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HEE to pilot 'enhanced' learning disability nurse apprenticeship

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The creation of an “enhanced apprenticeship” is one of the solutions being considered by Health Education England to address a desperate shortage of learning disability nurses, which risks harming some of the UK’s most vulnerable people.

The workforce body’s latest board papers underline the “acute need” to recruit more learning disability nurses and warns people with learning disabilities are at greater risk of dying, spending time in hospital and suffering care placement breakdowns because of a failure to tackle shortages.

“Just a handful fewer applicants can result in courses not being viable”

HEE report 

Learning disability and autism are among clinical priorities set out in the long-term plan for the NHS in England, the delivery of which will require at least another 300 learning disability nurses on top of other allied health professionals and new caring roles, the papers said.

Yet – as previously reported in Nursing Times - HEE models indicate the number of nurses will “hit critical levels in the five years” with a 16% vacancy rate in learning disability nursing posts in 2018 increasing to 30% or more.

“Without immediate interventions this will compromise both quality of care and the successful implementation of the long-term plan and its associated workstreams,” said the report written by HEE’s national disability programme manager Tim Devanney and regional chief nurse Ray Walker.

Key issues highlighted in the report include the fact the number of people embarking on learning disability nursing degree courses has plummeted since the scrapping of the nursing bursary, which has put off many mature applicants concerned about being saddled with debt.

But numbers had been on the wane before then with a 46% drop in students since 2014, which has led to some courses closing, the report explained.

“The relatively small scale of learning disability numbers in training means education providers are unable to adjust to the decline in applicants,” said the report.

“Just a handful fewer applicants can result in courses not being viable. This threatens to further accelerate the decline in numbers,” it added.

For example, there were no pre-registration nursing programmes available outside London south of the M4 corridor in 2018, the report stated.

Meanwhile, the pool of learning disability nurses is being further diminished with nurses moving into other fields such as mental health.

When it came to attracting people into the sector employers have struggled to set up new routes such as apprenticeships, the report said.

“Employers have reported they are unable to attract and afford to establish apprenticeship routes due to the costs of commissioning, students’ study time and supernumerary time that are not covered by the levy,” said the report.

Staffing shortages across the NHS meant there were many other options open to people who wished to work in healthcare, it added.

Solving the learning disability nurse recruitment crisis would require a range of measures to prevent people leaving the current workforce, promote learning disability nursing as an attractive career and bring in new people, it suggested.

“Without immediate interventions this will compromise quality of care”

HEE report 

One idea on the table is an “enhanced apprenticeship approach” using financial incentives to spur the creation of learning disability nurse apprenticeship schemes, the report confirmed.

According to the document, this will involve “targeted incentives” for local partnerships that support employers to develop learning disability nurse apprenticeships and recruit people “who would not otherwise join the workforce”.

The report, which revealed HEE is looking into setting up a pilot scheme, said the body would also seek to support the establishment of apprenticeship schemes in areas with the greatest need and those that offer flexible learning for people with family commitments, good quality work placements and a guaranteed job at the end.

The report said HEE was also planning further work to develop career pathways for learning disability nurses and for other roles in the sector.

Key questions for HEE included whether the situation was desperate enough for the body to “intervene to support the market” and whether financial incentives could help “address the lack of interest in careers in this branch of nursing”, said the report.

It also said HEE needed to look at what actions would deliver the best value for money and whether or not the body needed to divert resources from other areas to prop up the learning disability sector.

It said more detailed proposals and costings should be presented to the next board meeting.

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