District Nursing Today

The UK’s District Nurse workforce is under severe threat due to long-term underinvestment in training, education and skills, posing a direct threat to patient safety, according to independent report, commissioned by the Queen’s Nursing Institute (QNI)

Image source: http://www.qni.org.uk

Findings of a new report reveal an evolving healthcare workforce crisis, set against a backdrop of rising demand for district nursing services across all UK regions.

This study shows that for District Nurses (DNs), working conditions, pay, education and training have not improved since the previous QNI report was published (2014). If anything, conditions, lack of support and career development for DNs has deteriorated further, leading to:


  • Working large amounts of unpaid overtime: One in five (22%) of respondents work a day or more of unpaid overtime each week.
  • An ageing workforce heading for retirement: 46% of respondents planning to either retire or leave in the next six years
  • Lack of IT support to do the job efficiently: 36% of respondents reported that Information Technology, or lack access to efficient IT systems, connectivity and support infrastructure is one of the main factors making their role more difficult to sustain
  • The lack of training and development available to District Nurses is a key factor reported to be influencing those looking to leave the profession.
  • Unmanageable caseloads per individual is cited as another challenging factor with almost 30% of teams having a caseload of over 400 patients/people
  • Insufficient time to devote proper care to patients. 63% respondents say they defer visits or delay the delivery of patient care on a daily basis
  • Stagnation and lack of progression in the workforce: 75% of respondents state they have vacancies or ‘frozen posts’ in their teams
  • No administrative support: 28% of respondents have no access to administrative support staff
  • Variation in pay of District Nurses acting as team leaders and significant regional variation in the pay band of District Nurses holding the Specialist Practitioner Qualification.

Full report: District Nursing today: the view of District Nurse Team Leaders in the UK

See also: Sharp Decline in District Nursing Workforce Poses Direct Threat to Patient Safety | QNI

Health and social care experiences

This quarterly briefing aims to provide health and social care professionals with a summary of the issues raised with Healthwatch

Between July and September over 10,500 people shared their experiences of using health and social care with Healthwatch. This briefing looks at 128 reports published by local Healthwatch and aims to provide health and social care professionals with a summary of the issues people have raised with us.

What issues does the briefing look at?

  • Emerging themes across primary care, hospital care, social care and mental health. For example, the importance of good communication when GP services are changing and people’s mental health and physical health not being given equal consideration in A&E.
  • In focus – the support available for people with incontinence and how services can help by making sure patients can easily access the continence products they need.
  • Spotlight on experiences – the challenges people from diverse ethnic communities can face when using health and care services.

Full briefing: What have people been telling us?  A summary of our evidence – July to September 2019 | Healthwatch

[NICE Guideline] Fever in under 5s: assessment and initial management

NICE |  November  2019 | Fever in under 5s: assessment and initial management

This guideline covers the assessment and early management of fever with no obvious cause in children aged under 5. It aims to improve clinical assessment and help healthcare professionals diagnose serious illness among young children who present with fever in primary and secondary care.

Full details from NICE

Cold weather alert

Public Health England | November  2019 |Cold weather alert

Public Health England (PHE) has issued a cold weather alert following the arrival of colder weather in some parts of England.


Dr Emer OConnell, Consultant in Public Health at Public Health England, said:

“Older people and those with heart and lung problems are at risk of getting sick in cold weather.

Keep an eye out for those who may need help staying warm, ensure they wear lots of thin layers and have everything they need.

Below 18 degrees, changes to the body mean that the risk of strokes, heart attacks and chest infections increase so heating homes to this temperature is particularly important to stay well.”

Full details from PHE