The number of district nurses working in the NHS in England has fallen by 43% between 2009 and 2024, new analysis has suggested.
The findings from the Nuffield Trust, first revealed at an event in parliament yesterday, also showed that the number of adult nurses in hospitals had increased by the same level (43%) during this time.
The research, commissioned by the Queen’s Institute of Community Nursing (QICN), suggests there are now only three district nurses for every five that there were in 2009.
It shows that the between 2009 to 2024, the number of staff recorded in NHS district nurse roles fell from 7,643 to 4,322 (-43%).
Related Article: Dr Crystal Oldman reflects on decade as head of ‘trailblazing’ QICN
While the numbers are full-time equivalent and based on individuals with ‘level’ recorded as district nurses, researchers noted that the 2024 population figure was estimated based on historical trend.
The report, which is based analysis of NHS England and Office for National Statistics data, suggested the decline in district nurses can be partly attributed to a shift to provide more community services via voluntary and independent sector providers.
It estimates that staffing levels relative to need have fallen by over half (55%) since 2009 – comparable to losing around 4,200 full-time equivalent district nurses.
Responding to the report Professor Alison Leary, director of the QICN’s International Community Nursing Observatory which examines district nurse numbers, told Nursing in Practice that this stark decline was ‘concerning’.
‘We know that patients are already going without nursing care in the community and for the government to shift care into the community, this must be addressed,’ she warned.
A shift to community and preventative care is core to the government’s 10-Year Health Plan which is expected to be published later this summer.
The district nurse pay band
The Nuffield Trust also revealed that over a quarter (27%) of staff recorded as ‘district nurses’ are employed at a lower pay level than the Band 6 grading that qualified district nurses are typically expected to start at.
The findings also showed that the 3,171 district nurses that were at Band 6 or above as of September 2024 represented just one in 117 of the total NHS nursing workforce at that time.
Related Article: ‘Powerful’ employer action needed to protect community nurses from abuse
Dr Billy Palmer, senior fellow at the Nuffield Trust who led the research, also said that there were ‘too few’ district nurses leadership positions.
He stressed that this was not only a concern for ‘career progression’, but also prevented ‘high quality’ service delivery.
‘It’s well established that there’s issues in terms of accessing professional development for those careers,’ he explained.
The full analysis is expected to be published by the Nuffield Trust in July.
Related Article: Interview: ‘GPNs are very much part of the community nursing family’
In December the health and social care secretary, Wes Streeting, said district nurses are an ‘absolutely vital part’ of the NHS that are often ‘undervalued and understaffed’.
