UK Government plans to move more NHS England care into the community and out of hospitals won’t be achievable with far fewer district nurses than in Scotland
By stewartb
Another contrast in favour of Scotland’s healthcare system which will receive no MSM media attention and candidly, little or acknowledgement either from the relevant trade union, concerns District Nursing.
Source: Nufffield Trust (May 31, 2025) 1 in 4 district nurses leave NHS – fix district nursing or risk jeopardising plans to shift care closer to home, warns think tank.‘
(Typical of England-based health think tanks, one has to read into their reports to confirm the scope is England only! Why cannot they simply – and always – use the term ‘NHS England’ in titles when that is what they are referring to?)
From the Nuffield Trust: ‘Government plans to move more NHS care into the community and out of hospitals won’t be achievable unless action is taken to address the dire state of district nursing, with an estimated one in four district nurses having left the workforce in the year to September 2024.
‘From 2009/10 to 2023/24, the number of district nurses fell by 43% …. It is projected that, as more people live for longer and with more complex health needs, demand will increase by another 34% over the next 15 years to 2040. The Nuffield Trust says this trend must be urgently addressed, and restoring the service to 2009 levels, relative to current population, could cost £376 million.’
In a press release dated October 31, 2025 in response to the report from the Nuffield Trust, the Royal College of Nursing (RCN) General Secretary said:
“This report shows the value of district nursing to the government’s ambitions, but also how far this workforce has been allowed to fall. Numbers are half what they were over a decade ago, all while demand has risen and is set to continue to rise.
“District nursing is among the best investments a government can make. They are key to delivering expert interventions to help people live healthier lives in their communities, their visits are vastly cheaper than expensive hospital admission, and they will be absolute vital in the success of the planned neighbourhood health service.”
And now to the contrast, using data reported by the RCN itself: Royal College of Nursing Scotland (May 6, 2025) The Nursing Workforce in Scotland.
From page 21, on the District Nursing workforce between Dec 2019 and Dec 2023:
- Whole Time Equivalent district nursing posts increased by 22.5%
- WTE nursing support workers increased by 45.2%
- WTE registered nursing staff in district nursing teams increased by 16.8%.
And more from RCN Scotland, within the increase in the registered district nursing workforce since 2019, the number of Band 7 nurses – more senior/experienced staff- in Scotland increased by 53.7% in the period to Dec 2024.
Sources:
chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/file:///D:/Users/John/Downloads/The-Nursing-Workforce-in-Scotland-2024.pdf
https://qicn.org.uk/resources/outstanding-models-of-district-nursing-report/
Talking-up Scotland 'Albatraz' 
And very helpful they are too.
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