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District Nurse should become band 7 on Agenda for Change, says QNI chief

District Nurse should become band 7 on Agenda for Change, says QNI chief

District nurses are undervalued within Agenda for Change pay scales and should be reassessed to a band 7 role, the QNI chief executive Dr Crystal Oldman has said.

Dr Oldman told Nursing in Practice that the role of district nurse now requires such levels of additional responsibility and training, adding that changing the banding was a ‘no-brainer’ for boosting retention and recruitment.

After the introduction of Agenda for Change in 2004, newly qualified district nurses are almost always offered contracts at band 6. An employee on a band 6 contract could expect to earn between £33,706 and £40,588 depending on their experience.

Band 6 roles include positions such as school nurse, clinical psychology trainee, and health records manager.

However, speaking to Nursing in Practice, Dr Oldman said that band 6 ‘is just nowhere near mapping to the knowledge and skills that they [district nurses] have got and the responsibilities that they’ve got, and that will make a difference to retention.

‘I think Agenda for Change (AC) is probably due for a review. What you can actually do in a patient’s home now is so phenomenally different from when AC was set up that now they should definitely be at a band 7.

‘There is no question about it as far as I am concerned. These [district nurses] are leading and managing such a huge amount of risk in their team in unpredictable environments, they hit all the requirements for a band 7.’

This, says Dr Oldman, could have a significant impact on recruitment and retention of district nurses.

In the past ten years, the number of district nurses has fallen over 40%. This has left only around 4000 district nurses across England and a ratio of just one district nurse for every 14,000 people.

‘If you qualify as a district nurse and really love what you do, but you look around and see that there’s a job for a community matron who doesn’t have a team to manage and they’re a band 7, you would go and apply for that. There’s a huge leakage of nurses who qualify in these team leader roles that then disappear.’

However, it’s not just newly qualified district nurses leaving their roles that is bad for retention. The current agenda for change banding also puts off those who would otherwise want to train and further their career.

Amanda Beckett is a community staff nurse working with in a district nursing team, and often has to take on the role of the district nurse when they are absent.

‘I have been offered the opportunity to further my career by completing the DNSPQ,’ says Ms Beckett, ‘but turned it down following interview as I was not convinced the extra work and responsibility would be worth only a band 6 wage.

‘The workload responsibilities of the district nurses in my area has now expanded to completing the off duty, annual leave requests, back to work interviews following sick leave, clinical supervision, TURAS appraisals and assisting staff with revalidation.’

Ms Beckett pointed out that in addition to all these roles which ‘previously been part of the role of the band 7 team leader or band 7 professional lead’ the district nurse was also responsible for advising GPs on medication, prescribing for palliative patients, carrying out clinical assessments, training staff, and liaising with specialist nurses and consultants.

She says that the current pay scheme is ‘unlikely’ to entice band 5 nurses into carrying out further training without alterations to agenda for change.

The DHSC did not respond to a request for comment.

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