Cuts to the district nursing workforce are impacting on patient care, a King’s Fund report has stated.
Understanding quality in district nursing services identified evidence of a growing gap between capacity and demand in district nursing services. The number of district nurses has declined at a time when the number of patients and the complexity of care has increased their needs.
The report concluded that this has resulted in staff feeling rushed and abrupt with patients, reductions in preventive care, visits being postponed and lack of continuity in care. This is in turn impacting on staff wellbeing, leading to stress, fatigue and ill-health.
‘District nurses and their teams are being stretched to the point where quality is at risk – and there is no sign
that the rise in demand will abate,’ said Kathryn Yates, the professional lead for primary and community nursing at the Royal College of Nursing (RCN).
The King’s Fund analysis also identified that district nursing shortages were impacting on general practice and social care caseloads and delayed hospital transfers.
‘There is a lack of expansion in the district nursing workforce at the moment. We are still working with community nurse staffing levels from years ago,’ said Vicki Smith, district nurse and integrated healthcare team leader in Staffordshire. ‘Since then the landscape of district nursing has changed and staffing levels have not adapted to reflect that. With education funding cuts, district nursing is really going to struggle.’
The report argued that NHS leaders should recognise the importance of district nurses in sustaining the healthcare system and to increase recruitment into district nursing by raising the profile and portraying it as an attractive career option. It also recommended developing robust mechanisms to look at staffing and resourcing of community care for older people.
‘We need to end the perception of district nursing as a quiet, gentle role, it is actually incredibly demanding and unpredictable. Nurses must be allowed to treat patients holistically and to stop becoming so task-orientated,’ said Ms Smith.