No assessment has been made of admiral nurses in England, who are developed and supported by Dementia UK as an independent charitable organisation.

Provision of dementia health services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services, which may include admiral nurses, based on local population needs, taking account of National Institute for Health and Care Excellence guidelines.

The Frailty and Dementia Modern Service Framework will seek to reduce unwarranted variation and narrow inequality for those living with dementia and will set national standards for dementia care and redirect National Health Service priorities to provide the best possible care and support.

We welcome the Queen’s Institute of Community Nursing’s (QICN’s) continued engagement in informing planning and solutions to address capacity gaps, following our 10 Year Workforce Plan call for evidence. The Minister of State for Health is planning to meet the QICN.

The Government recognises the essential role of district nurses and wider community nursing teams in delivering high-quality care closer to home, preventing avoidable hospital admissions, and supporting people to live well in their communities. We are committed to strengthening the community nursing workforce and ensuring services are equipped to meet rising demand and increasing clinical complexity.

The Government is working with NHS England and professional organisations, including the QICN and the Royal College of Nursing, as we implement the ambition of the 10-year plan to deliver more care outside hospital and build neighbourhood teams. The 10 Year Workforce Plan and the Professional Strategy for Nursing and Midwifery will set out how we will build the multi-professional teams we need to deliver that ambition and ensure we have the workforce with the right skills to meet population need.

The Government recognises the essential role of district nurses and wider community nursing teams in delivering high-quality care closer to home, preventing avoidable hospital admissions, and supporting people to live well in their communities. We are committed to strengthening the community nursing workforce and ensuring services are equipped to meet rising demand and increasing clinical complexity.

NHS England supports the development of future district nurses by funding the Specialist Practitioner Qualification either as an apprenticeship or as a full-time course at a higher education institution. The Level 7 District Nursing Specialist Practice Qualification, including the apprenticeship route, provides a sustainable and nationally consistent route into district nursing roles.

Alongside this, NHS England has continued to modernise career pathways within community nursing, supporting clear progression from healthcare support worker roles through to advanced and consultant practice. This is helping to retain experienced staff and create attractive, long-term careers in community settings.

We are also improving workforce planning through the Community Nursing Safer Staffing Tool. This evidence-based tool supports providers to assess and plan safe and responsive staffing levels, ensuring district nursing teams are resourced appropriately for the needs of their local population.

The Government is working with NHS England and professional organisations, including the Queen’s Nursing Institute of Community Nursing and the Royal College of Nursing, as we implement the ambition of the 10-Year Health plan to deliver more care outside hospital and build Neighbourhood Teams.

This includes developing principles to help organisations identify, record, and address care and population needs. We are also supporting systems to expand multidisciplinary neighbourhood teams, recognising that contemporary care is delivered by a blend of registered nurses, specialist district nurses, healthcare support workers, allied health professionals, and advanced practitioners. This approach helps manage demand, improves continuity of care, and ensures that people receive the right expertise at the right time.

The Government recognises the essential role of district nurses and wider community nursing teams in delivering high-quality care closer to home, preventing avoidable hospital admissions, and supporting people to live well in their communities. We are committed to strengthening the community nursing workforce and ensuring services are equipped to meet rising demand and increasing clinical complexity.

NHS England supports the development of future district nurses by funding the Specialist Practitioner Qualification either as an apprenticeship or as a full-time course at a higher education institution. The Level 7 District Nursing Specialist Practice Qualification, including the apprenticeship route, provides a sustainable and nationally consistent route into district nursing roles.

Alongside this, NHS England has continued to modernise career pathways within community nursing, supporting clear progression from healthcare support worker roles through to advanced and consultant practice. This is helping to retain experienced staff and create attractive, long-term careers in community settings.

We are also improving workforce planning through the Community Nursing Safer Staffing Tool. This evidence-based tool supports providers to assess and plan safe and responsive staffing levels, ensuring district nursing teams are resourced appropriately for the needs of their local population.

The Government is working with NHS England and professional organisations, including the Queen’s Nursing Institute of Community Nursing and the Royal College of Nursing, as we implement the ambition of the 10-Year Health plan to deliver more care outside hospital and build Neighbourhood Teams.

This includes developing principles to help organisations identify, record, and address care and population needs. We are also supporting systems to expand multidisciplinary neighbourhood teams, recognising that contemporary care is delivered by a blend of registered nurses, specialist district nurses, healthcare support workers, allied health professionals, and advanced practitioners. This approach helps manage demand, improves continuity of care, and ensures that people receive the right expertise at the right time.

Officials from the Department regularly meet with their counterparts in the devolved administrations to discuss and update on the development of the 10-Year Health Plan in England.

As set out in the 10-Year Health Plan, the Government is committed to making the National Health Service the best place to work, by supporting and retaining our hardworking and dedicated healthcare professionals.

NHS England is already leading work nationally through its retention programme to drive a consistent, system-wide approach to staff retention across NHS trusts. This ensures trusts have access to proven retention strategies, data-driven monitoring, and can foster a more stable, engaged, productive, and supported workforce.

Specialist community public health nurses in England are typically paid on the National Health Service’s Agenda for Change (AfC) pay system.

Annual AfC pay awards are decided following recommendations from the independent NHS Pay Review Body (NHSPRB). We accepted the 2025/26 recommendations in full, and the Government has asked the NHSPRB to begin the 2026/27 pay round. Relevant stakeholders are invited to submit evidence to the NHSPRB to inform its deliberations.

Officials and ministers continue to engage with AfC unions on pay and contractual matters via the NHS Staff Council.

The Neighbourhood Health Service will bring together teams of professionals closer to people’s homes to work together to provide comprehensive care in the community. We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations, and so they could include dementia specialist nurses. While we will be clear on the outcomes we expect, we will give significant licence to tailor the approach to local need. While the focus on personalised, coordinated care will be consistent, that will mean services will look different in rural communities, coastal towns, and/or deprived inner cities.

The provision of dementia health care services is the responsibility of local integrated care boards (ICBs). We would expect ICBs to commission services, which may include dementia specialist nurses/admiral nurses, based on local population needs, taking account of the National Institute for Health and Care Excellence’s (NICE) guidelines. NICE recommends providing people living with dementia with a single named health or social care professional who is responsible for coordinating their care.

The Neighbourhood Health Service will bring together teams of professionals closer to people’s homes to work together to provide comprehensive care in the community. We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations, and so they could include dementia specialist nurses. While we will be clear on the outcomes we expect, we will give significant licence to tailor the approach to local need. While the focus on personalised, coordinated care will be consistent, services may look different in rural communities, coastal towns, or deprived inner cities.

Provision of dementia health care services is the responsibility of local integrated care boards (ICBs). We would expect ICBs to commission services, which may include dementia specialist nurses/admiral nurses, based on local population needs, taking account of the National Institute for Health and Care Excellence’s (NICE) guidelines. NICE recommends providing people living with dementia with a single named health or social care professional who is responsible for coordinating their care.

Under the 10-year plan, those living with dementia will benefit from improved care planning and better services.  We will deliver the first ever Modern Service Framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, expected in 2026.

Agenda for Change mileage reimbursement rates are reviewed twice a year in line with the process set out in the national contract. These reviews incorporate the latest information on the cost of fuel. The next review is scheduled for April 2025 and any changes required would then be implemented in July 2025. We cannot pre-empt the outcome of this review, however it does not necessarily mean that changes will be made to the reimbursement rates.

The Government is aware that some National Health Service trusts may have local arrangements in place for reimbursing mileage. This would be for local employers and trade unions to manage in partnership.

NHS England publishes Hospital and Community Health Services workforce statistics for England. These include staff working for hospital trusts and other core organisations, but excludes staff working for other providers such as in primary care, general practice, or social care. This data is drawn from the Electronic Staff Record, the human resources system for the National Health Service. The statistics, including those for district nurses, are available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/monthly-nhs-hospital-and-community-health-service-hchs-workforce-statistics

We know that district nurses will also work outside NHS trusts, for other providers of community services. We do not hold data on the number of district nurses working outside the NHS. The Nursing and Midwifery Council publishes data on the number of nurses with district nursing qualifications on the professional register across the United Kingdom, and is available at the following link:

https://www.nmc.org.uk/about-us/reports-and-accounts/registration-statistics/

Between the end of March 2023 and the end of March 2024, the number of supported discharges for patients assessed as no longer meeting the criteria to reside has increased by 17% for patients on pathway 1. Pathway one is for patients returning to their usual place of residence with new or additional health or social care needs. Packages of post-discharge support for these patients may include support from district nurses.

We recognise the importance of increasing district nursing capacity. Through the NHS Long Term Workforce Plan we aim to increase training places for district nurses by 150% by 2031/32. As of January 2024, there were 4,295 full-time equivalent district nurses working in community services in NHS trusts and other core organisations in England, this is 0.5% fewer than in 2019.

What steps she is taking to support the recruitment and retention of community and district nurses.

We hear from Opposition Members who love nothing more than to crow and criticise as their health system declines around them, despite record funding from the UK Government. Scotland has, sadly, some of the worst health outcomes in the western world. Earlier this year, when the UK Government stepped in to offer support, the SNP Health Minister rejected the offer. I reiterate that if the Scottish Government need help to reduce their waiting lists, we stand ready to provide such support.

In Scotland, the vacancy rate for registered nursing posts in the community is 8.5%, and for registered district nurses it is 6.6%—in England, the situation is actually worse in most parts. However, these posts are fundamental, not just to care in communities and to our communities themselves, but to addressing bed blocking. It is obviously for the Scottish Government to address terms and conditions of employment, but their overall funding package is dictated by the block grant and Barnett consequentials. Is it not time that the Department stood up for the NHS? When there is money for weapons abroad, why can we not provide care at home? We were told during the referendum that we would be better together and that the NHS would be protected. Instead, it is being undermined.

As the hon. Member may know, in September 2023, we met our commitment to deliver 50,000 more nurses working in the NHS compared with September 2019. As of January 2024, there are over 68,800 full-time equivalent community nurses working in NHS trusts and other core organisations across England, which is over 2,000 more than a year ago. However, we want to go further, which is why the NHS long-term workforce plan sets an ambition to increase training places for district nurses by 150%, to nearly 1,800. It also commits to improving retention in the NHS.

The Department does not hold this information.

In order to build and sustain the district nursing workforce, NHS England has increased the number of district nurse places available for 2023/24. NHS England does not anticipate a disruption to education provision whilst it undertakes its procurement exercise to secure programmes ready for September 2024 starts.

NHS England does not employ staff in district nursing roles. A range of organisations, and staff groups within them, provide community health services in England and employ district nurses, including National Health Service trusts, Community Interest Companies, charities and private providers.

For district nurses who are employed by the NHS, NHS Digital publishes Hospital and Community Health Services workforce statistics for England which can be accessed at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/

These include staff working in NHS trusts and commissioning bodies, but exclude staff employed by general practitioner surgeries, local authorities, and other independent providers who make up a significant sector of the Community Health Services provider market.

District Nurses work within Community Health Services. It is the responsibility of integrated care boards to commission Community Health Services to reflect local needs. The Government is committed to supporting and retaining the current workforce and training new District Nurses.

The government is on track to deliver on its target of 50,000 additional full-time equivalent nurses by March 2024, through improved retention and investment in a diversified training pipeline and ethical international recruitment. Nursing numbers are over 38,000 higher as of November 2022 than when the commitment was made in September 2019.

No specific assessment has been made. Local commissioners are responsible for ensuring access to palliative and end of life care medicines. NHS England has included a new criteria in this year’s Pharmacy Quality Scheme which incentivises pharmacies to maintain stock levels of 16 critical palliative and end of life care medicines.