A new report published by The King’s Fund has found that patients are being left without pain medication for up to eight hours during end-of-life care due to cuts in nursing staff.
The report, Understanding NHS Financial Pressures, looked at the financial performance of the NHS in comparison to the quality of service being provided with the aim of establishing if financial pressures were affecting its operational effectiveness.
According to the report, district nursing services often have to cover for other failing departments within the NHS such as GP related tasks, providing additional support for the elderly and social care.
It also found that there is a significant gap between demand for district nursing and the available resources in terms of funding and staff numbers.
The report states that district nursing staff are increasingly rushed, visits have become more task-focused, and there is less opportunity for thorough assessments. It also found that there is evidence of increasing delays for non-urgent referrals.
Resulting pressures are having a negative impact on nurse wellbeing and morale leading to high levels of stress amongst nursing staff.
A hospice manager interviewed as part of the study said: ‘The district nurses working at night are not able to give effective response times; you can wait up to eight hours… for patients experiencing pain and discomfort in the last two to three days of their life, it has a massive impact. It’s a frightening time for patients and we are seeing an increasing volume of calls coming through to our advice line where people are in genuine distress.'
Responding to the King's Fund report, Royal College of nursing (RCN) chief executive and general secretary Janet Davies said: ‘This report lifts the lid on the dangers of trying to provide nursing care on the cheap. Patients waiting for district nurses at home are being let down as the funding pressures bite.
‘Nursing staff are straining to hold things together for their patients but they can only hold the fort for so long.
‘Safety for patients is compromised when district nurses are asked to do more with less as lost colleagues are not replaced.
‘Nurses in our communities cannot keep absorbing the problems in the other parts of the NHS and social care system - neither for patients leaving hospital too soon nor vulnerable people who no longer receive enough social care.
‘Patients turn to A&E because of short-sighted cuts to primary, community and social care. But last week, the Government directed funding towards emergency departments and not community services. We need to address the cause, not just the symptom.
‘The RCN has consistently highlighted that the district nursing workforce has been cut back since 2010. Investment in district nurses reduces unnecessary hospital stays and helps get people home again. If the Government wants to support patients away from hospital, it must fund an integrated system with community services at its core; support existing district nurses and stop the cuts to community training places.’
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