The number of district nurses has declined alarmingly over the last twenty years. District nurses require a year's additional training after nurse qualification.
According to the Royal College of Nursing and the Queen’s Nursing Institute in 2003, there were 12,620 district nurses in England. By 2013, the number had dropped to 6,656. In 2019, it was down to just 4,000 - a reduction of two thirds in 16 years. That left only one district nurse for every 14,000 people, despite the national policy direction of providing more treatment in people’s homes. The number has since increased only marginally, to the equivalent of 4,409 full-time posts in the latest figures from March 2022. Overseas recruitment in the sector is limited as its not a service that is common in many other countries and the sector can be less visible to newly qualified graduate nurses. This is despite their importance to innovations such as Virtual Wards and Urgent Community Response Teams.
The number of mental health nurses has also declined. This means that the ratio of qualified to unqualified staff on mental health wards has declined.
Between 2010 and 2019 due to cuts in funding the number of mental health nurses plummeted from 7,053 to 4,031.This, despite the rhetoric of parity of esteem between mental and physical health.
In 2012 the number of training places for nurses was cut across the country. In London there was a reduction from 2,000 places a year to 1,580. A spokesperson for NHS London said, "We intend to concentrate on quality not quantity." The fact that training 2,000 nurses a year was barely enough to keep pace with leavers, mainly those retiring, seemed lost on those who should have known better.
The Nursing Times reported in February that applicants for nurse training have dropped alarmingly: -18% in England, -17% in Northern Ireland, -22% in Wales and -24% in Scotland. All this at a time of record numbers of vacancies and rising workload.