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Nursing academic speaks out against district nurse cuts


Cutting back on district and community nurse numbers to try and save money is a “false economy”, a nursing academic has warned.

District nurse numbers dropped below 10,000 in England and Wales during 2010 and the trend has continued, despite government rhetoric about the need to transfer care from acute settings into the community.

University of Huddersfield senior lecturer in primary care Vicky Kaye said community nursing teams played a vital role in modern healthcare and argued that district nurse cutbacks by trusts were short sighted.   

“They actually offer exceptionally good value, because they combine clinical, leadership and management skills,” she said.

Ms Kaye, a former district nurse in Bradford, made the comments following her successful application to become a Queen’s Nurse.

She said: “I will try and raise the profile of district nursing and argue for its importance.

“District nursing has changed dramatically,” she added. “Care in the community is now a lot more clinically focussed and complex. It used to be a lot more about social care.

“For example, you have patients at home who are on ventilators, with really complex needs, who previously would have been kept in hospital, or preventing people from being admitted to hospital so they can remain at home.”


Readers' comments (10)

  • Anonymous

    District/community nursing is important.

    But, a well-designed engine has only the parts it needs to run well, so except for very fine-tuning, all of the parts are important.

    I cannot help thinking, that one of the motives for the goverment's current attempt to 'place decision-making in the hands of operational clinicians', is to then try to push any blame for cuts, and any resultant lower quality of service, onto the hands of clinicians.

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  • Community Nursing is very important. Patients are being sent home from hospital sooner than in the past with much more complex needs. Palliative care is also much more common in patients own home than in the past.

    We are quite often stretched to our limits in the community so to cut posts is just ludicrous.

    Hopefully Miss Kays voice will be heard.

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  • I thought one of the aims was to nurse more people at home to save costs?

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  • when it comes to it, are care services aimed at making financial gains and saving costs or is their purpose to improved the lives of patients?

    what is all this 'greater choice for patients' all about?

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  • Perhaps I missed something recently, but I thought the health reforms were meant to have more people being cared for at home, and to reduce admissions to hospital. Also people with chronic illness were to be closely monitored and treated to avoid the need for hospitalisation if they relapsed. This obviously can't be done without a proper infrastructure in the community, so cutting back district nurses in order to save money defeats the object, and is ridiculous. Whatever next I wonder!

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  • Anonymous

    Anonymous | 25-Feb-2012 1:54 pm

    I don't think you missed anything.

    But most DN services were originally operational arms of PCTs, and PCTs are being killed off - this is causing reorganistation of many DN services, and it looks to me as if the reorganisations are not necessarily leaving DNs with the strength to fight their own corner strongly enough.

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  • Anonymous | 25-Feb-2012 1:54 pm

    you seem to have understood the same as me, and probably many other people as well, and that is what the government said initially isn't it?

    but I get the impression not that they are lying as everyone accuses them of, but just that they have absolutely no clue what they are talking about. they just need to try and show they are in charge and in control but which they haven't succeeded in demonstrating too much proof of so far!

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  • I find it offensive to both patient and district nurses that the goverment does not see the value of nursing patient in there own enviroment with well trained Nurses. Our care Our Health Our Say seem to have been another lip service to the public.

    We have now sicker patient in the community and I think that community nurses do a brilliant job. Saving the NHS in reduced hosital admission, and nursing patient were they want to be. I feel devalued.

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  • Anonymous 25-feb 2012 2.49pm.

    Clueless is a good word for it.

    Ruthless and not giving a s--- is probably closer to the mark.

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  • DN

    The problem is that senior managers left from the PCT are the ones who are making the decisions and their aim seems to be to protect their own jobs rather than preserve what has been excellent about District Nursing. gone are the numbers of trained DN's based at the GP surgery with a small team and good local knowledge and in come mega teams headed by a sole senior DN who no longer even sees patients but manages an army of nurses. Patients can see up to 30 different nurses, have no continuity and no one to take responsibility for their care. More and more rigid pathways and care plans are produced to try to reduce the need for training which means that we will end up with an unthinking workforce who try to make patients fit into the paperwork rather than the other way around.

    The specialist practitioner DN has been the backbone of nursing in community and has traditionally offered a service that is highly responsive with no waiting lists and a very individualized approach to care that incorporated social and clinical skills. We are the familiar reassuring nursing service that people want and can easily recognise and get in touch with. Now we have a plethora of community nursing services with massive duplication of work and a bewildering criteria with nurses who now say no. Historically DN's have been the ones to say 'yes it is us'. This is what we need. Chronic long term conditions are the very bread and butter of District Nursing so why have our roles not been developed in this area instead of introducing new teams that overlap our work and make things so confusing to patients.

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