Запросы к общинным медсестрам выросли на 50%, но количество пациентов осталось прежним

Referrals to community nursing services up 50% over last decade, study suggests Referrals to district and community nursing services have increased by 50% over the last decade, a study has revealed. Researchers from the University of Hull found that despite the uptick in referrals, the number of people receiving care has remained largely unchanged. Though the average length of time patients spent under community nursing care had fallen. The study, published in the Journal of Clinical Nursing, set out to evaluate adult palliative and end-of-life care provision and the role of community nursing teams in this area of care. In doing so, it has also explored community nursing services demands more widely and researchers have warned, based on their findings, that district nurses are ‘being asked to do more with no corresponding increase in capacity’. Funded by the National Institute for Health and Care Research (NIHR) Policy Research Unit in Palliative and End of Life Care (PRU-PEOLC), the study found that nationally, referrals to community health nursing services increased steadily from around 4,000 to around 6,000 per 100,000 of the population between 2013 and 2024. Related Article: Visa changes ‘do not go far enough’ to stamp out exploitation of care workers During the same time period the findings suggest the number of patients ‘remained stable’ at around 2,600 to 2,800. However, despite the number of patients remaining the same, it was found that nurses had a shorter time on average for each caseload, indicating a ‘system under pressure’, researchers said. They found that the average time spent per caseload reduced markedly from over 150 days to around 50 days, despite frequent contact (23 total contacts per patient). Meanwhile, regional data included within the study – based on Birmingham from 2023 to 2025 – showed that palliative and end-of-life care accounted for 9.6% of all community nursing clinical time during the three-year period. Researchers said this was equivalent to around 30 to 32 hours of care per 1,000 population each year. Study authors determined that palliative and end-of-life care accounts for ‘a growing proportion of workload’, with much of this activity taking place outside normal working hours. They also suggested that district and community nurses are ‘increasingly having to fill gaps’ when patients cannot access other community services, including GP support. Dr Sophie Pask, research fellow at Hull York Medical School who led the research said: ‘By combining national and local data, we were able to build a detailed picture of the contribution community nurses make to palliative and end-of-life care. ‘More people are living longer with complex long-term health conditions. The rise in demand for community-based nursing care is in line with our expectations. Related Article: District nurse shortages ‘contributing’ to end-of-life care being given in hospital corridors ‘That we also found no significant increase in the number of patients receiving community based care and a significant a reduction in “time on caseload” indicates a system under considerable pressure. ‘Patients are being seen for shorter periods before discharge and then often re-referred later. Under pressure, nurses are prioritising end of life care, increasingly responding to crises, often out of hours, rather than offering planned care.’ Director of the Wolfson Palliative Care Research Centre at the University of Hull, Professor Fliss Murtagh, said: ‘This study adds to a growing body of evidence showing that the way we provide end-of-life care is increasingly out of step with rising need.’ She said that district and community nurses were ‘central’ to delivering good palliative care and reducing pressure on hospitals, but that the ‘findings suggest they are being asked to do more with no corresponding increase in capacity’. ‘The impact of being unable to deliver the standard of care they aspire to can affect workforce wellbeing, recruitment and retention, putting further pressure on a system already under strain,’ added Professor Murtagh. ‘If we are serious about improving access to high-quality end-of-life care and reducing inequalities, we must invest in the community workforce that makes that care possible.’ Related Article: Social care nurse prescribing needs ‘system-wide’ approach This comes as nurses recently warned that access to specialist palliative care ‘remains inconsistent and often insufficient’, as they argued for better investment in the nursing workforce. Nurses were speaking at this year’s Royal College of Nursing (RCN) Congress in May when they stressed the need for sustainable funding, expanded 24/7 community care, and early identification of palliative care needs, as well as better investment in the palliative care nursing workforce. It follows an exclusive feature published by Nursing in Practice last year which revealed district nursing teams are being pushed to breaking points due to stretched caseloads from hospice funding constraints. District nurses reported taking on extra care for patients who would have been receiving hospice care. See how our symptom tool can help you make better sense of patient presentations Click here to search a symptom