District Nurses are senior nurses in the United Kingdom’s National Health Service who manage care within the community.

They lead teams of community nurses and support workers, as well as visiting house-bound patients to provide advice and care such as palliative care, wound management, catheter and continence care and medication support.

District nurses are able to prescribe medication to patients in a similar way to General Practitioner doctors, as Community Practitioner Nurse Prescribers under the Nurse Prescribers’ Formulary for Community Practitioners (Part XVIIB(i) of the Drug Tariff), depending on individual qualifications.

District nurses as ‘the air traffic control of healthcare’ – cut the numbers and you might expect more plane crashes or not being able to take off at all. It’s a risk to all of us, we’re more likely to need nursing care in our lives than any other kind of care. In terms of safety, it’s essential that this care is coordinated – that’s what district nurses do. We have a lot of evidence now that specialist nursing helps prevent avoidable admissions to hospital.

And the bottom line now is that if you need a district nurse, you might not get one. Increasingly, the chances of you being able to get care at home, or die there, are diminishing because the services are just not there.

You can teach anyone to take blood pressure or clean a wound. But I’ve certainly come across civil cases where less experienced workers were going in and beautifully dressing wounds and taking observations but then the patient becomes very unwell because they didn’t recognise the signs of, say, gangrene.*

Professor Alison Leary, QNI's ICNO Director

They may be trained to assess patient’s needs for equipment provision such as mobility and independent living aids, medical equipment such as specialist beds and mattresses, as well as guidance in applying for grants and welfare benefits. Their work involves both follow-up care for recently discharged hospital inpatients and longer term care for chronically ill patients who may be referred by many other services, as well as working collaboratively with general practitioners in preventing unnecessary or avoidable hospital admissions.

District nurses assess people to see how to provide nursing care that allows people to remain in their own homes, maintain their independence, or have additional support after discharge from hospital. A district nurse will manage a team of nurses that may provide wound care, train carers to administer eye drops if individuals can not do it themselves, support catheter care, and administer complex medication within a patient’s home as well as immunisations. As well as treatment, a district nurse can offer advice and support with health concerns and refer to other organisations. District Nurses can specialise in different areas such as palliative care.

Read the ICNO‘s report on ‘District Nursing Today: the View of District Nurse Team Leaders in the UK’ here.

*Quote taken from the Daily Mail’s article, ‘Is hiring more district nurses the smartest way to tackle the NHS care crisis as overstretched staff claim they are quitting hospitals due to intolerable pressure.’ (13 November 2021)

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