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District nurses 'wiped out' by 2025 without investment

District nurses numbers have dropped by half over the past ten years, and could be wiped out by 2025 according to research released today (17 June 2014). 

The National Nursing Research Unit's study, commissioned by the Royal College of Nursing (RCN), has shown that 35% of the remaining district nurses are above the age of 50 and nearing retirement, posing more problems for the healthcare system.

Despite the NHS and government's commitment to delivering more care in people's homes, urgent investment into district nurses is required and the RCN has called for them to fulfil this need of an ageing population by adding 10,000 community-trained staff to the workforce.

Community nurses are at “breaking point” according to the chief executive and general secretary of the RCN, Dr Peter Carter and he went onto explain the importance of them within the healthcare system.

He said: “When expert care at home is not available for vulnerable or dying people, the end result is unnecessary hospital admissions which are both expensive and distressing.  It is a false economy to leave patients in limbo, rather than training and employing enough district nurses to meet demand.”

The RCN-commissioned study reported only 37% of time was spent directly on patients care, owing to other commitments of community nurses such as paperwork, which supposedly took one fifth of their day.

More than 80% of community nurses reported working addition hours in their shifts, 75% said they left necessary activities unfinished because of lack of time and 40% revealed that they would quit their job if they had the opportunity.

A nurse told the RCN: “It is a privilege to work in the community and in people's homes. If I was given more time to do my job I would love it but at times I can't help but feel I have been unable to provide the care I feel I want to give. This frustrates and saddens me. The need to keep patients out of hospital is being highlighted at the moment but no extra help is being given to front line staff.”

District nurses differ from community nurses in that they have advance training in treating patients in their own homes, but on average they only make up 20% of the staff in a community nursing team.

Furthermore, 16% of nursing teams are without any specifically qualified district nurses.

The RCN also wants trainee nurses to take a compulsory placement in the community as part of their training and experience.

Dr Carter said: “The district nurse role is the foundation of a system which 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.”

He went onto say: “The NHS, and the people who run it, have long paid lip service to the ideal of moving care closer to home. But many people up and down the country are still in need of expert care from district nurses.”

A survey released by the Queen's Nursing Institute has suggested concerns about the morale and the staffing of district nurses.

New reports will be published by the RCN describing the experience of integrated care in the UK and lessons from the current models used in the United States for integration.