Urgent action needs to be taken to recruit and develop more diabetes specialist nurses (DSNs) to avert a crisis of care for people with diabetes, according to Diabetes UK, which is warning the profession is at ‘breaking point’.
The charity, which has conducted a survey of the profession , say that nearly four out of five (78%) DSNs voiced concerns that their workload is having an impact on patient care and/or safety and almost four in ten respondents (39%) said they considered their current caseload ‘unmanageable’.
A highly committed workforce struggling to cope
Diabetes UK says the survey paints a picture of a highly-committed workforce struggling to cope as demand for diabetes services continues to soar without a corresponding increase in the number of DSNs.Almost 9 out of 10 DSNs reported working above their contracted hours. Several respondents said that their contracted hours have remained the same but they are working unpaid overtime to ensure good patient care.
Workforce numbers have not kept pace with increasing prevalence
The survey suggests that DSN workforce numbers have not kept pace with increasing diabetes prevalence. In little over a decade, the number of people diagnosed with diabetes in the UK has increased by 72%. Yet almost a third of respondents (29%) said there had been cuts to DSN posts in their team over the past two years, suggesting that current financial pressures in the NHS are having a direct impact on diabetes care and safety – storing up further problems and costs for the future.Workforce shortages are likely to worsen in coming years unless more DSNs enter the profession. Worryingly over half of respondents (57%) are eligible to retire within 10 years or fewer. This is a significantly higher figure than the 33% of nurses overall that will be retiring in the next 10 years . In the same time period the number of people in the UK with diabetes is expected to increase by at least 700,000, taking the total number of people living with diabetes to 5.2 million by 2025.Bridget Turner, Director of Policy and Care Improvement at Diabetes UK, said: “Evidence shows that DSNs reduce length of stay in hospital, improve patient satisfaction and are cost effective. But as they are relatively more expensive than non-specialist staff DSNs are vulnerable to cost-cutting measures in times of austerity.
DSNs "not a luxury", they are "vital to delivering safe, quality care"
“Unless urgent action is taken to recruit and develop more DSNs, including to senior grades, workforce shortages are likely to worsen in coming years and this will have a potentially devastating impact on patient care and safety. We know that there are fantastic examples of good practice and innovation in some local areas but the national picture shows a profession at breaking point. DSNs should not be viewed as a luxury, they should be recognised as vital to delivering safe, quality care for people with diabetes, including by supporting people to successfully self-manage their condition.”The charity is calling for a national workforce strategy, as well as local action, to ensure there are sufficient appropriately skilled DSNs to meet current and future demand. Diabetes UK wants to see an end to inconsistencies in the DSN role across the country and is recommending a national system to accredit the specialist skills of DSNs, benchmark standards across the UK and create clear career pathways from entry-level specialist through to senior roles.Helen Atkins, Lead Diabetes Specialist Nurse at University Hospitals of Leicester NHS Trust, said: “Every day I see the positive impact my team has, often against the odds, supporting people with diabetes to manage their condition, avoid complications and keep them out of hospital. Yet in many areas our health system is neglecting this highly skilled workforce just when we need them most.“No nurse wants to deliver anything but the best care possible but the DSN workforce is being pushed to their limits. If we are to rise to the challenge of increasing diabetes prevalence, we need urgent action at both a local and national level to tackle DSN workforce shortages.”The survey was supported by Novo Nordisk.