Overworked district nurses are struggling to provide high-quality care as the gap between demand on services and available resources widens, a new report has found.

The King’s Fund report, entitled ‘Understanding NHS financial pressures: How are they affecting patient care?’ found district nursing under particular strain due to NHS funding pressures.

Health spending during the past six years has increased by an average of 1.2 per cent in real terms, less than half the annual growth rate of 3.7 per cent in previous years and something the report states is “not sufficient to cover growing demand”.

The King’s Fund, an independent charity working to improve health care in England, investigated the impact of financial pressures on four services: genito-urinary medicine, district nursing, elective hip replacement and neonatal services.

Researchers interviewed national stakeholders, local commissioners, health care professionals, managers and patient representative organisations. They also analysed national data and other published evidence.

The report found “strong evidence that district nursing services are under pressure and that this is negatively affecting patient care”. While demand grows, services are facing funding constraints and critical staff shortages.

The report’s researchers heard examples of providers reducing access to services, increasing delays for non-urgent referrals, and jeopardising quality of care because visits were rushed and task-focused.

To try to reduce the impact on patients, many staff were working long and intense hours, leading to low morale and high stress levels. This was also common among staff in other NHS services.

The report concluded community health services were particularly vulnerable to financial constraints because care is less available and not subject to national data collection, making it “easier to squeeze funding, but more difficult to see the consequences of doing so”.

“Relentless budget squeezes on patient care and frontline staff are starting to have a real impact particularly on staff who are finding it increasingly challenging to provide high-quality care,” said Clair Wilson, senior clinical negligence solicitor at Thompsons Solicitors.

“Knowing where the finger of blame should be pointing doesn’t make the findings of this report any easier to swallow. The consequences of real terms cuts by this and the coalition government are now being felt in the health service by the very patients it is there to protect. The evidence is clear and the government should be ashamed that they are overseeing a year on year dismantling of the NHS.

“The consequences of overworked staff and over pressured services are that avoidable mistakes will happen, costing lives and ultimately costing taxpayers’ money when negligence claims succeed against the health service.”