The Queen’s Nursing Institute has announced the publication of its latest review of District Nurse education.

The report covers all four countries of the United Kingdom and summarises the results of an audit of District Nurse education in the UK during the academic year 2020/21. This is the ninth annual District Nurse (DN) Specialist Practitioner Qualification (SPQ) education audit, a review process that was established in 2013.

Programme Directors for Nursing and Midwifery Council (NMC) approved Specialist Practitioner Qualification programmes in District Nursing from across the four countries of the UK were invited to complete an online survey. The report includes quantitative data and also comments from educators that complement them.

Headline findings

709 nurses gained the Specialist Practitioner Qualification in District Nursing (DNSPQ) in the 2020/21 academic year; this represents an increase of 28% from the previous year, although the number is affected by those who chose to postpone or delay courses due to the impact of the Covid-19 pandemic.

710 new students were enrolled on the DNSPQ for the 2021/22 academic year: 559 were full time, 168 part time and 90 were apprenticeship students (the apprenticeship route is only available in England). This represents a decrease of 14% on the previous year, though as above this number will also have been affected by the Covid-19 pandemic.

There are 41 Higher Education Institutions registered to deliver the DNSPQ programme with the Nursing and Midwifery Council (NMC) and 38 of these are currently offering the programme. 37 universities responded to the audit.

Educators expressed concerns over the future of central funding of the DNSPQ. Their responses also highlighted that the delay in the publication of the NMC SPQ standards for community nursing education and practice added to the uncertainty around future programmes. The new NMC standards have now been approved by NMC Council and published (see note below).

This report by the QNI is an accurate and independent analysis of the District Nursing education across the UK. Students and educators in all parts of higher education faced severe impacts due to the Covid-19 pandemic and they deserve great praise for navigating a time of such uncertainty and challenge.
Various factors affect the continuing demand for the DNSPQ programme and it is difficult to determine the individual impact of these factors on the final numbers enrolled each year. Student numbers may be affected by the supply of central funding for universities, the opportunities to release employees to undertake the programme, and the attractiveness of the programme as an educational and career pathway to prospective District Nurses.
Community service providers and HEIs show strong support for the DNSPQ programme but in England at least, they are navigating an unclear future where Apprenticeship and centrally funded places need to be carefully balanced to deliver the number of qualified and well-prepared District Nurses needed to meet the growing healthcare needs of the communities served. The adoption of the ‘virtual wards’ model by the NHS is just one of the policies that will place greater demands – and value – on district nursing services as more complex care is delivered in the home, supported by new technologies.

Dr Crystal Oldman CBE, QNI Chief Executive

The QNI report’s conclusion notes: ‘The National Health Service is now three years into its Long Term Plan, published in January 2019 and supported by the NHS People Plan. Longer term visions for the growth of the NHS workforce are to be encouraged and the number of qualified District Nurses are a key component of the workforce. However, central funding for post registration nurse education is agreed only on an annual basis by the Treasury, which appears to contribute to a climate of uncertainty for HEIs and may act as an unwarranted brake on investment in the system. Education is necessarily an investment in the future and is crucial if the NHS is to achieve its long-term goals of improved population health.’


Notes to Editors:

In February 2022, the QNI published Workforce Standards for District Nursing, highlighting the workload and capacity issues faced by services using data collected over the previous seven years. It is envisaged that these new Workforce Standards will highlight the need for greater numbers of District Nurses required to deliver and lead services effectively for a growing and ageing population with increasingly complex health needs. This in turn may boost the demand for the DNSPQ from provider organisations and commissioners. (https://www.qni.org.uk/news-and-events/news/ new-workforce-standards-for-district-nursing-launched/).

DNSPQ programmes reflect an advanced level of practice, with many already mapped to demonstrate this level. The NMC post-registration standards for Specialist Practice Qualifications (SPQ) and Specialist Community Public Health Nursing (SCPHN) were approved by the NMC Council in May 2022. These reflect an advanced level of practice and programme providers need to revalidate their DNSPQ programmes against these new standards by September 2024. The new NMC SPQ standards comprise a single set for all fields of practice in the community, though the annotation of ‘District Nursing’ will continue to be recorded by the NMC.

Recognising the unique nature of District Nursing practice, the QNI is developing field specific standards for District Nursing to support the annotation, alongside field-specific standards for other community specialisms.

Media Contact:

Matthew Bradby, Head of Communications

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