Cuts to services hitting the most vulnerable in society

Published: 16 May 2012

Cuts to services hitting the most vulnerable in society

Cuts to services are hitting some of the most vulnerable members in society according to a new survey published today by the Royal College of Nursing (RCN).

The survey of almost 500 learning disability nurses found that nearly three quarters (74 per cent) of respondents have seen cuts to services in the past year and of those who have, 73 per cent now have real concerns about the safety of their clients. They fear that people with learning disabilities could be missing out altogether or face a reduced service as the demand increases, but the resources aren’t being made available.

Nearly 1.5 million people in the UK have a learning disability 1 and this figure is expected to have increased by 14 percent between 2001 and 2021 2. An estimate of the population with learning disabilities in Wales is around 12,000. Improving care at a young age means that the number of children with complex health needs are living longer and require services to be responsive to their needs. More people with learning disabilities are living to older age and encountering the health issues of older age (e.g. dementia).

People with learning disabilities are more likely to have long term health conditions with many of them relying on the care provided by learning disability nurses. These specialist nurses offer an array of services including personal care plans, capacity assessments, health promotion and screening as well as supporting families and carers.

Today’s survey also found that the availability of various services is inconsistent, with over half (56 per cent) reporting that in the past year they have seen a decrease in the range of services offered, including:

 Just over half of nurses surveyed (57.5 per cent) said the area in which they worked offered a patient passport – a document which puts the patient at the centre of their care and informs healthcare staff about an individual’s preferences and how best to treat them.

 Personal care packages or person-centred plans are only being carried out in around three quarters of areas (75.2 per cent and 78 per cent respectively)

 Only　59 per cent of nurses said their area provided health education.

Amid reductions in staffing levels, nurses also reported an increase in their workload. Almost three quarters (71 per cent) said their case load had increased and that they were dealing with increasingly complex health needs (75 per cent).

Commenting on the results of the survey, Peter Meredith-Smith, Associate Director (Employment Relations) , said: "There have been significant changes in services for people with learning disabilities over the past 30 years. Wales has moved from the outdated institutional model of care to supporting people as citizens within their communities with equal rights to health and wellbeing.

"However, particular areas the service needs to focus on include the need to ensure an effective transition from children’s services to adult services and the planning of services to bring people back from current placements in England to their local areas in Wales."

Both acute liaison learning disability nurses and learning disability nurse consultants add great value to the provision of care. However, just over half of respondents (51 per cent) had an acute liaison nurse involved in their work and less than a third (28 per cent) were linked in with a nurse consultant. Current figures indicate that there are only 30 learning disability nurse consultants practising in the UK.　

As a result of nurses’ views, the RCN has called for urgent investment in learning disability services including:

 An acute learning disability nurse in every hospital

 A guarantee that one-to-one specialist learning disability nursing be given to all those who need it

 A focus on learning disability services as new NHS bodies come into being – including at commissioning consortia group level

 Training and development opportunities to be provided to all learning disabilities nurses to reflect the advanced skills of their jobs

 Learning disability nurses should have access to regular clinical supervision and with a focus on nurse leadership.

Wayne Crocker, Director of learning disability charity Mencap Cymru said:

"People with a learning disability can be at greater risk of poorer healthcare, often because their needs might not be understood, or because long term health problems won’t be picked up. This is where the expertise provided by learning disability nurses can make a real difference. The Welsh Government is due to produce a strategy on learning disability nurses, which we hope will affirm their commitment to creating more　learning disability liaison nurses. We’re also proud that Wales was the first country in the UK to provide free annual health-checks for people with a learning disability, which can help maintain good health and wellbeing, and stop illnesses from going unnoticed."

Challenges to Learning Disability Nursing in Wales:

Mr. Meredith-Smith continued:

"The RCN in Wales has worked tirelessly to champion the cause of learning disability nursing. Learning disability nurses are an invaluable part of the nursing family and a crucial component of the health and social care workforce. We recently welcomed the publication of Strengthening the Commitment, but the ‘proof of the pudding will be in the eating’. The aspirations set out in this key document, which may be seen as having been informed by RCN position paper Learning from the past: setting out the future, must now be realised."

Ends

^{Notes for Editors}

1. The survey ran between 5th and 19th April. Members of the RCN’s learning disability forum were emailed a link to an online survey. 492 people responded.

2. The RCN is asking people to pledge their support for learning disabilities at www.rcn.org.uk/LDnursing

3. Members voted in 92 per cent favour of the resolution "That this meeting of RCN Congress asks Council to lobby for a learning disability liaison nurse in all hospitals"
http://www.rcn.org.uk/newsevents/congress/2010/congress_2010_resolutions_and_matters_for_discussion/6._a_learning_disability_nurse_in_every_hospital
4 [1] Source: Mencap (http://www.mencap.org.uk/all-about-learning-disability/informationprofessionals/more-about-learning-disability).

^{[2] Emerson E, Hatton C (2008) Estimating Future Need for Adult Social Care Services for People with}

5 For further information, please contact the RCN Wales Communications Office on 02920680717 or 07773367707.

6. The Royal College of Nursing (RCN) is the voice of nursing across the UK and is the largest professional union of nursing staff in the world. The RCN promotes the interest of nurses and patients on a wide range of issues and helps shape healthcare policy by working closely with the UK Government and other national and international institutions, trade unions, professional bodies and voluntary organisations.