The Queen's Nursing Institute

The Queen's Nursing Institute works with the public, nurses and decision-makers to make sure that good quality nursing is available at home for everyone when they need it.

Healthcare at home

In this section:

NGS logo

This year, why not enjoy a day out at a National Gardens Scheme garden - you'll be helping fund the QNI too! 

Visit the Burdett Trust website

Providing vital funding for projects that help improve patient care.

DN150 logo

Visit our nursing heritage website, a celebration of District Nursing around the world since 1859.

Nurses' Views

Below is a selection of quotes from community nurses who have written to tell us about their experiences and views:

Vulnerable patients:

"Nursing sick people at home behind closed doors must constitute some of the most vulnerable people in our society. We need to protect them and do this by giving community nurses the best education and training possible."

Nursing values:

"At present, I feel district nursing is losing its values. From being autonomous practitioners, I feel the new role of case managers has started to erode the true values of patient-centred care, turning patients into tasks and nurses into robots."

A different perspective:

"I am a community nurse as well as a carer looking after my mother at home. She is 87 years old and requires assistance with most daily living activities and also has fairly advanced dementia. Since my mother came home from hospital 18 months ago, I have been extremely impressed by the skills and compassion of the district nurses and carers involved. I have now witnessed the service from a totally different perspective and, although I am a qualified nurse myself, I have truly valued the support, skill, advice and genuine empathy displayed by the district nurses. I am very concerned and saddened that the changes taking place to the skill mix within district nursing teams will severely compromise the quality of care provided to what is a very vulnerable group of people and put them at real risk." 

Poor care:

"I am a nurse, but I can give an example from my personal life. My 91 year old mother died at Christmas. Although she was confined to a wheelchair for 12 hours a day, she was not regularly assessed re her tissue viability and ended up with a massive Grade 4 pressure sore. Carers were left to deal with the sore and dress it as best they could although they tried to get the district nurse to visit. Eventually, I got the out of hours district nurse to come out and she was superb. Sorting out analgesia, pressure relief, appropriate dressings, and daily visits from the district nurse. Unfortunately my mother died 24 hours later, and I feel her last few weeks could have been so different with skilled nursing care."


"Qualified district nurses are no longer trained. Newly qualified nurses are now employed directly into the community. Sisters are now covering more and more practices so the staff nurses run the day to day care - fine when they are experienced but there is no support for new staff posts. Health care assistants are now doing first visits and complex dressings with very little, if any, training and are not registered. Where does the buck stop?"

Unsafe working:

"We have known for the past five years that this was going to happen. The aim within our PCT is for 40% trained and 60% untrained. 50 nurses have left my PCT since April and the teams are always on red alert which is working to unsafe practice levels."

Limitations of skills:

"When a skilled nurse retires they are being replaced by a person without the proper community skills. The situation where health care assistants have visited some of my elderly patients and introduced themselves as 'nurses' is a deception and causes confusion for the patients. The health care assitants should be obliged to wear badges indicating the limitations of their skills."

Not just ticking boxes:

"I am very supportive of the role of health care assistants (...) but when you hear, as I did recently, of an HCA writing to GPs and offering to 'see patients with long term conditions and carry out annual reviews for QOF at a much cheaper cost than a nurse' you have to start to worry about the direction in which health care is going: cost first, quality second. I would like to think that nursing care encompasses far more than ticking boxes or carrying out tasks. Caring for someone holistically encompasses a whole range of talents, both practical and interpersonal, in a role which I would consider to be both vocational and highly skilled. There is a place for everyone out there but the place of the skilled, trained, competent and intelligent nurse is pivotal to a strong NHS."


Supporting Carers

Transition to Community

Homeless Health