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SEP 01/2014

Examining the growing need to create more jobs for district nurses

The government is coming under increased pressure from the healthcare sector to step up its efforts to create additional jobs for district nurses across the UK.

It is widely recognised that district nurses have a crucial role to play in the primary healthcare system, helping cater to the complex care needs of older patients in residential care homes or those who require treatment in their own homes.

However, in recent times there has been a struggle to find the number of qualified staff needed for these roles, leading various industry bodies to call upon the Department of Health to take much-needed action as soon as possible.

The fall in district nursing numbers
The recent issues with hiring the right number of district nurses in the UK has been highlighted by several reports in the last few weeks. At the beginning of June, the Nursing Times reported the findings of a Queen's Nursing Institute (QNI) survey of 1,035 community nurses, which revealed a widespread feeling that numbers were falling.

Indeed,  60 per cent of those polled said they believed unequivocally that they did not have enough appropriately skilled or qualified staff to deliver the necessary care, with a further ten per cent expressing clear reservations about the staffing or skill mix.

Meanwhile, 36 per cent said the proportion of qualified nurses on their team had fallen, with 54 per cent saying it had stayed about the same and only ten per cent noticing a rise.

These findings were corroborated a few weeks later by data collated by the Royal College of Nursing (RCN), which calculated that a 47 per cent reduction in the number of qualified district nursing staff in England has taken place in the last decade.

Similar concerns were raised north of the border, with RCN Scotland associate director Ellen Hudson noting that 44 per cent of the community nursing workforce is aged 50 or over, meaning the next generation of staff needs to be encouraged to emerge.

The need for action
The RCN has called on the government to fulfil a commitment to increase the community workforce by 10,000 in order to provide the additional manpower needed to bring sustainability to district nursing, as well as to reduce the amount of bureaucracy current staff need to deal with.

QNI chief executive Crystal Oldman concurred that measures should be taken to improve productivity and efficiency, with 35 per cent of teams still relying on manual paper-based systems to allocate work, compared to only one-quarter who used modern mobile technology to record patient care data.

Bolstering recruitment and performance in this sector could be especially crucial given the government's stated intention of moving the focus of NHS care from hospitals to the community, coinciding with population ageing trends that will increase the number of frail older people in the care system over the coming decade.

Moreover, safe staffing levels are being scrutinised more intently than ever before, making it essential that more is done to ensure district nursing numbers do not fall below a threshold that can be considered safe.

Dr Peter Carter, chief executive and general secretary of the RCN, said: "The district nurse role is the foundation of a system that should be able to manage conditions and keep sick and frail people at home. Remove those foundations and the whole edifice could come crashing down."

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