Revitalising district nursing

Evidence demonstrates that what patients want from their health-care providers is:

‘A care provider who looks and behaves professionally; is caring, competent, knowledgeable and compassionate and provides holistic, timely, seamless care and information; a care partner who works with patients and relatives to plan care, gives constant feedback and reports and helps then to navigate the health and social care system; a champion who puts their interests first and protects them when they are vulnerable; a coordinator who is constant, accessible and accountable for commun icating the plan and monitoring the delivery of care.’ (Department of Health (DH), 2008)

District nurses have been doing just this for more than 150 years while responding to changing political influences and population needs. While recent official figures from the Health and Social Care Information Centre indicate a dramatic drop in district nurse numbers, NHS England claims this has been countered by rises in other community staff (Brimelow, 2013). This very statement should be cause for great concern, as the rise in the plethora of community staff is already leading to fragmentation of care, overlap, confusion for patients and their families, and lack of overall accountability for integrated care, with serious risk to vulnerable people at home. Such services must be led by those who have the appropriate knowledge, leadership and clinical skills. Qualified district nurses are specialist practitioners in community nursing and have just those skills.