Morale among community nurses is low and many are leaving the service due to stress and an increased workload, a report has claimed.

The report from a Welsh assembly committee said the changing nature of healthcare, in particular the move to provide more help in the home and the ageing population, made the role of community nurses increasingly important.

But it said many community nurses feel they do not get the support they need and some see themselves as the “invisible service”.

While the assembly’s health, social care and sport committee focused on Wales, its findings will resonate across many areas of the UK.

Members expressed concern that despite the importance of the service they could find no accurate national picture of the number and skill mix of community nursing teams, or the number of patients receiving care in their own homes. They concluded this was likely to have an impact on the effectiveness of the service.

One of the biggest issues raised by nurses in Wales during a committee inquiry was their inability to access to technology to enable them to do their job effectively.

Community nursing is a collective term for all nurses, midwives and health visitors working within a community setting. A district nurse is a nurse who has successfully completed training that has led to a specialist practitioner qualification (SPQ) being formally recorded against their Nursing & Midwifery Council registration.

Half of the community nurses who took part in the inquiry said they had no access to a mobile. They also reported that many mobiles provided by the employer had no software access to office calendar or emails. Instead, the committee found they were reliant on paper-based systems and outdated technology.

Dai Lloyd, the committee chair, said: “We are proud of the work that community nurses do. They are unsung heroes in the health service. We are concerned to hear from nurses about low staff morale and in some cases nurses are leaving the service as a result of stress and increased workload.

“For the service to improve and thrive we need to make sure that staffing levels are right, that nurses are provided with the mobile technology they need to do their jobs effectively and that community nursing is seen as an attractive career.”

The committee made 10 recommendations to the Welsh government including doing more to understand staffing levels and making sure nurses had access to the technology they need.

Members also said they were extremely concerned to hear that children were less likely to be cared for at home at the end of life than adults because of shortages in skilled community nurses.

It called on the government to make sure there were enough skilled community nurses to deal with the specific needs of children with complex medical conditions.

Lisa Turnbull, of the Royal College of Nursing in Wales, who gave evidence to the inquiry, said: “Morale is quite low, particularly at the senior levels, in community nursing because of the tremendous pressure they’ve been under and feel that they’ve been under for a long time, and also this feeling of being invisible to the wider service.”

A report from the Queen’s Nursing Institute flagged up by the committee said enrolment levels across the UK for the district nurse qualification had been steadily falling.



