Debate over future of 24-hour district nursing

Debate over 24-hour district nursing has increased after one English PCT found its service was not cost-effective.

Wiltshire PCT operated a pilot of overnight district nursing services working alongside GP out-of-hours from November last year. However, it received a very small number of calls on a limited range of health needs. Each call-out costed an average of £759 over the time of the pilot.

Sally Sandcraft, the PCT's director of nursing, said they had decided to extend the pilot for a further two months and look at ways to make it more efficient as well as looking at other options such as working more closely with social care.

Brighton and Hove PCT has contracted out its 24-hour district nursing services to South East Health Ltd, a not-for-profit company, which already operates GP out-of-hours and unscheduled care services.

Naomi Jones, director of nursing for South East Health, said she felt the key to a cost-effective service was investing in district nursing training so they could take on more advanced roles and provide a useful link with the other out-of-hours services.

Sharon Mayglothling, director of district nursing at Herefordshire PCT said that improving end-of-life care meant 24-hour district nursing will become more common.

‘The way we have managed it means it is cost-effective. We wanted to keep it in-house so we introduced shift-working between 8am and 10pm. Then two district nursing sisters are on call overnight.'

She said the shift system meant a reduced number of calls in the out-of-hours period and on-call nurses were then on administrative duties the next day to reduce the risk of clinical errors due to tiredness.

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