Dear Mr Morris,

Thank you for the Regulation 28 report of 29 May 2024 sent to the Department of Health and Social Care about the death of John Richard Hartey. I am replying as the Minister with responsibility for community health services.

Firstly, I would like to say how saddened I was to read of the circumstances of John Richard Hartey’s death, and I offer my sincere condolences to their family and loved ones. The circumstances your report describes are concerning and I am grateful to you for bringing these matters to my attention.

The report raises concerns that a national shortage of District Nurses and Community Specialist Practitioners can lead to a delay in patients being seen in accordance with their needs. In preparing this response, departmental officials have made enquiries with NHS England.

The correct staffing levels are key in delivering safe care. NHS England has developed a national Community Nursing Safer Staffing Tool which is being offered to community nursing providers to support them with identifying the right staffing levels. The tool can help to identify gaps in the service and enable strategies to be developed locally to address any shortfall in workforce numbers. This tool calculates clinical staffing requirements based on patients’ needs (acuity and dependency) which, together with professional judgement, guides chief nurses in their safe staffing decisions.

We have set out a clear commitment to move to a neighbourhood health service, with more care delivered in local communities to spot problems earlier, this includes over time shifting resources to primary care and community services. In the longer term, we are committed to training the staff the NHS needs to be there for patients when they need it.

Minister of State for Care 39 Victoria Street London SW1H 0EU

Demand is increasing nationally for community and district nursing services, and we have been informed that there is a high demand for district nursing services in the Trafford locality.

The Trafford district nursing service operates clinical triage, to ensure patients are seen as timely as possible. The organisation is working to review the service specification with commissioners, to provide necessary assurance and response based on clinical need in the future.

A recruitment and retention strategy launched on 16th July by the Manchester University NHS Foundation Trust, with recruitment events held in April and May and July, aim to increase service capacity. Four posts have also been offered as part of the "guaranteed jobs" programme to newly qualified staff and staff turnover has improved from 20.9% June 2023 to 10.7% May 2024.

Service transformation across the Trafford locality has brought together care to support discharge and provide urgent community response services. The implementation of the new model has meant an increase in establishment in the team, allowing development of the crisis service to meet the 2-hour response national standard.

These changes have been important to support patient flow in and out of hospital but have not reduced the demand on district nursing services in the area which has seen an increase in referrals of 15% in 2023/24.

There are ongoing discussions between the Integrated Care Board, Manchester University NHS Foundation Trust and Trafford Local Care Organisation (TLCO) in relation to the funding of the TLCO Community Services, recognising the capacity challenges.

I hope this response is helpful. Thank you again for bringing these concerns to my attention.