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Caseload management is key for community nurses

Tagged In:  Nursing

More emphasis on community nursing plays a major part in the new models of care outlined in the NHS Five Year Forward View. And that means supporting our district nursing workforce to be 'safe, effective and provide a high quality of patient experience'.


A report by the Queen's Nursing Institute (QNI) has highlighted what community nurses across the UK have been saying for some time. If community healthcare services are to take more of the strain and relieve pressure on overstretched hospitals, there's a central issue that has to be addressed: caseload management.

In a 2013 survey of community nurses by the Royal College of Nursing, workload and caseload were most frequently cited by respondents as sources of frustration. 77% agreed that their workload was too heavy and 60% disagreed with the statement 'I am given the support I need to manage my workload'.

In the same year, the QNI helped the Department of Health to create a new workplace model for district nursing, recognising 'the unique and specialist contribution of district nurses and their teams'. Caseload management was one of the three core elements of this model, acknowledging that it's a vital component of the district nurse role.

The QNI continues to support the national work on safe staffing by consulting with directors of nursing, service leads, patients and carers. The aim of their recent report is to open up a further debate on caseload management and inform NHS Improvement's work to deliver safe, sustainable staffing in the district nursing service. "The issue of safe caseloads is one that has been of growing concern to district nurses in recent years and we receive more questions on this subject than almost any other," commented QNI Chief Executive Dr Crystal Oldman.

Meanwhile, innovative IT systems are being developed to help employers and nurses with caseload management. All five HSC trusts in Northern Ireland have installed the Electronic Caseload Analysis Tool (eCAT), which provides a wide range of graphical reports to assist district nurses, team leaders, operational and strategic managers. In addition, nursing teams across Staffordshire and Stoke-on-Trent are using eCommunity, which helps staff to better manage their time and caseloads.

"eCommunity makes the allocation of patient visits far easier with its diary feature and also cuts down on travel time for staff," said district nurse Rob Ratcliffe. "It supports us to work remotely and improves the level of care and safety for patients. I don't know what I would do without it."

The move to a more primary care focused NHS has led to increased pressure on the community nursing service. If this important section of the healthcare workforce is to remain effective and motivated, it's vital that they receive the support they need to manage that additional pressure and deliver consistently high standards of care.


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