New standards for practice and education have been drawn up to help prepare district nursing for a “new era” of services focused on community settings and integrated care models.
They are intended to act as a “starting point” to support plans for further developing community roles in a variety of service models and integrated health and social care teams, said nurse leaders.
The Queen’s Nursing Institute and Queen’s Nursing Institute Scotland said the new framework made “explicit” what was expected of district nurses on completing training and provided a basis for education programmes “preparing the district nurse for a new era”.
“We have been able to create and agree a unified vision for district nurse practice across the UK”
The framework (see PDF attached, top-right) covers four main areas – clinical care, leadership and operational management, facilitation of learning, and evidence, research and development.
It sets out a broad spectrum of skills and practices, from implementing risk management strategies and undertaking case management to promoting self-care by patients, supported through the use of “e-health” technology.
It adds that district nursing teams should also be able to use “creative problem-solving”, demonstrate the “values of high quality, compassionate nursing” and foster a “culture of openness”.
The guidance is intended to reflect the “central” role that district nurses can play in the shift to more community-based and integrated healthcare systems.
The move comes as a range of new care models are currently being tested at so-called “vanguard” sites, as part of NHS England’s initiative to encourage more integration between hospitals, primary and community care services and social care.
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“Never has the specialist expertise of the district nursing service been more central to the provision of health and care in the UK,” stated the guideline document.
“There is a clear policy shift to community based, integrated health and social care in all four countries of the UK with an enhanced focus on admission avoidance, behaviour change and self-care,” it added.
“The need to articulate the role of the district nurse and the generalist specialist skills that they bring is vital”
The QNI and the QNIS noted that the current standards on which all district nursing courses are based were developed in 1994 by the nursing regulatory body that predated the Nursing and Midwifery Council.
They said the new voluntary standards were intended to enhance, not replace, the existing NMC standards, and would support the development of education programmes for contemporary and future practice.
The UK-wide standards were drawn up by an expert advisory group, which was led by Mary Saunders, head of the primary and social care department at London’s South Bank University.
The final version of the standards was published today at the QNI’s annual conference in London, following a consultation over the summer months.
QNI chief executive Dr Crystal Oldman said the new standards “clearly place the specialist profession of district nursing at the centre of community healthcare”.
“We have been able to create and agree a unified vision for district nurse practice across the UK,” she added.
Clare Cable, chief executive and nurse director of QNIS, said the guidance was “a timely contribution” to conversations nurses were having about delivering high quality care at home.
“As all four countries move towards integrated health and social care, the need to articulate the role of the district nurse and the generalist specialist skills that they bring is vital,” she said.
The QNI and QNIS are calling for universities offering the district nurse programme to work with service providers to create courses based on the standards.
They said by meeting them, universities would be demonstrating that their programmes were “preparing practitioners who are equipped to lead and manage current and future district nursing services”.
The NMC has also confirmed it would note where institutions have mapped future accreditation and validation against the new standards, they said.