Community Nursing Faces Enormous Post-Covid Challenge

The number of District Nurses working in people’s homes and leading Community teams had fallen from just over 7000 to a little over 4000 in the 10 years to 2019

The care Covid-19 survivors will need will be complex and demanding – and will inevitably require a massive Nursing and Care recruitment effort to avoid overwhelming existing teams.

The Long Tail Of Covid

A Community Nursing crisis may develop throughout 2021, with tens of thousands of intensive care patients and Covid-19 survivors requiring long-term Community Nursing support.

The situation facing Community Nursing hasn’t been paid much attention, despite being likely to worsen quickly.

As many as 100,000 intensive care patients, including around 15,000 Covid-19 survivors, will require Community support once discharged.

That’s on top of an unknown number of Covid patients from the 350,000 treated on general wards since March 2020.

Then there’s the many thousands of Covid survivors who were never hospitalised but may require help with the debilitating symptoms of long Covid.

The situation has been raised by some government ministers, but as yet a clear workforce and recruitment strategy across the NHS hasn’t been properly established.

Community Services Already Stretched

Signs of increased demand for Community Nursing services have already emerged.

NHS Community services have reported big increases in demand, with some services reporting a 50% increase in referrals and many staff working longer shifts.

Certain less critical services have even stopped.

Before the pandemic started, there were also worrying trends in Community Nursing numbers.

The number of District Nurses working in people’s homes and leading Community teams had fallen from just over 7,000 to a little over 4,000 in the 10 years to 2019.

And Covid protocol, like the need to wear full protective clothing for every visit, isn’t helping.

Estimates suggest Community Nurses are losing an hour every day following such protocols.

Funding for Community Nursing is a difficult problem to solve because it largely comes from block contracts – meaning it has to come from existing budgets.

NHS England doesn’t commission post-ICU rehabilitation services – which might explain why this crisis hasn’t been better prepared for.

But attention and focused budget will be needed – the headline NHS investments for all health services is largely irrelevant.

Public visibility of Community Nursing is also an issue.

Hospital Nursing is on the public’s radar – and consequently, politicians’ radar too.

But the vital work that Community Nurses do has been described as ‘invisible’ – and deserving of far more recognition.

And perhaps with more recognition, more investment might come too.