The new vision and service model outlined in this report builds on the “Compassion in practice” national vision for nurses, midwives and care staff. The model has been developed by the Department of Health, NHS Commissioning Board Authority, The Queen’s Nursing Institute with district nurse leaders and practitioners. District nursing services, and the district nurse-led team contribution to providing care and support in the community (including peoples’ homes) are covered.
This document is a resource for people designing and/or providing local community health services, i.e. for nurse leaders, health and wellbeing boards, clinical commissioning groups, and commissioners of integrated care for older people.
Foundations of district nursing services include:
- The Six C’s of Nursing (6Cs): the values underpinning the service and delivery.
- Trust: therapeutic relationships between patients and carers.
- Partnerships across GP and other services: collaborative working across agencies to support care.
- Supporting transitions 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.
Developments and innovations which are considered to ensure that district nursing services meet patients’ and carers’ needs include:
- Making every contact count: opportunistic public health interventions and supporting the health and wellbeing of carers.
- Maximising efficiency: i.e. applying productive community services and innovation to enhance care.
- Integrated working with health and social care: i.e. working with partners.
- Delivering complex care: supporting care in community settings; for example administering chemotherapy at home, reducing avoidable hospital admissions and promotion of early discharge.
- Use of new technology to enhance care: i.e. exploring the use of telehealth 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. Some of the topics discussed include: population and case load management, support and care for unwell patients who are recovering at home and at end of life, and the direction of support and care to promote independence.
Care in local communities: a new vision and model for district nursing. London: Department of Health, December 2012.