The Queen's Institute of Community Nursing (QICN) is a charity that works to improve the nursing care of people in their own homes in England, Wales, and Northern Ireland. It does not operate in Scotland, where the Queen's Nursing Institute Scotland performs a similar function. The QICN is also affiliated to the Queen's Institute of District Nursing in Ireland. The QICN is a member of the International Council of Nurses. In March 2025, The Queen’s Nursing Institute (QNI) was re-named as The Queen’s Institute of Community Nursing (QICN).
History In 1859, Liverpool merchant and philanthropist William Rathbone employed a nurse named Mary Robinson to care for his wife at home during her final illness. After his wife's death, Rathbone decided to employ Robinson to nurse people in their own homes who could not afford medical care. The success of this early experiment encouraged him to campaign for more nurses to be employed in the community.
Elizabeth Malleson was concerned to find that there was little local service of nurses for pregnant women in the 1880s. Malleson arranged for a trained nurse and midwife to be available to serve the people of Gotherington. Malleson's scheme was not the first but she decided to form a national organisation and her appeal for help brought her into contact with Lady Lucy Hicks-Beech. She was the wife of Michael Hicks Beach, 1st Earl St Aldwyn, and they gathered enough support to launch a Rural Nursing Association. This was despite the opposition of Florence Nightingale.(2004-09-23). Malleson [née Whitehead], Elizabeth (1828–1916), educationist and promoter of rural district nursing. Oxford Dictionary of National Biography. Retrieved 15 Jan. 2018, see link
These were the beginning of organised district nursing. By the end of the 19th century, with the approval of Queen Victoria, the movement became a national voluntary organisation responsible for setting standards and training nurses. In 1887 'the women of England' raised a Jubilee Fund of £70,000 to mark Victoria's Golden Jubilee. The Queen announced that the money should be used for nursing, and Queen Victoria's Jubilee Institute for Nurses (QVJIN) was chartered in 1889. Elizabeth Malleson's nurses became the Rural Nursing Division in 1891 with Malleson as its secretary. Rosalind Paget was the main organisation's first superintendent, and later inspector-general.Hannam, J. (2004-09-23). Paget, Dame (Mary) Rosalind (1855–1948), nurse and midwife. Oxford Dictionary of National Biography. Retrieved 15 Jan. 2018, see link Queen Alexandra agreed to be a patron in 1901, and a Queen has been patron of the charity ever since. From 1928 to 1973 It was known as The Queen's Institute of District Nursing (QIDN) 1928-1973, as the Queen's Nursing Institute (QNI) 1973-2025, and as The Queen’s Institute of Community Nursing (QICN) from March 2025.
Notable staff A number of the early superintendents and inspectors of the Queen Victoria's Jubilee Institute for Nurses trained at The London Hospital under Eva Luckes. These included:
Sarah Ann Andrew (1856-1942), worked at The London. Superintendent of Gateshead Nursing Association 1896-1912.
Rosalind Paget, who also trained at the Westminster Hospital.Rogers, Sarah (2022). 'A Maker of Matrons'? A study of Eva Lückes's influence on a generation of nurse leaders:1880–1919' (Unpublished PhD thesis, University of Huddersfield, April 2022) Paget was the first Superintendent and later an Inspector General, and William Rathbone's niece. Josephine Bourdillon (1863-1937), served variously as an Assistant Lady Superintendent, Inspector and lastly as Superintendent in Hackney, 1907-1920.Bourdillon, Josephine, Roll of Queen’s Nurses, 1891–1931; Roll No.1760; Vol.8 (1901–1902), 196; Queen's Nursing Institute Registers; Wellcome Library, London [Available at: www.ancestry.co.uk, accessed on 14 April 2018] Sarah Edith Butler (1872-1916), served as an Assistant and Acting County Superintendent, in Lincolnshire, before becoming County Superintendent, Sussex, 1912-1915. Butler 'accidentally' drowned in 1916 whilst serving as a sister in the Queen Alexandra's Imperial Military Nursing Service in Alexandria.Sarah Butler, British Army Nurses’ Service Records 1914–1918; WO399/1205; The National Archives, Kew.Sarah Edith Butler, The Last Will and Testament, 14 April 1916; Probate Search Service [Available at: https://probatesearch.service.gov.uk Norah Farrant (1880-1972), Assistant County Superintendent, and County Superintendent, Sussex 1912-1915, and Variously Inspector of: Eastern, Lancashire, Northern and London Areas, 1918–1928.Farrant, Norah, Roll of Queen’s Nurses, 1891–1931; Roll No.3919, Vol.17 (1910–1911), 119; Queen's Nursing Institute Registers; Wellcome Library, London [Available at: www.ancestry.co.uk, accessed on 26 August 2018]Matron’s Annual Letter to Nurses, No.20, Matron's Annual Letter to Nurses, 1894–1916; RLHLH/N/7/2, No.20, April 1913, 43; Barts Health NHS Trust Archives and Museums, London. Inspector of County Nursing Associations, 1928–1935. Agnes May Stanford (1870-1929), Assistant Superintendent, both in London and East Sussex, and County Superintendent, East Sussex, 1919-1921.Stanford, Agnes May, Roll of Queen’s Nurses, 1891–1931; Roll No.4779, Vol.20 (1913–1914), 229; Queen's Nursing Institute Registers; Wellcome Library, London [Available at: www.ancestry.co.uk, accessed on 18 June 2018] Alice Maud Mersham Tilbury (1857-1936), Superintendent, Essex County Nursing Association, July 1901 – April 1926.Tilbury, Alice M.M., Roll of Queen’s Nurses, 1891–1931; Roll No.840, Vol.5 (1897–1898), 24; Queen's Nursing Institute Registers; Wellcome Library, London [Available at: www.ancestry.co.uk, accessed on 26 August 2018] In 1944 Eleanor Jeanette Merry formed the education department of the Queen’s Institute. This led to the focus on continuing professional development with courses and refresher days organised for district nurses, tutors and health visitors. She became General Superintendent of the Queen’s Institute in 1951 until 1958. Notable representatives of the QICN include:
Elena Richmond who represented the QNI on the Nurses Salaries Committee chaired by Lord Rushcliffe which published two reports in 1943.
Campaigns One in four people over the age of 75 in the United Kingdom need a district nurse's care at home, rising to 1 in 2 people over the age of 85. District nurses visit more than 2.6 million people a year (c. 2011) but by that time the number of trained district nurses had fallen to fewer than 10,000 in England and has continued to decline ever since (QNI, 2022). The number of health care assistants - trained to do specific tasks but not educated or registered as nurses - had more than doubled.”Parliamentary Health Committee, Fifth Report: Commissioning: further issues”. April 5, 2011. https://publications.parliament.uk/pa/cm201011/cmselect/cmhealth/796/796vw36.htm It was against this background that the charity launched the 'Right Nurse, Right Skills' campaign.
Queen's Nurses
The title ‘Queen’s Nurse’ was first given to district nurses who had trained with the QICN and undertaken its written examination. The institute continued to award this qualification until 1968, when nurse education was taken into higher education and the title fell into abeyance. The QICN re-instated the title of Queen's Nurse in 2007 after a gap of 40 years with the approval of the charity's patron, the Queen. The modern Queen's Nurse title is not a qualification, but it is awarded following a rigorous anonymous assessment process, requiring applicants to submit details of their professional career, essays in reflective practice, and references from patients, managers and colleagues. It is available to all nurses who have worked in community settings for over five years and is not restricted to district nurses. In 2021, there are around 1700 Queen's Nurses in England, Wales and Northern Ireland. The Queen's Nursing Institute Scotland (QNIS) has also reintroduced the title of Queen's Nurse in a different form, using its own assessment criteria.
Programmes and services
Leadership Development The charity has opportunities for senior nurses working in the community who wish to progress personally and professionally.
Standards for Specialist Practitioner Qualifications The QICN develops voluntary standards of education and practice for community nursing specialisms. This area of work expanded after 2022 following the review by the Nursing and Midwifery Council of specialist practice.
Personal support The charity provides grants to nurses in financial need, and educational grants to support nurses taking accredited community nursing courses. In 2020, during the COVID-19 pandemic, the QICN launched TalkToUs, a confidential listening service for community nurses to be able to speak to someone about work or personal challenges. The QICN also has a programme called Keep in Touch, that puts working and retired Queen's Nurses together for regular phone contact.
Community Nursing Innovation Programme Since 1990, the QICN has supported hundreds of nurse-led projects through its Community Nurse Innovation Programme (CNIP). Dissemination of project results also helps nurses in other areas to learn from and implement new ideas. The projects—led by community nurses, midwives or health visitors—set up new services or improved ways of working. Grants of up to £5000 are available, in addition to a full year of professional development and support. All project leaders benefit from a professional development programme.
Homeless and Inclusion Health Programme The QICN launched the Homeless Health Programme in 2007, piloted with funding from the Big Lottery Fund until 2010, to offer support to all community nurses, health visitors, midwives and other health professionals working with individuals and families without a secure home.“QNI Homeless Health Initiative’s Improving healthcare for homeless people: A Learning Resource” pp. 2-3. This initiative established a national network of homeless health professionals, offering training events, specialist publications and other support.“QNI Homeless Health Initiative’s Improving healthcare for homeless people: A Learning Resource” pp. 3. http://www.qni.org.uk/docs/Section%20A.pdf The network has continued to grow and develop since its launch, and seeks to share knowledge and share practice for professionals who work with a wide range of people who may typically experience barriers to accessing health services, for example Gypsy, Roma and Traveller communities.
QNI Heritage project In 2009, the QICN launched a new website showcasing the history of community nursing since 1859, when the first District Nurse was employed in England. This website has since been updated and rebranded.
Policy Healthcare policy is a key activity for the QICN. The QICN works to influence decision-makers across England, Wales and Northern Ireland on health care policy including primary care, public health, nursing education, regulation and skill mix and issues such as services for homeless people and reducing health inequalities. To do so, the QICN contributes to stakeholder meetings, responds to national consultations, takes up issues raised by local projects where it appears they may have wider significance, and provides examples and information to policy-makers.
Publications