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District nurses must regain role as 'centre pin of local care'

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District nurses must reassert themselves as the traditional coordinators of health and social care, in order to ensure they care influence the future shape of services, according to a leading GP.

Dr Michael Dixon, a GP in Devon and chair of the NHS Alliance, said community nursing needed to regain its “power” and “position” in the health service.

“You’ve got the authority of being right at the centre of looking after people every day,” he said. Asserting that authority would help ensure the NHS remained “sustainable” by keeping people healthier and out of hospitals and GP surgeries, he suggested.

“You’ve got to kick open the doors of commissioning, you’ve got to make sure that you are redesigning local services”

Mike Dixon

Speaking at the Queen’s Nursing Institute annual conference last week, he said: “In the old days, my district nurse was the fixer. She was the one that brought the patient’s care together. I think we’ve lost that.

“With the increasing number of frail, elderly patients, and the increasing number of people with long-term diseases, district nurses need to reclaim that territory and be empowered as the coordinator of health and social care,” he said.

District nurses are “simply” the “best ones at doing it”, he added, describing them as having the expertise to be the “commissioners of care on the frontline”.

“We need to see the district nurse coming back, if you like, as the centre pin of local care,” he told delegates.

Dr Dixon added that doing so would help increase the profession’s influence at a time when the NHS attempted to realign itself more around the community and less in acute settings.

NHS Alliance

Michael Dixon

“[It’s] really important to get in on commissioning and to be defining how things look in your community services in the future,” he said.

Primary and community care staff were “best placed” to know where problems were in the local health economy, he suggested, especially in terms of keeping patients healthy and out of hospital.  

“If we’re to recognise the power and potential of community nursing, it’s going to be necessary to be bold, to be realistic, to be determined and courageous,” he told the conference in London.

“These are all qualities community nurses have in bags – you’ve got to kick open the doors of commissioning, you’ve got to make sure that you are redesigning local services,” he said.

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