District nurses are “critically endangered” and face extinction by the end of 2025 if urgent investment is not made, the Royal College of Nursing has warned.
The past decade has seen a 47% fall in qualified district nursing staff numbers in England. But research commissioned by the RCN predicts the present shortage of district nurses will get worse, with 35% currently over 50 years old and approaching retirement.
The research was carried out for the RCN by the National Nursing Research Unit at King’s College London and was due to be revealed on Tuesday at the college’s annual congress in Liverpool.
A quarter of nurses told researchers they had seen more than 12 patients on their last shift and more than 80% reported working additional hours. Three quarters said they had left necessary activities undone due to a lack of time, and nurses said a fifth of each day was spent on paperwork and only 37% of time was spent delivering direct care.
One respondent said: “At times I can’t help but feel I have been unable to provide the care I feel I want to give. This frustrates and saddens me.”
The skillset of community teams is also being diluted, with 16% lacking a specifically qualified district nurse. District nurses make up an average of only one in five of the staff employed in community nursing teams.
The college called on the government to fulfil a pledge to increase the community workforce by 10,000 and said these extra posts should specifically be filled by district nurses. It also called for all trainee nurses to undertake a mandatory placement in the community to meet the demands of the future.
Peter Carter, RCN chief executive and General Secretary, said: “The district nurse role is the foundation of a system which should be able to manage conditions and keep sick and frail people at home. Remove those foundations and the whole edifice could come crashing down.”
The report follows a similar survey by the Queen’s Nursing Institute, which was published at the start of June and also raised concerns about the morale and staffing of district nursing teams.