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Why train learning disability nurses to an advanced level if there are no jobs for them?

Advanced nurse practitioner training is a waste of public money if the skills cannot be put to use even during a recruitment crisis, argues this experienced learning disability nurse

Advanced nurse practitioner training is a waste of public money if the skills cannot be put to use even during a recruitment crisis, argues this experienced learning disability nurse


Falling off the conveyor belt:  learning disability nurses who train as ANPs can have an important role to play, particularly with prescribing, but getting a job is by no means certain 
Picture: Alamy

I read with interest the articles on the crisis in learning disability nursing in recruitment and retention covered by Learning Disability Practice. I felt compelled to explain my situation.

I qualified in 1996 as a learning disability nurse and worked the first few years at a hospital to gain ward-based experience. Two years later, I added a bachelor of science degree to my qualifications and shortly after joined the resettlement team, supervising the closure of the hospital site.

The resettlement team was put together to assess all the patients at the hospital and to move them into supported living in the community. We are an integrated health and social care service.

Local funding 

I moved into a community learning disability team to manage care, and coordinating care for people. I expressed an interest in becoming a transition worker, helping people move from children to adult services. My post is funded by the local council. I have now been a transition worker for almost 20 years.

I spent five years asking repeatedly to do a master’s degree and was eventually given approval to start on an advanced nurse practitioner masters pathway. The first year was amazing – reigniting my love for nursing and its clinical aspects. As a transition worker I complete social care act assessments and paperwork, not clinical tasks. It was a breath of fresh air, but I was told funding was not available for the second year.

I had to wait a year before I managed to get the trust to allow me to return and I was encouraged to do independent and supplementary prescribing.

'I cannot get any confirmation that a post will be there for me when I qualify and I am actively being encouraged to look outside of learning disability nursing'

They said that is what the trust and service needed – more advanced nurse practitioners and learning disability prescribers. I now think they meant in adult care, because I cannot get any confirmation that a post will be there for me when I qualify and I am being encouraged actively to look outside of learning disability nursing.

In my mind, this is a waste of public money and my time and effort. Despite explaining how much of a difference I could make as the first learning disability advanced nurse practitioner and prescriber in my area, the uncertainty over the post remains.

The possibilities and costs

I have years of experience of services in learning disability health and social care and my master’s degree is costing £21,000 roughly. I know as a learning disability advanced nurse practitioner and prescriber I could help GP surgeries meet reasonable adjustments. I could support annual health checks, help with screening and health promotion. 

I could work alongside specialist consultants to reduce polypharmacy. I could review people to make sure we are medicate people with learning disabilities correctly and do not use medication to control behaviours as the NHE England-backed campaign Stop the Over Medication of People with Learning Disability or Autism advocates.

'Learning disability nurses have highly specialised skills and I am trying so much to use them, but being held back whenever I try and push forward'

Learning disability nurses have highly specialised skills and I am trying so much to use them, but being held back whenever I try and push forward.

I am hoping that other learning disability nurses have had successes in their own profession which may motivate me to keep going and to keep trying to get my trust to see some sense. I do not know if this is a common experience but, sadly, I expect it is.

Yes, I will be the first learning disability prescriber in the trust but we have to start somewhere.


The author is a learning disability nurse who would like to remain anonymous

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