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Introduction to District Nursing

A District Nurse is a specialist generalist nurse in the community, an expert who is accountable at an advanced level of practice.

The District Nurse serves a whole community, holding and being responsible for a large and varied caseload of people with complex health needs, and managing admission to and discharge from that caseload. They are responsible for autonomous clinical decision‐making, deploying a team of regulated and unregulated staff to deliver care in peoples’ homes, and leading all the nursing care required. A community staff nurse is one of the nurses working under the direction of the District Nurse. District Nurses work above all in people’s homes and may give support to staff working in Nursing and Residential Homes too.

A qualified District Nurse is prepared for their role with a post‐registration Specialist Practitioner Qualification in District Nursing (SPQ DN) at a Higher Education Institution. These post‐registration programmes are currently approved and regulated by the Nursing and Midwifery Council (NMC) to ensure consistency and quality of standards for education and practice and to prepare nurses for the role of an autonomous practitioner.

Specialist Practitioner Qualifications are also available in Community Children’s Nursing (CCN), Community Learning Disabilities Nursing (CLDN), Community Mental Health Nursing (CMHN), and General Practice Nursing (GPN), and the NMC is consulting on additional qualifications for other community specialisms (2021).

This book describes some of the most important parts of a District Nurses’ role. It is not intended as an exhaustive or comprehensive list of everything that a District Nurse might be called upon to do, which is always changing and developing. The Covid‐19 pandemic has changed the landscape of nursing in the community profoundly and rapidly, and District Nurses are now caring for many people who are recovering from this novel disease.

The landscape of health services in the United Kingdom is also changing, and there is growing variation between England, Wales, Scotland, and Northern Ireland. Healthcare policy demands that more care is delivered in people’s homes and communities and a greater reliance on self‐care and the prevention of ill‐health, lessening people’s dependence on hospital services.

It is an exciting time to be a District Nurse, working with people, carers, and families across the life course, helping them to maintain health and independence, in communities in every part of the UK.