Dr Peter Carter, past president of the Royal College of Nursing, said unless urgent action is taken the dramatically falling numbers of district nurses, signal the death knell for the service.
He added that their vital services are not only essential but “cost effective” for keeping patients out of hospital and cutting a growing number of bed blockers.
Since 2010 the numbers of district nurses have dropped from 12,000 to just over 6,000, Government figures show.
Not enough new district nurses have gone into training to make up the shortfall so nurses who have retired or left the profession are not being replaced.
Dr Carter added: “Many people cannot leave hospital after routine procedures or surgery because they cannot be looked after in their homes.
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“This has a knock-on effect on the whole system meaning other patients cannot be admitted, ambulances are waiting to release patients and A&Es are backed up.”
He added: “Patients at home have very complex needs and without proper nursing care they are more likely to develop complications such as pressure sores, infections leading to hospitalisations. The current system is totally shambolic.”
The Royal College of Nursing said: “District and community nursing staff are vital to the work of the NHS. Many patients can only remain in their own homes because of the care and support they get from district nursing teams.
“As the NHS heads into another winter, district nurses will be working hard to keep thousands of frail, older and vulnerable people out of hospital by treating complex conditions like leg ulcers and urine infections that could otherwise escalate and lead to them being taken to hospital.
“Ministers need to realise that unless they take immediate steps to invest in the community nursing service and make it an attractive career, the number of district nurses will continue to fall, and patients and their families may not be able to rely on the service in future.”
District nurses have a wider range of skills than they did decades ago, and many are now able take on some of the work of GPs and hospital teams.
The Department of Health said: “District nurses and their team of community nurses do a fantastic job and supporting them is our priority.
“We are also ensuring the NHS has the staff it needs for the future through our 25 per cent increase in nurse training places – the biggest in the history of the NHS.”