A quarter of people who applied for district nursing for themselves or a family member experienced difficulties. It was unclear to them how to apply and what to look out for, or they were told there was no space for them. Applicants would have appreciated assistance from for example their general practitioner (GP) practice or their municipality. These are the findings of an RIVM study into the experiences of patients and informal carers.
Others did not have difficulty applying for district nursing because they had already received district nursing care before, or because they had received assistance with the application from their municipality or GP. The majority of people who filled in a questionnaire on this subject knew from their own experience and contacts which organisations provided district nursing care in their local area.
Choice of care provider
Furthermore, half of the respondents stated it was important to be able to pick their choice of care provider. Reasons included the quality of care or the provider’s cultural, linguistic or religious background. However, half of those who rated this as important had no choice in practice. They ended up with whichever provider happened to have capacity.
Lack of information
In-depth interviews with clients and informal carers revealed that those who had difficulty arranging district nursing themselves were not fully aware of how the current system works. They were also unsure about what type of care and support they could apply for and from which provider. This group had to call several providers in search of care. The application process took a long time as well. The people in this group expressed a need for a single point of contact that could help them find appropriate care, such as a designated GP, district team or district nursing providers.
Even better cooperation
The researchers also analysed the experiences of care providers and project leaders involved in partnerships. The findings showed that care demands can be handled faster if district nursing providers work together. Some regions have set up central offices to handle all incoming applications. This is easier for those applying for care. More extensive cooperation with GPs, hospitals and municipal social services is needed to improve the process of arranging appropriate care further. For example, involving a district nurse prior to upcoming surgery in a hospital makes it possible to determine what additional care and support is needed in advance.
Coping with demand for care and staff shortages
Care providers and project leaders involved in partnerships also expressed the need for better cooperation agreements with referrers and social services, for example about the types of care that district nurses should provide and which care could be organised some other way. This is necessary to cope with the growing demand for care and staff shortages. Lastly, care providers stated that care insurers could be more active in stimulating local and regional cooperation.
Visible and accessible district nursing
The Dutch Ministry of Health, Welfare and Sport has commissioned RIVM to conduct a study into increasing the visibility and accessibility of district nursing, and identifying what is needed to make progress in this regard. Visibility means that clients and professionals must have clear information about the providers they can turn to in their local area to meet care demands. Accessibility means that district nursing providers and other care providers, such as GPs, hospitals and social services, take responsibility for finding appropriate care and support for every client.
This report discusses the results of the second year of the study (from mid-2022 to early 2023).