District nursing must ‘grow and flourish’, says Streeting

The health and social care secretary has said he wants to see the district nursing workforce ‘grow and flourish’.

Answering questions before the Health and Social Care Committee Wes Streeting used his appearance to promote district nursing as a career path, urging prospective nurses to consider community-based roles rather than focusing solely on hospitals and GP practices.

‘I really want people who are thinking about a career in the NHS not just to imagine working in a hospital or a GP practice.

‘Some of my favourite shadowing of NHS staff I’ve done have been with district nurses, and I really want to see that part of the nursing profession grow and flourish,’ he said.

‘I want people who aspire to be nurses to imagine themselves not just on a ward or in a practice, but out there in the community, in people’s homes.’

‘Constructive’ pay discussions

Mr Streeting also noted that the government is in ‘constructive discussions’ with nursing unions over Agenda for Change (AfC) pay reform, including the long standing issue of district nurses working below their expected pay Bands.

Giving evidence alongside NHS England (NHSE) chief executive Sir Jim Mackey, Mr Streeting said talks with the Royal College of Nursing (RCN) and other unions had focused on recognising the professional status and value of nursing across the NHS and other healthcare settings.

The secretary of state said the government was working towards a potential multi-year deal for AfC staff that could include structural reform to pay, alongside improvements to overall remuneration.

‘We are in really constructive discussions on Agenda for Change, with a view to putting together a package which will be a combination of pay structure reform, which Unison and the RCN have been crying out for, to look at how we improve their pay,’ he said.

Mr Streeting noted that Professor Nicola Ranger, chief executive and general secretary of the RCN, has been ‘banging the drum really hard on the professional status of nursing, recognising the enormous contribution of nursing to the NHS and recognising the value of nurses wherever they work in the NHS’.

‘So, part of what we are currently talking to the RCN and the wider Agenda for Change family about is looking at this Band 5 to 6 issue.’

Mr Streeting’s comments come during a week of industrial action by doctors in England. A five-day strike by resident doctors began this week despite a new government offer.

The British Medical Association (BMA) said 83% of members voting in a snap online poll supported continuing the walkout, with a turnout of 65%. The proposed deal included increasing specialty training posts and covering out of pocket expenses such as exam fees.

On this, Mr Streeting added that any pay agreement to end the strikes would need to maintain parity across the workforce, saying: ‘I can’t go higher with the BMA on resident doctors than I am with Agenda for Change staff.’

‘Part of the conversation we’ve been having with the Agenda for Change unions has been around pay structure reform,’ he added.

In October, a report commissioned by the Queen’s Institute of Community Nursing (QICN) and carried out by the Nuffield Trust found that more than one in four district nurses in England are working below Band 6.

The analysis of data from 113 NHS trusts showed that 27% of staff listed as ‘district nurses’ and employed under Agenda for Change were paid at Band 5.

In November, Nursing in Practice reported warnings from the RCN District and Community Nursing Forum that some employers were creating ‘new roles’ at lower pay bands to replace district nurse posts.

In the same month, the QICN revealed that experienced nurses were being forced to accept lower paid roles in favour of flexible working opportunities and to escape toxic workplace environments.

Last December, Mr Streeting described district nurses as an ‘absolutely vital part’ of the NHS who are often ‘undervalued and understaffed’.

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