Warning over lack of learning disability nurses highlighted in new guidance

Draft guidance for safe staffing in learning disability (LD) services across England has warned of a ‘serious deficit of skills’ in the future.

Concerns over the number of nurses and other specialists likely to take early retirement coupled with a reduction in training places are highlighted in a consultation published yesterday (Wednesday) by NHS Improvement (NHSI).

Together with draft guidance on safe staffing on adult inpatient wards; the document is the first to be produced since the regulator took over from the National Institute for Health and Care Excellence (NICE) in June last year.

Shortfall of LD nurses predicted

The guidance states: ‘The number of psychiatrists, nurses and allied healthcare professionals in training today is expected to fall short of future demand for their services.

‘If this isn’t addressed there will be a serious deficit of skills in the workplace.’

The guidance highlights a lack of research into effective workforce planning tools applicable to community-based services such as for those with learning disabilities.

RCN professional lead for learning disabilities Ann Norman was part of the working group set up to help shape the draft guidance.

Ms Norman said: 'There is a distinct lack of evidence to support what we feel we should be doing in the future. Incidents like Winterbourne View helped us to focus on what we need to do next but we need to go further.’

She added that the RCN’s Connect for Change report, published earlier this year, highlighted concerns over the future of the LD workforce and the guidance reinforced those concerns.

She said: 'We will canvass RCN members’ views before responding to this consultation but I expect them to be broadly in line with our own. It's been a crazy past few years with senior nurses being down-banded or losing their posts altogether.

'So while I think this guidance will help in some way, ultimately it is not the full solution that we desperately need.'

Competition

RCN Learning Disability Forum member and LD nurse consultant Dave Atkinson said: ‘Social care needs staff, as do NHS services and community organisations, but they don’t acknowledge they are all competing for the same scarce number of nurses.

‘The RCN did a report on how many LD nurses are taking early retirement and it found the profession is just not being replenished at the same rate.

‘I would have liked to have seen mandatory safe staffing levels being explored in this guidance.

‘The nearest we are likely to get is when a report by NHS Benchmarking Network is published next year.’

Concern over identifying future need

Mr Atkinson also expressed concern at how the pattern of need for LD services is going to be identified in the future.

He added: ‘We know how many people are using specialist services, but we don’t know how many undiagnosed people are currently using mainstream services.

‘There’s currently a huge variety of data available nationally and making it uniform is going to be a real challenge.’

Areas he welcomed included the section on cost and inefficiency, saying: ‘I could see myself using the bullet points presented to create performance indicators which would help rate the impact poor performance has on services.

‘I also really like the section on new technologies available to LD nurses and would like to see that expanded on with some practical examples and case studies.’

The guidance recommends trust use professional judgement alongside ‘evidence-based processes’ for managing staff deployment.

It also highlights a ‘pressing need’ for future research on safe staffing in learning disability settings, taking into account a range of factors including models of service provision and hospital communication passports.

The consultation runs until February 3 and is available via the NHSI website

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