patients. Some people have always wanted to be cared for in their homes in familiar surroundings.

Prevention of admission and support at the point of discharge promotes economic viability as well as reduction of healthcare-associated infections. It is important to acknowledge that hospitals provide essential care to patients who are critically ill and that district nursing works with this rationale, together with the view that only patients who need to be admitted actually are admitted. District nursing teams now not only have more skills than ever before but also have confidence to provide a service to suit patient needs.

So, going back to the initial question of whether district nursing is practical in the current financial climate and whether patients feel supported: this could be seen as unsustainable in practice due to increased demands on community services and nurses. However, more funding is on its way and this can only help improve service delivery in the community. More nurses will be available with more clinical expertise - and they will be able to train healthcare assistants to support district nursing services further ensuring there is a service that delivers the care patients want in their own homes.

Neesha Oozageer is senior lecturer, community nursing team, Kingston University and St George’s University of London.

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