The impact of the district nurse advanced nurse practitioner role on the transformation of district nursing
Abstract
This article examines the role of the district nurse advanced nurse practitioner and its contribution to the transformation of district nursing services. Primary care is under increasing pressure to bridge the gap between demand and resources, with national and local priorities focusing on frailty and unscheduled care. This article outlines the implementation of the district nurse advanced nurse practitioner role within NHS Greater Glasgow and Clyde and presents findings from a local evaluation. By exploring the impact across the four pillars of advanced practice—clinical practice, research and development, facilitation of learning and leadership—the early findings suggest that this innovative role has had a transformational impact on optimising primary care provision and reducing avoidable hospital admissions for patients on a district nursing caseload. Further research into this role is necessary to ensure that its contribution is comprehensively measured, strengthening the case for recognising this highly skilled role as a key player in NHS Scotland's primary and community health care systems.
Health and Social Care Partnerships (HSCPs) were established in 2015 following the Scottish government's legislation under the Public Bodies (Joint Working) (Scotland) Act 2014 (Scottish Government, 2014). This legislation required the integration of health and social care services, ensuring that these services worked collaboratively by law, made the best use of local resources and promoted a positive experience for service users, carers and families. East Dunbartonshire is one of six HSCPs within NHS Greater Glasgow and Clyde in the west of Scotland and one of the largest health authorities in Europe (NHS Greater Glasgow and Clyde, 2023).
East Dunbartonshire has a population of just over 109000, with a significantly higher proportion of adults aged over 75 years than their neighbouring council areas (Healthandcare.scot, 2023). National Records of Scotland confirm a 69.6% increase in the number of adults aged 75 and over in East Dunbartonshire in 2001–2021 (National Records of Scotland, 2023a). This contrasts with Scotland's national picture which showed a 32.7% increase in this age group over the same period (National Records of Scotland, 2023b). The consequences of this have been an increased demand for healthcare services, with older individuals often requiring more complex care because of multiple comorbidities and polypharmacy.
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