This vision builds on Compassion in Practice’, the national vision for nurses midwives and care staff. It was developed by a strategic partnership of the Department of Health, NHS Commissioning Board Authority, The Queen’s Nursing Institute, and with the district nurse leaders and practitioners. The vision recognises the unique and specialist contribution of district nurses and their teams.
It sets out the strong foundations of district nursing services:
- 6Cs - enduring values underpinning the service and delivery
- trust - which starts with therapeutic relationships between patients and carers
- partnerships across GP and other services - collaborative working across agencies to support care
- supporting transition of care - working with partners to provide seamless support including discharge planning, transition to residential or hospice care
- supporting patient choice - working with patients and carers to encourage active participation in care and decision making
- managing risk - reducing social isolation through supportive care co-ordination, supporting the needs of carers and safeguarding vulnerable patients.
It also outlines the developments and innovations that ensure services can meet current and future needs including:
- making every contact count - providing opportunistic public health interventions and supporting the health and wellbeing of carers
- maximising efficiency - use of productive community services and innovation to enhance care
- integrated working with health and social care - developing strengthened ways of working with partners to maximise resources
- delivering complex care - supporting care in community settings e.g. administering chemotherapy at home, reducing avoidable hospital admissions and promotion of early discharge
- new technology to enhance care - the use of tele-health and mobile technology to support complex care in the home.
The district nursing service model outlines the district nurse-led team contribution to providing care and support in the community, including peoples’ homes. The three core elements include:
Population and case load management: Caseload management and providing population interventions to improve community health and wellbeing. Surveillance of caseload and local population needs. Working with partners for health protection and improvement for adults and their carers, at home and in other community settings.
Support and care for patients who are unwell, recovering at home and at end of life: Responding when specific expert health intervention is needed e.g. with short-term health issues, or sudden health crises or when patients are discharged from hospital, or have a sudden deterioration in a health condition. Providing interventions within the home including chemotherapy and intravenous therapy. Working with community specialist nurses including community matrons, to deliver specialist care including palliative and end of life care.
Support and care for independence: Leading and prioritising supportive care to help wellbeing and independence including advice on ‘assistive technology’ such as telehealth and telecare, working with patients and their families to help them care for themselves. Leading and co-ordinating care in partnership with health and social care, other agencies and specialist services. Working together with patients to deal with more complex issues over a period of time.
Viv Bennett, Director of Nursing DH/PHE said:
“In order to meet the needs of our ageing population we have to change the way we work and provide more care in the community. People are living longer and we need services that support people to be as well and as independent as they can for as long as possible. District nurses have the professional expertise and knowledge to lead and provide these services.”
The vision aims to be a resource for those designing and providing local community health services including nurse leaders, health and wellbeing boards, clinical commissioning groups, and others with an interest in developing integrated care for older people.