Care closer to home: The role of district nurses

The reduction of about 40% of district nurses within the last decade, who held the specialist practitioner qualification (SPQ) (Health and Care Information Centre, 2013), raises cause for concern at a time when health policy is moving to care closer to home. Community nursing services and the local populations benefit from skill mix. However, the move in some areas away from employing SPQ district nurses has been at the detriment of quality patient care. For example, a recent King's Fund report (Imison et al, 2012) identified that the availability of community services and integrated care reduces emergency bed use, and yet 68% of emergency bed days are filled by the over 65s. For nurses working within primary and secondary care there is an opportunity to consider a move into district nursing, where advanced practice can be developed to provide safe quality care for individuals in their own home and avoid patients being admitted to hospital unnecessarily. In order to support the increase in district nursing numbers, it is crucial that nurses across all areas of healthcare delivery understand the complexity and potential of the role.