Unsafe staffing warning as district nurse workforce in England falls 43% in 10 years
There has been a 43% drop in the number of district nurses in England in the last 10 years, leading to sometimes unsafe staffing levels, according to a new report.
The study, from the Royal College of Nursing (RCN) and the Queen’s Nursing Institute (QNI), found that district nursing – which provides care in people’s homes and nursing homes – is “significantly under-resourced”.
It said the number of NHS district nurses has fallen from 7,055 to 4,031 working the equivalent of full-time in just 10 years.
Researchers said nurses had become increasingly “task-focused” as a result, were working at capacity, and sometimes conditions were unsafe.
They pointed to serious problems with retaining district nurses as well as recruiting new ones to fill gaps.
An older workforce means there are not enough nurses coming into the profession to replace those who are nearing retirement age, they said.
At present, there is just one district nurse for every 14,000 people.
The analysis, published at the RCN’s annual Congress in Liverpool, calls for immediate investment to shore up district nursing numbers and increase opportunities for training.
Dr Crystal Oldman, chief executive of the QNI, said: “This new joint report illustrates the central position of the district nurse as the key professional in delivering outstanding healthcare to people in the home and the community.
“Working with GPs and other members of the multidisciplinary team, district nurses have the knowledge and skills to support people living with complex long-term conditions to manage their own health and avoid unplanned hospital admissions.
“Conversely, lack of investment in the district nursing service leads to greater strain on other parts of the health service, including GP practices and hospitals.
“With a rising and ageing population, many of whom are living with multiple long-term conditions, we need a deliberate and intentional investment to support district nurses to continue to deliver complex care to the patients, families and communities that they serve.”
Yinglen Butt, associate director of nursing at the RCN, said: “Given the fundamental role district nurses play in delivering personalised care close to home, and in reducing the burden on hospital providers, the chronic under-funding of this service is an outrageous false economy.
“District nurses provide a lifeline for patients, many of them frail and elderly, who often can’t leave their own homes to get care elsewhere.
“It’s time ministers undertook a proper assessment of staffing needs based on the fundamental principle of patient safety, and enshrined explicit accountability for delivering this into law.”
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