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What does the future look like for learning disability nursing?

Seven years ago, recommendations were made to ensure a safer future of learning disability nursing in the NHS. Here, professor of learning disabilities Bob Gates considers whether anything has changed. 

Seven years ago, recommendations were made to ensure a safer future of learning disability nursing in the NHS. Here, professor of learning disabilities Bob Gates considers whether anything has changed. 

Seven years ago I chaired a review of learning disability nursing for the Professional and Advisory Board for Nursing and Midwifery – Department of Health and Social Care, England. We concluded that learning disability nursing had moved from a narrowly defined role in long-term care, to a much broader role in the NHS and beyond. 


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We stated that it was a health profession supported and endorsed by many as unique in its breadth of employment base, located as it is among the various sectors.  It was and still is the case that learning disability nursing roles span community support specialists, liaison roles between services and agencies, and roles in secure or forensic health settings, and these roles offer support across the age continuum.   

We predicted that a unique interplay between four major factors: higher education issues, workforce issues, along with poor data and ‘intelligence’ issues, and field of practice issues collectively threatened this specialist workforce. 

So what has changed in seven years?

Seven years little has changed except that the numbers of learning disability nurses have continued to decline as predicted and, with the added compounding variable of a change to bursaries, the future of this specialist field of nursing practice is under serious threat.

I also cannot help but notice a lacunae in comment, action, and promotion of this field of nursing practice from nursing leaders, whether it be from practice, management, or academia.

I still believe passionately that this field of nursing has much to offer the NHS and wider health and social economies, to bring about improvements for people with learning disabilities, their life expectancy, and their inclusion. I would urge the NHS, the Department of Health and Social Care and the Council of Deans to consider the continuing validity of the recommendations made then. 

The 2011 recommendations

  • This specialist field of nursing at pre- and post-qualifying level moves to a regional model, and education is provided through a limited number of regional academic centres informed by all key stakeholders on an ongoing basis – adopting a ‘hub and spoke’ model.
  • An effective national recruitment campaign is considered to ‘boost’ levels of recruitment. This should be undertaken simultaneously within a detailed review and articulation of a clear career structure for this field of practice. 
  • Further research be considered to identify the specialist learning disability nursing contribution to a reduction in preventable deaths.
  • Further work articulating new and emerging areas of practice for learning disability nursing that contribute to the health and well-being of this group of people.
  • Urgent promotion of nursing roles in ‘mainstream’ services that might benefit from learning disability nurse appointments to bring about greater skill mix to NHS services, and that might simultaneously assist the inclusion and experience of people with learning disabilities in those services. Examples include: child and adolescent mental health services, children with life limiting conditions, and liaison nurses.
  • Urgent need for engagement with the third sector is needed to understand future workforce requirements better. 
  • The RCN and the nursing leads in the four health departments re-establish the unique contribution of learning disability nursing from a UK perspective, to promote the health and well-being of people with learning disabilities, and acknowledge that this contribution can be made by these nurses in a wide variety of health and social care settings.

 

Reference

Gates B (2011) Learning Disability Nursing: Task and finish Group: Report for the Professional and Advisory Board for Nursing and Midwifery – Department of Health, England. Hertfordshire University, Hatfield, Hertfordshire. 


About the author

Bob Gates is professor of learning disabilities at the University of West London, visiting professor of learning disabilities at the University of Derby and emeritus professor at the University of Hertfordshire.

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