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District nursing ‘should not be overlooked’ in home visit debate

District nurses should not be overlooked in the debate about how to deliver care for patients in their own homes, the Queen’s Nursing Institute (QNI) has said.  

The warning comes after GP leaders in England voted for a motion for home visits to be removed from core GP work at the England LMCs conference in London last month. 

They argued the move was necessary due to lack of capacity and said home visits could be carried out by other health professionals including paramedics and physician associates.  

However, the QNI has pointed out the risk of ‘highly skilled’ district nurses, ‘who liaise closely with GP colleagues’ and treat complex conditions and provide end of life care in patient’s own homes, being overlooked in the debate about GP home visits.

Dr Crystal Oldman, chief executive of the QNI, added that the recent vote underlines the ‘need for greater investment in the district nursing workforce’ and ‘need for this skilled nursing care is arguably greater than ever’.  

She continued: ‘There are many reasons why people may be unable to go to a GP surgery or to a hospital appointment. If they are not mobile then a home visit is often the safest setting for the delivery of care to take place. It is also more cost effective, as the alternative is that families and carers will turn to ambulance call outs or attendance at an Emergency Department.  

‘While changes in technology and advances in treatment mean that some care must be delivered in a clinical setting, there are also new opportunities for more advanced care to take place in the home.'  

English GPs, who voted by 54% to seek the change, also voted for the General Practitioners Committee (GPC) to negotiate a separate acute service for urgent visits. 

The votes mean that the GPC will be mandated to negotiate for this in contract negotiations. In the debate, the GPC said that it was highly unlikely NHS England would accept such proposals.  

Last month, it was revealed that half of district nurses plan to leave the profession in the next six years amid ongoing issues over staff recruitment and retention.  

The QNI and the Royal College of Nursing also argue for more co-location of district nurses and GPs, in order to achieve more efficient care for patients, in their recent Outstanding Models of District Nursing report.