What we have done
This project was done to improve our understanding of quality in district nursing services by learning from the experiences of older people receiving care, their informal carers and district nursing staff to answer the following questions:
- What does good-quality care look like?
- How does that compare to the experiences of people receiving and delivering care?
- What factors support ‘good care’, and what is getting in the way?
To answer these questions, we have:
- conducted a review of existing policy and research literature
- had scoping conversations with national stakeholders
- conducted focus groups with senior district nursing staff
- carried out interviews with patients, carers and staff in three case study sites.
Our findings are available in the publication, Understanding quality in district nursing services.
Why we have done this work
The increasing number of older people and a policy impetus to provide more care closer to home are set to place greater demands on community health services. However, we know very little about the quality of care provided by these services. While the Francis report has put a spotlight on quality in hospital services, very little national attention has been given to quality in the community sector.
This project builds on our work on measuring and managing quality in community health services, which highlighted a series of challenges to understanding, assuring and improving care quality in community-based services, including:
- fragmented and often poorly co-ordinated services
- a variety of different organisational models and structures
- care often delivered by individuals in people’s homes
- care often being long-term, with ongoing personal and social benefits mattering as much or more than clinical outcomes
- very limited routine national data collected on quality.