‘The nursing shortage in England is harming some of the most vulnerable members of society,’ a senior nurse and Royal College of Nursing (RCN) leader warned on Tuesday. Learning disability care is facing a major crisis as the latest workforce data shows a 40 per cent drop in specialist nurse numbers, the RCN warns.
The latest figures from NHS Digital show the number of learning disabilities nurses down from 5,368 to 3,247, a reduction of 2,121 posts since May 2010. A lack of new students could exacerbate the existing staff shortage.
A national survey carried out by the Council of Deans for Health on behalf of Health Education England found that 46 per cent of institutions have discussed discontinuing their learning disability nursing programmes this September. Since the removal of funding for nursing education, learning disabilities has been hard hit.
It is feared that as student numbers dwindle universities are determining that courses are no longer financially viable for them to run. In May, Health Minister Stephen Barclay promised to offer £10,000 golden hellos to postgraduate students in specific hard-to-recruit disciplines such as mental health, learning and disability and district nursing, but waited too long to provide investment, missing yet another chance to address the recruitment crisis this year.
The fall in mature students is particularly worrying. People with significant life experience are more likely to study learning disability and mental health nursing, the areas most seriously hit by the national nurse shortage. Yet there has been a 16 per cent drop in the number of students aged over 25 in June 2018, compared to the same time last year, and a total decline of 40 per cent since June 2016.
The situation has become so critical that Health Education England has promised extra funding to train 200 nursing associates who spend at least 50 per cent of their time working in learning disability, and are able to start training before the 31 December 2018. However this does not address the core problem of insufficient numbers of registered learning disability nurses.
Whilst the nursing associate role has the potential to support people with a learning disability, they should never be used to substitute for registered nurses. According to Mencap, 38 per cent of people with a learning disability died from an avoidable cause, compared to 9 per cent in a comparison population of people without a learning disability.
Specialist learning disabilities nurses play a vital role in improving outcomes. Learning disabilities nurses work in a variety of settings, where they support patients with a learning disability and help them access healthcare. Many of these specialist nurses work in the community, providing vital support to patients with a disability and their families.
Without this help, many patients may not be able to remain at home with their loved ones.
Some acute trusts also employ learning disabilities teams to plan care and work with patients who need specialist help.
Dame Donna Kinnair, Director of Nursing, Policy and Practice at the Royal College of Nursing, 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. ‘Funding for 200 extra nursing associates is 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. ‘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.’
Jonathan Shaw, a member of the learning disability steering group for Mencap’s Treat me well campaign, said: ‘Learning disability nurses are very important. ‘If you are unwell and have something seriously wrong with you, the learning disability nurse can explain everything clearly.
‘They can make things more comfortable for your family too.
‘Learning disability nurses are an important way for hospitals to make sure people with a learning disability don’t die avoidably. ‘It is worrying that these universities are stopping the course. ‘I feel like more people should be getting this training, not less!’
• Bristol City Council had no regard for children’s welfare and only cared about balancing their books when they made £5million of ‘unfair’ funding cuts, the County Court ruled at the beginning of August.
Two local mums won a landmark case against the council after it made a 10 per cent reduction to its budget for children with special education needs and disabilities (SEND).
The case, which is the first of its kind in the country, has set a precedent for other upcoming cases, with parents in Hackney and Surrey already launching similar judicial reviews. Bristol council has been ordered to reverse its cuts, which had been done without proper consultation, Judge Barry Cotter QC said in his judgement.
He also said the council was only worried about ‘balancing its books’ and had not taken into consideration how the cuts might impact children, despite its lawyers insisting the council ‘actively promoted’ children’s welfare. ‘There is no evidence, from the extensive paperwork evidencing the defendant’s (council’s) decision-making process, that members of the council had any regard the need to safeguard and promote the welfare of children, still less “actively promote” children’s welfare, when making the decision to proceed with the proposed savings,’ Judge Cotter added.
‘Indeed, the decision-making process appears to be driven entirely from the standpoint of ensuring a balanced budget by 2020/21.’ More than 500 vulnerable children have been left to ‘struggle’ by Bristol Council after the authority failed to carry out a vital yearly review for their needs. Legally the authority has to conduct annual reviews for children with special educational needs who have a care package.
But of the 1,872 children, it only finished 1,360 – leaving more than 500 without a proper assessment. This means vulnerable children are not being given the appropriate care and support, according to Sally Kent who is a member for Bristol Independent SEND Community. The authority is also missing its six week target to assess children for their needs before they enter the educational system.
Sally Kent said: ‘These delays are having a terrible effect on vulnerable children and causing a lot of stress for families. ‘Children’s needs change each year so it’s vital they are assessed to ensure they are getting the appropriate care. ‘I’m sure the council are just understaffed and it’s not more sinister but it’s our children who are paying for it. ‘They need to make children’s education a top priority.’
Last week, two brave Bristol mums who took the council to High Court over its £5 million cuts to SEND children won their case. Judges ordered the court to reverse the spending slashes and said they were not lawful. One mum, who wished not to be named, said delaying an assessment for a child has huge ramifications.
She said: ‘Every time there is a delay like this on a child’s case it often means the child in question will be struggling to cope in a setting that does not have adequate support to meet their needs.
‘In some cases children are being regularly excluded, because their schools are ill equipped to support them from their existing resources and expertise: places a huge strain on the teachers who have a duty to support all the children in their class and affects the other children in the class as well. ‘The knock on effect of children with SEND being inadequately supported while they “wait” for needs assessments and appropriate specified support cannot be underestimated.’
Cllr Anna Keen, cabinet member for education and skills, said: ‘Demand has been increasing at an unprecedented rate over the past year and colleagues are working extremely hard to keep up with requests. ‘Since the end of June we’ve seen applications for statutory assessments increase by 100% and all of these will be responded to within the six week timescale we aim for. ‘Helping families get the support they are eligible for as soon as possible is hugely important to us and we are recruiting more staff for our SEND and inclusion services to help make workloads more manageable and ensure expected timescales are met.’
