Exclusive: Is it time for learning disability nursing to press the 'reset' button?

Leading nurse figures discuss what action to take on the future of the specialty and on the care of people with learning disabilities

Learning disability nursing could be in need of a ‘visionary reset’ in the wake of the latest care scandals, NHS Improvement has suggested. Such a reset would help the sector respond to future demands of care.

The 'reset' idea was shared at a Learning Disability Nursing Taking Action (LDNTA) meeting, organised by the National Mental Health Nurse Directors Forum, at London South Bank University (LSBU). LDNTA is a group of learning disability nurses, policy leads and academics concerned at recent high profile reports and cases, and who are developing an action plan to improve the field of practice and prevent further failures of care.

Response to criticism

The meeting was called to draw up a response to criticism of the learning disability nursing sector following NHS England's latest Learning Disability Mortality Review; a Children's Commissioner report for England about ‘unacceptable’ placements of children in hospital; an interim Care Quality Commission report on seclusion and restraint; the investigation into failures of care allegations at Muckamore Abbey Hospital in Northern Ireland; and the BBC Panorama undercover programme on Whorlton Hall in County Durham, which showed care staff intimidating residents.

• RELATED: Five days that rocked the learning disability care sector

The ‘reset’ concept came from NHS Improvement, the LDNTA meeting heard.

Learning disability nurse consultant Dave Atkinson explained: ‘We have challenges in terms of numbers and in terms of reputation, but we need to retain nurses as specialists. We are the only specialist profession.

‘We need to describe what we are doing already that works, what we have done in the past that works, and what do we know that works. 

‘The concept of a reset is a vague conceptual idea, but we do not want to be presenting this at conferences over the next few months. We need to make a pretty quick decision on this.’

LSBU professor of mental health nursing Ben Thomas said: ‘Every time there is a scandal it looks like the care of people with learning disabilities is getting more than its fair share of abuse,’ he said.

‘We have to strengthen learning disability nursing because it is the largest part of the nursing workforce involved in the care of people with learning disabilities.’

Benchmark report

NHS Improvement, which launched its learning disability improvement standards for NHS trusts in 2018, is shortly to release a benchmarking report for England showing:

• Three quarters of people with learning disabilities reported that healthcare staff spoke to them in a way they understood.
• Two thirds of staff spoke to people with learning disabilities about their rights.
• Six out of ten people with learning disabilities had a health passport. 
• Eight out of ten patient computer records referred to the person having a learning disability.

An improvement toolkit has also been developed and is set to be used in conjunction with the standards to improve care and outcomes for people with learning disabilities.

• RELATED: Learning disability is an 'equal and valuable' branch of nursing, says report

UK Learning Disability Consultant Nurse Network chair Rebecca Chester raised concerns about nurses working alone who could become isolated and needed support from a wider learning disability nursing network. 

‘Whorlton Hall is not an isolated incident. It is not going to be happening only in NHS-commissioned services. It will be happening locally,’ she said. 

And Geoff Brennan, learning disability nurse and chief executive officer with charity Star Wards, called for greater visiblility and influence in the sector. ‘The time is now, while there is the political will,’ he said.

Find out more

• Belfast Health and Social Care Trust (2019) Summary of ‘A Review of Safeguarding at Muckamore Abbey Hospital – a Way to Go’
• Care Quality Commission (2019) Review of restraint, prolonged seclusion and segregation for people with a mental health problem, a learning disability or autism
• Children's Commissioner (2019) Far Less Than They Deserve
• NHS England (2019) Learning Disability Mortality Review (LeDeR) Programme: Action from Learning
• NHS Improvement (2018) The Learning Disability Improvement Standards for NHS Trusts
• BBC Panorama (2019) Undercover Hospital Abuse Scandal