Duncan Monica
Freelance health economist and senior NHS interim manager.
Br J Community Nurs. 2019 Sep 2;24(9):419-423. doi: 10.12968/bjcn.2019.24.9.419.
District nursing (DN) teams deliver high-quality, complex care under extremely difficult circumstances. DN team resilience depends on the balance between capacity (funding and staff availability) and demand (workload and both clinical and quality standards). The caseload is where capacity and demand meet. Resilience in teams is stretched to the limits and often breached, despite which district nurses remain positive about their role. The overwhelming issue appears to be high workload exacerbated by staff shortages and increasing referrals to DN services. The time is rapidly approaching when district nurses may not be able to keep their caseloads open. If demand and capacity are to be better aligned, the demand should be better predicted, so that lead times are considered and resources are available.
地区护理（DN）团队在极其困难的情况下提供高质量、复杂的护理服务。DN团队的恢复力取决于能力（资金和人员可用性）与需求（工作量以及临床和质量标准）之间的平衡。工作量是能力与需求的交汇点。尽管团队的恢复力已被拉伸到极限且常常被突破，但地区护士对自己的角色仍保持积极态度。最突出的问题似乎是高工作量，而人员短缺和转介至DN服务的人数增加又使这一问题雪上加霜。地区护士可能无法维持其工作量的情况很快就要到来。如果要更好地平衡需求与能力，就应该更好地预测需求，以便考虑前置时间并确保资源可用。
