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First national training framework for community nurses


The first national framework for district and practice nurse education and training has been published, laying out how the two roles each require specialist skills but also how they can overlap.

Drawn up by national workforce planning body Health Education England, the framework covers the entire community nursing team – including healthcare assistants – and is designed to help develop a workforce that can deliver future models of care.

It is aimed at practitioners as well as a range of other groups including employers, commissioners, education providers, regulators, workforce planners, indemnifiers, service users, carers and the public.

“It is vital to recognise commonalities that apply to nurses working in primary care and in district nursing, but also to be clear about how the roles differ”

HEE training framework

HEE noted there had previously been a lack of strategic planning and limited resources earmarked for this part of the nursing workforce.

This had led to an increase in workload pressures and rising waiting times in community settings, it said in the introduction to the framework document – called the District Nursing and General Practice Nursing Service Education and Career Framework.

Limited training and support for nurses moving across to community roles from hospitals, plus a lack of placements for pre-registration student nurses, and cuts to specialist posts in the setting were also all noted.

It referred to official data from the Health and Social Care Information Centre which showed a 44% reduction in specialist district nurses between 2003 and 2010, at the same time as there was a 34% increase in other registered nurses in community teams.

HEE highlighted that NHS England’s Five-Year Forward View plan, published last year, had noted the health service was “yet to see a significant shift from acute to community sector based working”.

There have also been increasing concerns raised in recent months about the need to develop community services to increase treatments in this setting and reduce the growing demand for hospital services.

HEE said the framework was the “first attempt” to develop a “national solution to enable a consistent approach to ensuring the whole district and general practice nursing team are equipped to deliver health outcomes now and in the future”.

“[This is] the first attempt to…enable a consistent approach to ensuring the whole district and general practice nursing team are equipped to deliver health outcomes now and in the future”

HEE training framework

The framework provides an overview of the overlapping key characteristics of community nursing, such as long-term condition management, anticipatory care, connecting to other services to provide holistic care, and public health responsibilities.

It also describes specialist skills, knowledge and minimum qualifications required for district and practice nursing for different members of the team – from healthcare assistants to advanced nurse practitioners.

“In order to ensure general practice and district nursing staff are fit for both practice and purpose in the new [care models in the FYFV], it is vital to recognise commonalities that apply to nurses working in primary care and those working in district nursing, but also to be clear about how the roles differ,” said the framework.

“This document gives versatility in terms of the commissioning and development of these [district and practice] roles, as either can be generated in isolation of each other or via a hybrid model that combines the two,” it said.


Readers' comments (11)

  • Some of them could do with it that's for sure! I've never met a bunch of nurses with such poor clinical knowledge. Sorry folks but it's true.

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  • The above comment is totally unhelpful and unecessary, a sweeping generalisation. Adds nothing to the debate.
    Primary care nursing demands an extended and unique knowledge base which is complimentary to clinical care in the patients home. This new framework will be a strong foundation on which to build practice and improve quality.

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  • Thing is if you're out on the community you should have built some practice,remember you are alone most of the time and need to recognise signs and symptoms and not just accept them as the norm for that patient. Nurse often the last person in and illness very often goes unreported

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  • Is a community nurse not a district nurse and vice versa, as a district nurse works in the community! Am I missing something? I would appreciate if somebody could clarify

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  • Same same!

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  • I don't know the difference between community and district nurses either.

    I did meet a district nurse who had been employed in a hospital previously. She had been told that she would get training on the job as a district nurse but she didn't. She found a job back in a hospital but I don't know what happened next because the district lot were holding back on a reference for her.

    It appears there is a need for training to be genuinely delivered. Once out in the community it could be a lonely business. Small teams of nurses with a chance to meet and discuss could be helpful?

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  • Reading the new framework may clarify some of the questions as outlined above.

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  • The Queen's Nursing Institute carried out surveys in 2009 and 2014 which found that the job title 'District Nurse' is not used consistently - even though it's the term most often used and understood by patients. It may be too much to expect there to ever be one single job title, with so many different employers operating ... -

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  • When are we going to change the broken record???

    It is not training that is important, but learning, practice, competence, understanding, knowledge and safety to practice.

    Not training, but the outputs of training. Training infers "people in a room - bums on seats", but learning is much more powerful and can be done anywhere.

    Imagine shadowing a more experienced colleague, in the community, with the people we support and facilitating learning relevant to that person - Person Centred Learning.

    Much more valuable!

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  • A District Nurse usually refers to the District Nursing Sister
    All other nurses, the staff nurses and HCAs are known as Community Nurses
    You need experience to do the role and new staff all receive an induction are competancy assessed. spending time in the team shadowing more experienced nurses. Many staff have the community nurse prescribing r independent nurse prescribing qualification.The DN sisters have all had additional training to Degree or Masters level in Community Health Nursing. Education oportunities are good and clinical knowledge is very high often better than some of the hospital based nurses.

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