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CNOs outline action plan to halt slide in learning disability nursing

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The NHS must do more to develop and make the most of specialist learning disability nurses, says a major UK-wide review of the sector.

A report by the four UK chief nursing officers sets out a series of recommendations designed to halt a decline in learning disability nursing as demand for services grows.

These include developing advanced and extended roles for learning disability nurses that would give them more scope to prescribe drugs, provide therapy, and work in highly specialist services.

The Strengthening the Commitment report comes amid a Care Quality Commission investigation into the standard of learning disability services and concern over a shortage of specialist nurses.

CNO for Scotland Ros Moore, who led the review, said she wanted to build on the “strength and commitment we already have in learning disability nursing”.

“It’s not that things are desperately bad, more that because of changes and challenges, such as the population increasing and people living longer, we really need to look at learning disability needs for the future,” she told Nursing Times. “We are building from a very strong foundation.”

The report was welcomed by the Royal College of Nursing, which has highlighted problems including a serious decline in the number of learning disability nurses and cuts in specialist training courses.

“The real test will now be in how services are improved and if enough learning disability nurses are recruited,” said RCN general secretary Peter Carter.

Michael Brown, chair of the RCN’s learning disability nursing forum, said a lack of career progression for learning disability nurses meant they were sometimes managed by people without the necessary skills and experience.

Meanwhile, newly qualified adult or mental health nurses have been getting learning disability nursing posts in some parts of the country due to shortages of specialist nurses.

Ms Moore said: “One key thing for us is to really get to grips with where the workforce is at the moment across health and social care, and look at how we support workforce planning.”

She added that this needed to include the independent and voluntary sectors, where learning disability care took place “as much, if not more, than in the health service”.

The report calls for closer collaboration between the four UK health departments to develop the sector, including establishing a clear career framework, revamping education and training, and improving clinical supervision and leadership.

It urges the four health departments to look at ways of making the most of specialist nurses’ wide-ranging skills and expertise.

Proposals include the development of advanced and extended roles for learning disability nurses in settings such as prisons, mental health and dementia services, and working with people with autism.

“The potential for extending roles through non-medical prescribing for learning disabilities nurses should be explored, particularly in relation to epilepsy and mental health care,” the document adds.

It also suggests there is more scope for learning disability nurses to provide psychological therapies and specialist “telehealth” services.

Health departments should also seek to further develop learning disability nurses’ role in specialist services for people with complex and intensive needs and ensure they have the skills and training to take on that work, says the report.

Developments set to come out of the review include a UK-wide project to nurture potential leaders in learning disability nursing and a UK-wide academic network to share best practice and promote evidence-based research.

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