Supporting the district nurse to consolidate advanced clinical skills

Heather Bain, Alison Moggach

Research output: Contribution to journalEditorialpeer-review

1 Citation (Scopus)


Despite evidence that district nursing is valued by the population it services and that the policy agenda supports healthcare at home (Scottish Government, 2017), it is well recognised that the district nursing service in some areas is in crisis (Maybin et al, 2016). It is also acknowledged that the practices of the district nurse vary considerably across the UK. The northeast of Scotland led the way in district nursing in 2013, by moving education and service delivery beyond the traditional district nurse model to supporting education at Master's level and integrating advanced clinical skills in learning. However, this move was not without its challenges for some. With district nurses being lone workers and existing district nurses not practising advanced skills, student district nurses faced considerable challenges in consolidating their skills. At this point, the education was more advanced than the practice experience available.

Concurrently with this being recognised, NHS Grampian employed two advanced practice nurse consultants, one for primary care and the other for acute care. These appointments resulted in a practice development project, in which the transforming nursing roles were incorporated in the development of an advanced care academy concept to support robust initial preparation of advanced skills for all health professionals under the supervision of skilled and experienced mentors. In this collaboration between Robert Gordon University and NHS Grampian, medical colleagues supported key components of competency development in advanced practice.

As part of this workstream, the district nurses in the region of Grampian were targeted to support the consolidation of their advanced skills, including high-level decision making, clinical examination and history taking, interpreting the significance of findings, developing a differential diagnosis and treatment plan and building prescribing competence. Fortnightly, these district nurses participated in a clinic, initially supported by a nurse consultant and district nurse practice teacher with advanced practice skills, including prescribing. Over time, they have developed their competence and confidence.
Original languageEnglish
Pages (from-to)153
Number of pages1
JournalBritish Journal of Community Nursing
Issue number4
Publication statusPublished - 10 Apr 2019


Dive into the research topics of 'Supporting the district nurse to consolidate advanced clinical skills'. Together they form a unique fingerprint.

Cite this