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RCN issues bleak warning on learning disabilities nursing 'crisis'

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Critical shortages of learning disabilities nurses could lead to more vulnerable patients being sent to Victorian style institutions away from their loved ones, a union has warned.

The Royal College of Nursing today called on the government to take urgent action to avoid this dystopian vision of the future becoming a reality.

“Ministers have known about the steady drop in applications for the best part of a decade”

Donna Kinnair

Its warning comes as latest figures from NHS Digital show the number of learning disabilities nurses practising in England has dropped by 40% since 2010, from 5,368 to 3,247.

At the same time, it noted that other evidence suggested that the number of students choosing to embark on a career in the field is depleting.

As previously reported by Nursing Times, a national survey carried out by the Council of Deans for Health on behalf of Health Education England found 46% of education institutions have discussed dropping their learning disability nursing programmes this September due to lack of student interest.

The survey forms part of wider piece of analysis by Health Education England that suggests a 30% to 35% gap between the supply and demand for learning disability nurses, which was revealed by Nursing Times at the end of last month.

The figures were described as “really scary” when they were discussed recently at a summit jointly organised by the Learning and Intellectual Disability Nursing Academic Network (LIDNAN) and the UK Learning Disability Consultant Nurse Network (UKLDCNN).

The RCN has partly blamed the dwindling number of applications on the government’s decision last August to replace bursaries for nursing students with loans.

A fall in mature student applications in the wake of the scrapping of the bursary was “particularly worrying”, said the RCN, as people with “significant life experience” were more likely to study learning disability and mental health nursing, the areas most seriously hit by the national nurse shortage.

It highlighted data from the Universities and Colleges Admissions Service (UCAS) shwing that there there had been a 16% drop in the number of course applicants aged over 25 in June 2018, compared to the same time last year, and a total decline of 40% since June 2016.

“We want to see urgent investment to attract more applicants into learning disability nursing”

Donna Kinnair

In fact it said the situation had become so critical that Health Education England had promised extra funding to train 200 nursing associates who would spend at least 50% of their time working in learning disability, and were able to start training before the 31 December 2018.

However, it said this move would not address the core problem of insufficient numbers of registered learning disability nurses. While the new nursing associate role had the potential to support people with a learning disability, it should “never be used to substitute” for registered nurses, said the RCN.

The college also noted that ministers had promised to offer £10,000 “golden hellos” to postgraduate students – which have also now lost the bursary – in specific hard-to-recruit disciplines such as mental health, learning and disability and district nursing.

However, the government had waited too long to provide this investment to help address the recruitment crisis this year, the college claimed.

Dame Donna Kinnair, director of nursing, policy and practice at RCN, said: “The nursing shortage in England is harming some of the most vulnerable members of society – those with learning disabilities already face a lower life expectancy and poorer health outcomes than the general population, and a lack of specialist knowledge will make matters worse.

“Without the specialist support provided by registered nurses, more patients may end up in institutions, away from their families and friends and shut off from society – this bleak Victorian image is not what care should look like in the 21st Century,” she said.

A spokeswoman for the Department of Health and Social Care insisted work was underway to boost learning disabilities nursing numbers, including introducing fast-tracked postgraduate courses and exploring the £10,000 golden hello offer for postgraduate students entering the profession.

Donna Kinnair

Dame Donna Kinnair

Donna Kinnair

The spokeswoman added: “While there are now record numbers working in the NHS, investing in our workforce will continue to be a top priority and we recently announced the biggest ever increase in training places for nurses, doctors and midwives.”

But Dame Donna branded efforts “too little too late”. “Ministers have known about the steady drop in applications for the best part of a decade and have allowed a crisis to develop in learning disability care,” she said.

“We want to see urgent investment to attract more applicants into learning disability nursing, and an effective workforce plan to ensure every member of our society receives safe and effective care,” she added.

Meanwhile, according to Mencap, 38% of people with a learning disability die from an avoidable cause, compared to 9% in a comparison population of people without a learning disability.

Specialist learning disabilities nurses played a vital role in improving outcomes, said the charity.

Jonathan Shaw, a member of the learning disability steering group for Mencap’s Treat Me Well campaign, said:

Learning disability nurses are very important,” he said. If you are unwell and have something seriously wrong with you, the learning disability nurse can explain everything clearly.

“Learning disability nurses are an important way for hospitals to make sure people with a learning disability don’t die avoidably,” said Mr Shaw.

He added: “It is worrying that these universities are stopping the course. I feel like more people should be getting this training, not less.”

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