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.