Why learning disability nurses need to be service leaders

If outstanding care and delivery of services for people with learning disabilities and/or autism is to be realised, specialist nurses need to lead the change

If the COVID-19 pandemic has taught us anything it is how inhumane the experience of social isolation is.

Under normal circumstances most of us are free to choose socialising versus self-imposed isolation – something that usually depends on what sort of mood we are in. Autonomy is defined as ‘freedom from external control or influence’ and it is something we take for granted.

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This is not the experience, however, of many people with learning disabilities who have lived in or are living in hospitals that have been described by England’s Care Quality Commission (CQC) as ‘undignified and inhumane’.

More than 2,000 people with a learning disability and/or autism in inpatient units in England

Whorlton Hall, the specialist hospital in County Durham, which closed after undercover filming showed staff intimidating, mocking and restraining patients with learning disabilities or autism, and Cawston Park mental health hospital in Norfolk, which closed in 2021 after reported ‘consistent failures’, are examples. There have been many others.

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The comment by the CQC that ‘there is no excuse for this’ is an understatement.

The NHS remains committed to reducing the number of people with learning disabilities in acute hospitals. But, cut through all the rhetoric of ‘taking action’ to ‘stop people falling through the gaps’ as the CQC said, and the reality is that, as recent data showed, there are more than 2,000 people with a learning disability and/or autism in inpatient units in England.

‘The skills of learning disability nurses should be used in all settings to help achieve, promote and drive equal rights in healthcare’

We need NHS leadership and specialist staff who can work in systems to develop processes that would help to stop systemic abuse becoming the norm and influence a system that ensures people with learning disabilities are respected and given maximised independence and support to make the most of their lives.

And yet there are only about 17,000 learning disability nurses in the UK and posts go unfilled.

If learning disability nurses spend years training to be specialists and hold the knowledge and education to help and understand the daily struggles of people with a learning disability, these skills should be used in all settings to help achieve, promote and drive equal rights in healthcare.

Without the basics, you cannot promote safe, caring and equal healthcare for all

One answer might be for there to be a legal requirement for any service or institution that supports people with learning disabilities and/or autism to be led and staffed by learning disability nurses.

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Expensive perhaps, but if these basic principles cannot be achieved then it will be impossible to promote safe, caring and equal healthcare for all.

The All-England Plan for Learning Disability Nursing exists to support the delivery of outstanding learning disability practice in the UK. It is time for this plan to be delivered.

Wendy Johnson is associate director of safeguarding at Great Western Hospital NHS Foundation Trust, Swindon

Find out more

• Care Quality Commission (2020) CQC demands national system change to prevent future generations of autistic people and/or people with a learning disability from 'falling through the gaps’
• Care Quality Commission (2020) Out of Sight – Who Cares?
• Health Education England (2020) All-England Plan for Learning Disability Nursing: Resetting the Profession
• RCN (2021) Connecting for Change: for the Future of Learning Disability Nursing