Question to the Department of Health and Social Care:

To ask Her Majesty's Government whether the number of district nurses in England in community service organisations, such as NHS Community Healthcare Trusts, has reduced since 2010; and, if so, what measures they are taking to address any problems caused by such a reduction.

Community health care services are a crucial part of the health and social care system that allows patients to be cared for at the right time in the right place.

NHS Digital data shows a reduction in the number of full time equivalent district nurses in England from 7,546 in September 2010 to 4,587 in May 2018. These include staff working in hospital trusts and clinical commissioning groups, but not staff working in primary care or in general practitioner surgeries, local authorities or other providers. The number of district nurses in independent healthcare providers increased by 273, from September 2010 to September 2017. As a result of changes made in 2009 to the ways in which community services are provided – i.e. from a range of different types of provider – this does not represent the full picture and there will be a number of district nurses providing National Health Service services in organisations that do not provide a return to the Electronic Staff Records.

The training of new district nurses is important in maintaining a workforce that can deliver the needs of the population in the community. Health Education England has commissioned and funded the District Nursing Specialist Practice Qualification at a steady state over the last six years. These are based upon the requirements that local providers have informed Health Education England. However, year on year these commissions are not fully taken up and therefore Health Education England is working to better understand the reasons this may be.

Health Education England is now exploring the capacity and capability required of our community workforce to best meet the future needs of the population. Health Education England is evaluating the skills and knowledge required within the wider community workforce including district nurses. This has involved extensive engagement across England to understand how best to meet to needs of the local population, as well as develop a role that has a more desirable career pathway for prospective healthcare professionals. The Government is also supporting incentives for postgraduates who go on to work in community nursing roles, including ‘golden hellos’.

Patient safety remains a key priority for the Department and in 2017 we restated our commitment to the NHS being the “safest healthcare system in the world”. The Care Quality Commission (CQC) assesses all registered providers that deliver regulated activities against the Fundamental Standards, below which the standard of care must not fall. Staffing is one of the Standards, and the CQC inspections check that sufficient numbers of suitably qualified, competent, skilled and experienced staff are deployed within service providers. To this effect we would expect providers to continue to ensure patient safety in the community.