QNI responds to Autumn Budget

The Queen’s Nursing Institute (QNI) welcomes the Chancellor’s announcement of additional funding for the NHS. This shows the government recognises the challenges facing the health service and will go some way in alleviating pressures.

The QNI is pleased to hear the Chancellor recognise the work and contribution of the nursing workforce and the commitment to provide additional funding to meet NHS pay awards is good news.

However, we are disappointed that the funding committed has been largely directed to the hospital sector and tied to performance measures in this setting. Government policy has placed increased emphasis on the provision of care within the community, yet this has not been followed with the required level of investment. Community nursing services are facing significant pressures, yet the ‘invisible workforce’ has once more been overlooked in this budget.

We know that patients want to be cared for in their homes and government have reflected this in policy developments such as the ‘Five Year Forward View’. Community nurses are at the core of this, but without significant levels of investment and resource, the vision for “far more care delivery locally”[1] will not translate into reality.

Health services face significant challenges and it is community nurses who play an integral part in alleviating these pressures. In the UK, an estimated 15 million people live with a long-term condition and 6.75 million of these have multiple conditions. 18% of the population are aged over 65 and 2.5% over the 85[2].

Research indicates that one in four people over the age of 75, and one in two over the age of 85 will receive care from a District Nurse[3]. Yet, as reported last week, over the last seven years the number of District Nurses in England has fallen by almost 50%[4]. Approximately 63% of the UK population wish to die in their home, yet only 20% fulfil this wish[5].

Whilst the Chancellor’s decision to provide £350 million to help trusts plan for winter 2017/18 is welcome, we note the fall in District Nurses has led to increasing numbers of patients admitted to hospital and experiencing delayed discharge[6]. Community nursing services are buckling and the Chancellor has missed the opportunity to inject much needed resource into community nursing services to assist the whole system in meeting the current needs of our population.

We welcome the allocation of £200 million to support efficiency and fund technology. Community nurses are often using technology which is antiquated and inefficient, with 27% of the community nursing workforce still working from paper[7]. Directing the technology funding to community nursing services would ensure the development of technology to improve efficiency and productivity, with systems built to reflect their need and suit the context in which they work.

[1] NHS England (2014) Five Year Forward View

[2] Office for National Statistics (2017) Overview of the UK population: July 2017

[3] The Queen’s Nursing Institute (2009) 2020 Vision: Focusing on the future of district nursing

[4] BBC News, 20 November 2017, District Nurse numbers under pressure

[5] Marie Curie, Sue Ryder, Help the Hospices (2013) Can giving patients choice be cost effective for the NHS?

[6] Christie and Co (2017) Adult Social Care 2017: Funding, staffing and bed blocking challenge

[7] QNI research to be published January 2018