Latest data shows drop in district nursing students across UK

There has been a 13% reduction in the number of nurses enrolling onto specialist district nursing courses in the UK for 2021-22, analysis from the Queen’s Nursing Institute (QNI) has revealed.

The drop in district nursing students comes after a record number of nurses gained the Specialist Practitioner Qualification in District Nursing (DNSPQ) the year before.

“Various factors affect the continuing demand for the DNSPQ programme”

Crystal Oldman

The QNI has today published its latest review of district nurse education, based on an audit of programme leads across the UK, carried out in December 2021 to February 2022.

A total of 709 nurses gained the DNSPQ in the 2020-21 academic year – equivalent to a 28% rise on the year before. A total of 110 students (13%) did not qualify from this cohort.

In the most recent academic year, 710 individuals enrolled on DNSPQ courses, including 559 who are full-time, 168 part-time and 90 apprenticeship students. This represented a 13% drop on the year before, the data showed.

However, the QNI flagged that numbers for those who qualified and those who enrolled would have been impacted by the coronavirus pandemic and the fact that some individuals had chosen to postpone or delay their courses.

Further data for 2020-21 showed that 40% of applicants to a district nurse programme were not offered a place. Some respondents said this was due to limits on practice placements (12%), or because the student did not meet the shortlisting criteria (26%) or lacked skill or experience (30%) or recent study (18%).

“This is a high percentage of applicants being declined a place, which will require further investigation in future audits,” the QNI said in its report.

The review also highlighted concerns from educators over the funding of programmes, with some in England claiming that the future appeared focussed on apprenticeships and not funding from Health Education England (HEE).

One programme leader, out of the 37 who responded to the audit, said they were considering closure of their district nurse course because of a lack of confirmed funding.

Some respondents said the delayed publication of the Nursing and Midwifery Council’s new specialist practice qualification standards for community nursing education had led to uncertainty for future programmes, noted the QNI.

In addition, almost a third of respondents (29%) said they did not require their district nursing students to be supernumerary while in practice.

The QNI reiterated that “many” district nursing students continue in their usual place of work as both a student and a team member, which “can be problematic for both the student and their colleagues”.

Meanwhile, the pandemic had “exacerbated” the situation and had made “supernumerary status very difficult to maintain”, it added.

Crystal Oldman

Commenting on the findings, chief executive of the QNI, Dr Crystal Oldman, said: “Students and educators in all parts of higher education faced severe impacts due to the Covid-19 pandemic and they deserve great praise for navigating a time of such uncertainty and challenge.

“Various factors affect the continuing demand for the DNSPQ programme and it is difficult to determine the individual impact of these factors on the final numbers enrolled each year.”

She added: “Student numbers may be affected by the supply of central funding for universities, the opportunities to release employees to undertake the programme, and the attractiveness of the programme as an educational and career pathway to prospective district nurses.”

In England – the only UK country to provide a district nursing apprenticeship – there was a need to balance the number of apprenticeships and centrally funded places from government departments to help “deliver the number of qualified and well-prepared district nurses needed to meet the growing healthcare needs of the communities served”, she noted.

Professor Mark Radford, chief nurse at HEE, said: “We know how important the district nurse role is and how much communities and patients value the care they provide, which is why we are committed to continuing to develop this vital workforce.

Mark Radford

“HEE utilises its workforce development fund and transformation monies to develop the workforce, and investment is informed by what employers tell us they need.”

He added: “Salary support and payment of tuition fees are crucial elements of our continued investment of £18-20m per year to develop future district nurses.”

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