Outstanding Models of District Nursing

This report aims to identify what makes an outstanding District Nursing service.  It explores a variety of District Nursing service models as well as the views and experiences of a wide range of stakeholders.  The report makes a number of recommendations based on the findings | Royal College of Nursing (RCN) and Queen’s Nursing Institute (QNI) 

In meeting the needs of patients, families and carers in the community, the key recommendations of this project are:

  • To create a workforce fit for purpose it is essential that District Nurses continue to
    gain a post qualifying District Nurse Specialist Practice Qualification (DNSPQ).
  • To develop a strategy which will expand commissioners’, providers’ and the public’s understanding and knowledge of the District Nurse role.
  • To promote the population health element of the District Nurse role.
  • To develop a national standardised data collection system and data set within
  • To develop a national standardised approach to the assessment of quality.
  • To support safe staffing and safe caseloads.
  • To actively explore the co-location of District Nursing teams within Primary Care

Full report:
Outstanding Models of District Nursing.  A joint project identifying what makes an outstanding District Nursing Service.

Community pharmacy integration and innovation

Primary care home: community pharmacy integration and innovation | The National Association of Primary Care  

community pharmacy
Image source: http://napc.co.uk

This guide is intended to further the integration of community pharmacy within primary care homes (PCHs) to improve patients’ health and support them to manage their conditions.  It looks at ways local pharmaceutical committees, community pharmacies and PCHs can make greater use of pharmacists’ skills as part of a whole population health approach.

It focuses on the three key roles outlined in the Community Pharmacy Forward View: a facilitator of personalised care for people with long-term conditions (LTCs), trusted, convenient first port of call for episodic healthcare advice and treatment, and a neighbourhood health and wellbeing hub.

The guide also proposes a list of actions to galvanise PCHs and community pharmacy to come together to create innovative solutions to the current challenges and improve services for their local population.

Allied Health Professions supporting patient flow

This quick guide demonstrates how NHS emergency care, in particular patient flow through the health and care system, benefits from allied health professionals | NHS Improvement

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Bringing the AHP workforce into patient flow planning can improve quality, effectiveness and productivity.

Each section gives a brief overview of the contribution that AHPs have made to deliver safe, effective patient care and flow, followed by case studies which demonstrate how AHPs:

  • work in the community keeping people safe and well at home
  • ‘front door’ assess, diagnose and treat patients in emergency departments, ambulatory care and assessment units
  • support avoidance of hospital admission
  • enable early rehabilitation and reducing overnight admissions
  • drive ‘Home First’ (discharge to assess) to avoid in-hospital deconditioning of frail, older people.

Full detail: Quick guide: allied health professions supporting patient flow

Reimagining community services: making the most of our assets

Source: Kings Fund

The purpose of this research was to understand the current state of community services and to explore how the health and care system needs to change to enable these services to meet the needs of the population now and in the future.

Growing financial and workforce pressures are having an impact on the ability of community service providers to meet the needs of the population and to make a reality of the vision set out in the NHS five year forward view. Community services are often fragmented and poorly co-ordinated, and are frequently not well integrated with other services in the community. This results in duplication as well as gaps between teams delivering care.

There is a great deal of innovative work going on across the NHS and beyond to improve community-based care. This is mainly happening through innovative projects rather than system-wide transformations in care delivery. A radical transformation of community services is needed, making use of all the assets in each local community wherever these are to be found, breaking down silos between services and reducing fragmentation in service delivery.

The most promising possibilities in the short term are through sustainability and transformation partnerships (STPs) and accountable care systems (ACSs), where plans have already been developed to strengthen community services and improve population health. More work is needed to ensure that all STPs offer a credible basis for improving care for their populations and strengthening services in the community, drawing on the design principles set out in this report

Integrated Care Services (iCares). Transforming and Integrating Community Services within admission avoidance, care management and community rehabilitation services

NICE Shared Learning Database

Sandwell and West Birmingham Hospitals NHS Trust

This summary highlights outcomes from implementation of an integrated care service, a single point of access for service users with long term conditions. It demonstrates how key recommendations from NICE’s guideline for intermediate care (NG74) can be delivered in practice.

Reducing delayed transfers of care over winter

NHS Improvement has written to the chief executives of all trusts providing community services setting out actions they must implement to reduce delayed transfers of care over winter. | NHS Improvement | HSJ


NHS Improvement  chief executive Jim Mackey has said trusts must help improve delayed discharges over winter and listed six actions they need to carry out in the next six months:

  1. Facilitate the sharing of patient data with acute and social care partners and from 7 November ensure daily situation reports are completed “to enable better understanding of community services at a national level”.
  2. Jointly assess discharge pathways with local partners including “being an active participant in the local acute provider’s discharge and hosting operational discussions daily where necessary to discharge patients in community settings”.
  3. Develop “discharges hubs” over the next six months and beyond, designed to be a single point of access for patients moving between acute and community services.
  4. Ensure a “robust patient choice policy” is implemented.
  5. Clarify to partner organisations what services the trust offers to patients.
  6. Ensure collection of patient flow data and data on plans to improve patient flow.

Full detail is given by NHS Improvement who have produced the following  report to help improve flow into and out of community health services:

Flow in providers of community health services: good practice guidance

Related HSJ article: Trust chiefs given new instructions to tackle winter DTOCs

Implementing a people powered approach to health

This report gathers a wide range of insights taken from three community sites on how to implement a people powered approach to health and wellbeing.

Image source: http://www.nesta.org.uk

These three main insights were found to be the most important to making a difference on the ground:

  • Helping people help themselves
  • Creating opportunities for people to help one another
  • Creating value between the professional and social spheres – helping health and care

Mobilising Communities was a short, experimental programme aimed at exploring the practical applications of the idea of ‘social movements’ in health in three communities in England.

The objective of the programme was to work with three sites to explore the opportunities to support effective ways of combining people power and community resources, together with publicly funded services, for better health outcomes across local communities.

The report goes into detail on how each of the three insights above can be developed to support a social movement in health for people and communities.

Download the full report: Mobilising Communities: Insights on Community Action for Health and Wellbeing