The District Nursing Service works 24 hours a day, seven days a week, 365 days a year. District nurses provide 24-hour expert care to housebound adults over the age of 16, working closely with health and social care colleagues including acute services, carers, GPs, practice nurses, care homes, clinical nurse specialists, palliative care, hospices, social workers, dietitians, physiotherapists, occupational therapists and many more, to make sure patients receive the right care in the right place.

The referral pathway is through the integrated health and care front door. To refer your patients, see the How to Refer section below.

The Islington Integrated Health and Care Front Door referral pathway allows GPs to refer patients into adult social care services, as well as to district nursing and community therapists, should your patients have multiple needs. See the Integrated Health and Care Front Door Service page for more information.

Services include

• bowel care
• catheter care
• hickman/PICC line care
• PEG care
• medication
• continence
• stoma care
• palliative care
• CHC assessment
• pressure ulcer
• diabetic foot wound
• tracheostomy
• other wound care
• diabetic care
• INR/routine/urgent blood test
• observation
• nephrostomy care
• drains and drain site care
• traumatic/post-op wound care
• tracheostomy dressing only
• negative treatment wound care only
• IV medication (OPAT pathway) Note: this must be discussed with district nurses

Referrals for district nursing should be sent at least 48 hours before the patient's first visit is required. Note: any new referrals made at the weekend will be allocated visits from Monday.  

Referrals for the administration of medication should be clear and include the name of the drug, the dose, the dosing time, and the length of treatment. The medication record needs to be signed and dated by the prescribing doctor.

Eligibility Criteria

Inclusions

• patients must have consented to the referral 
• they must have an identified nursing need and be: 
  • aged 16 years or above 
  • Islington resident and
  • permanently or temporarily housebound*

Please note: an individual does not have to be bedbound to be considered confined to the home. However, the condition of the patient should be such that there exists a normal inability to leave the home, and consequently, leaving the home would require considerable taxing effort. Any absences of the individual from the home must be infrequent and of a relatively short duration. Long and/or frequent absences will indicate that the patient has the capacity to access healthcare outside the home and does not need the DN service, i.e. if a patient can physically get to their GP, they are not eligible for the service.

Exclusions

• mobile patients/non housebound
• emergency visits
• check/welfare visits, social calls, personal care, 
• prompting oral medication - should be referred to social services
• collect and deliver prescriptions
• nail cutting
• annual checks for patients with diabetes who are not on the caseload
• over 65 screening for patients not on the caseload
• cover for practice nurse sick leave, annual leave, or vacancies
• intermittent self-catheterisation patients
• Trial without Catheter (TWOC)
• district nurses no longer offer the annual review for doppler clinics as the service is the gateway to the leg ulcer clinics. They also do not accept referral for monitoring of patient pressure areas where there has been no identified pressure ulcer
• patients who meet criteria for Continuing Health Care

How to Refer

Locations

Islington Council