Learning Disability Nursing task group call on NICE to establish evidence based guidelines for commissioning


In recent years, the number of people training as learning disability nurses has been falling. This report presents some of the issues believed to be at the heart of this and presents some potential solutions.

The report includes an analysis of:

  • the difficulties in reliably identifying national supply and demand problems with numbers of student places being commissioned
  • the number and geographical spread of education and training courses
  • key issues with clinical placements

The authors also present as problematic, the non-strategic way in which this specialist part of the National Health Service workforce is being commissioned, planned and managed.

They consider that there is a lack of strategic leadership in commissioning and delivering training for learning disability nurses and action is needed urgently to avoid what they describe as a compromised workforce.

In addition, it is argued that as there is clear evidence to show that not only do people with learning disabilities have more health problems when compared with the general population but also receive an inequitable from mainstream health services that is it critical that the National Health Service make the best possible use of its specialist learning disability workforce to help address the health burden and improve the quality of mainstream health service responses.

The authors conclude that:

Learning disability nursing has moved from a narrowly defined role, within long term care, to a much broader role within the National Health Service and beyond.

They suggest that a:

Unique interplay between four major factors; Higher Education issues, workforce issues, along with poor data and ‘intelligence’ issues, and field of practice issues collectively threaten and compromise this specialist workforce in the short to medium term.

They make a number of recommendations, including:

  • Moving education commissioning to a regional commissioning model
  • Consideration of a national recruitment campaign
  • They also make a number of recommendations aimed at ensuring the involvement of LD nursing in work to improve the health and well being of people with learning disabilities, in work on preventable deaths and a range of new and emerging areas of practice, including working within ‘mainstream’ services.
  • Finally, they call on the National Institute of Clinical Excellence to establish evidence based guidelines for future commissioning in learning disability, particularly for those with profound learning disabilities and complex needs.

You can read the full report here: Learning Disability Nursing: Task and finish Group: Report for the Professional and Advisory Board for Nursing and Midwifery – Department of Health, England. Bob Gates

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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