District nurses are the hidden heroes of the NHS – so why are they being cut?

From The i in Britain


Liz Alderton’s day is a complex choreography of motion. As a district nurse in greater London, she leads a team of 18 nurses and four healthcare assistants. She teaches students, supervises trainees and works closely with 10 to 12 GP practices. She coordinates with pharmacists, hospice and care home staff and carers who go into patients’ homes.

Then there are the patients. On any one day, her team will see between 100 and 130 of them and help manage their acute and chronic conditions. Many of them have, among other conditions, cancer, asthma, diabetes, chronic obstructive pulmonary disease, leg ulcers and mental health problems.

One of her main responsibilities is to make sure that for patients with terminal conditions, their last days of life are lived in comfort and with dignity, and that they die in their preferred place – most often, their own homes.

Liz Alderton is a Queen’s Nurse – a title given by the Queen’s Nursing Institute, a charity established in 1887 to train district nurses. In 2018, she also received the Queen Mother’s Award for Outstanding Service. After 32 years, she has lost none of her zeal for the work. “This is the best job in the world. Don’t let anyone tell you any different,” she says. Unfortunately for her patients, and the thousands of district nurses across England, NHS planners don’t seem to agree.





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