Challenges and opportunities: the role of the district nurse in influencing practice education
The responsibility of the district nurse (DN), alongside complex case management and leadership, is to ensure Specialist Practitioner Qualification District Nurse (SPQDN) education continues to create practitioners delivering quality evidence-based care. DN leadership and its importance have come to the fore during the COVID-19 crisis, where hospital discharges have increased rapidly to make way for highly complex admissions (HM Government, 2020). This paper examines the importance of the SPQDN qualification, exploring the role of the DN within practice education. Continuation of the vital DN qualification will ensure that the numbers of qualified DNs increase, ultimately protecting community capacity. With a move towards an apprenticeship model to achieve the SPQDN, DNs must engage with and influence curriculum development to confirm courses deliver requirements of the workplace, commissioners and the 2019 NHS Long Term Plan. Expectations of the DN role within practice education have changed, moving away from the practice teacher standards to the new Nursing and Midwifery Council Standards for Student Support and Assessment. This poses new challenges in DN education in practice. The implications of this transition threaten to de-value the quality of the assessment process by removing the high standards of preparation previously demanded; ultimately, this is a risk to the provision of the quality practice education that previously existed.
The qualified district nurse is vital in meeting the challenges in contemporary community practice, which has become more pressured during the ongoing COVID-19 crisis. The need to provide high-quality care with consideration of commissioning requirements has been challenging with the rapid rise in caseload numbers. According to Alderwick et al (2016), commissioning requirements including sustainability and transformation plans (STPs) were introduced by NHS England in response to challenges faced in health and social care, highlighted in the NHS Five Year Forward View (Department of Health and Social Care (DHSC), 2014; NHS England, 2016). This has since resulted in the development of the NHS Long Term Plan (NHS England, 2019), which sets out targets in achieving a new service model joining up care in the most appropriate setting, with community care being a main focal point. This focus of the transfer of care to the community setting has been highlighted as essential during the pandemic. NHS organisations in differing geographical fractions of the UK have been asked to work in partnership, with many clinical commissioning groups (CCGs) merging to counter health and social care concerns and examine service provision required to meet the needs of local populations to attain the targets set by the NHS Long Term Plan (DHSC, 2014; NHS England, 2019; NHS England, 2020).
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