Community Nursing Key to 2-Hour Crisis Response in England

At The QNI, we see a future where more people are treated in their homes or usual place of residence, including care homes, rather than in hospital – and with community nurses at the very epicentre of that vision.

2-Hour Crisis Care for Adults

In the coming months, we expect to see a step change, by giving anyone over the age of 18 access to community crisis care in their own homes or usual place of residence, including care homes, within two hours, if there is a sudden deterioration in their health and wellbeing.

This could be in response for example, to a fall at home, if an individual is in need of urgent palliative pain relief, or if they have had a hypoglycaemic episode and are in need of urgent support for their diabetes.

There are many examples where we know that by arriving quickly, nurses from the District Nursing service can prevent an unnecessary admission to hospital, and the individual can be safely treated at home, confident that highly skilled, professional help is at hand. We know this because many District Nursing teams already offer this service, seven days a week within their local services.

When those teams respond, they can not only deal with the immediate crisis, but follow this up with colleagues in the multidisciplinary team to ensure there is holistic and personalised care and support in place that meets all the individual’s ongoing needs.

It is brilliant that this service will soon become ‘business as usual’ across the country. By April 2022, crisis response teams in all parts of England will be provide that 2-hour response, 8am to 8pm, 7 days a week.

New NHS Guidance

NHS England and Improvement has now published guidance with practical support and information to help community services to develop in order to meet this new standard.

It covers design and delivery principles, demand and capacity modelling, monitoring and benchmarking, clinical requirements, referral pathways, assessment and diagnostic tools, and workforce.

The QNI has provided advice on this guidance and we support its direction and core principles. We have also made clear that there are District Nursing services that already offer this service and can share their considerable expertise with those new to the delivery and roll out of the new standard.

Creating and delivering 2-hour crisis response services across the whole of England, coordinated through a local single point of access and fully aligned to other urgent care services, such as NHS111, can only help increase support to people, their carers and families in the home.

District Nursing Services

District nurses deliver complex care every day, playing a central role in supporting people with long-term conditions, helping people often with multiple, complex co-morbidities, and caring for those who are recently discharged from hospital or near the end of life. District nurses will be vital to the delivery of the 2-hour response standard, acting as the lynchpin between primary and social care, hospital teams and care homes, leading and working alongside members of these teams. They often have the closest relationship with the individual being cared for and their family and will be able to ensure that they can give personalised, appropriate and holistic care.

It is critical that the highly skilled District Nursing workforce needed to deliver this standard and to manage this and other risks in the community setting are provided with the opportunity for professional development to underpin this work. We look forward to working with Health Education England and our Community Nurse Executive Network (CNEN) to inform the community nursing workforce development needs in the years ahead.