District nurses will disappear by 2025, says union

‘The decline in district nursing has occurred even though the demand for their solutions has increased.’ Photograph: Bubbles Photolibrary/Alamy

District nurses, a cornerstone of NHS care, are disappearing so quickly that by 2025 they will “face extinction”, the Royal University of Nursing warns in a report published on Tuesday.

Official figures present that numbers functioning in the NHS in England have nearly halved, from 12,620 in 2003 to 6,656 last 12 months, a 47% drop in a decade. That fall is so significant that they are now a “critically endangered” kind of health expert, the nurses’ union claims.

District nurses go to individuals at house to give chemotherapy to individuals with cancer, make certain diabetics get normal doses of insulin and support the dying finish their days as painlessly as achievable. They can visit patients many occasions a day if necessary, and aid maintain individuals out of hospital unnecessarily.

However the decline in district nursing has occurred even although the demand for their services has enhanced – due to the fact of the ageing population, a increasing number of men and women with life style-connected conditions this kind of as sort 2 diabetes, stress on hospital beds and a drive to provide much more solutions outside hospital.

District nursing teams are hampered by employees shortages which will worsen in the following few many years as numerous – 35% of district nurses are in excess of 50 – reach retirement.

District nurses are typically under such pressure that 75% say they leave at the end of residence visits without possessing undertaken some required tasks, such as providing the patient with a complete explanation of their problem or therapy, or answering all their queries, including their prospects for recovery, or completely assessing their psychological wellness.

Though they have carried out important health care duties, such as administering drugs and checking dressings, they are frustrated by lack of time. The same constraints also restrict their time to speak to a patient’s GP or social staff, in accordance to research among 2,438 neighborhood-primarily based nurses in England carried out for the RCN by the national nursing research unit at King’s School London and Employment Research Restricted.

The survey also discovered that just 37% of district nurses’ time is spent on direct patient care travelling (12%), administration (19%) and evaluation, care organizing and co-ordination (20%) consider up a lot of their week, too, respondents stated.

“The district nurse position is the basis of a technique which must be able to manage circumstances and preserve sick and frail individuals at house. Eliminate individuals foundations and the complete edifice could come crashing down,” warned Dr Peter Carter, the chief executive of the school.

By 2025 there will be several thousands of families with frail, elderly family members, who could nicely have survived a quantity of illnesses. But when they appear for aid to control at house, it basically won’t be there, he warned.

The union would like the NHS to commit to doubling numbers, to get back to the degree noticed a decade ago, in buy to meet the growing demand and offer higher-top quality care.

The Division of Overall health agreed that far more local community-primarily based nurses were essential. Even though Robert Francis’s report into the Mid Staffs scandal had led to hospitals using much more nurses in latest months, “we now require to make confident this transpires across the NHS and in the neighborhood”, a spokesman explained.

“Which is why the chief nursing officer has set up a doing work group which is hunting specifically at what we can do to boost the variety of neighborhood nurses and we are committed to education ten,000 more frontline local community workers by 2020.”

The college’s yearly congress in Liverpool debated calls from some nurses for drunk individuals to be taken care of someplace other than A&ampE units due to the fact they can be disruptive and suggest personnel have significantly less time to commit with other patients.

Some components of the NHS have experimented with alcohol recovery centres, “drunk tanks” and “booze buses” to maintain inebriated folks away from hospitals.

But Carter said that, although he supported pilot tasks to assess the viability of such schemes, the risk of a drunk patient dying as a result of having the head injury they had suffered in a fall being misdiagnosed and want to give them proper diagnostic tests meant that the scope for diverting drunks might effectively show to be limited.

“When somebody is inebriated, just pondering ‘They’re drunk let’s place them in a bus or something’, the problem with that is that if they have fallen in excess of and got a subdural haematoma or some other issue, they could die”, he said.

District nurses will disappear by 2025, says union