Cuts to services hitting the most vulnerable in society
Published: 16 May 2012
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. 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.
The findings - released at the RCN’s annual Congress - come on top of news that over 60,000 jobs are to be lost across the NHS. This latest survey bears this out the reduction of staffing levels across the board with:
• half (50 per cent) of respondents said that the number of registered nurses where they work has decreased
• A third (34 per cent) said that the number of healthcare assistants has decreased
• 37 per cent said the number of social workers had fallen
• 36 per cent said the number of administrative staff has decreased
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, RCN Chief Executive & General Secretary, Dr Peter Carter, said:
“The NHS has a duty to treat everyone as equals and provide the care we all require. However, when it comes to people with learning disabilities, today’s survey clearly shows that this is just not happening. With increasing caseloads and complexity of care, alongside decreasing staffing levels, it is hardly surprising that nurses are voicing concerns about the safety and welfare of their patients. Our worry now is that in this tough economic climate, the NHS could end up forgetting people with learning disabilities.
“The expert continuing care provided by these specialist nurses greatly improves the quality of life for people with learning disabilities and their families. However, over the past fifteen years we have seen real underinvestment in learning disability care and this trend must be reversed as a matter of urgency.”
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.
Dan Scorer, senior campaigns and policy manager at learning disability charity Mencap:
“Mencap campaigned heavily for the appointment of learning disability nurses, and where these are in post, they have made a positive difference to the quality of health care and experiences of people with a learning disability and their carers. However, overall improvements in the NHS for people with a learning disability have been slow, and in some cases non existent.
“Therefore it is deeply worrying to see that any progress that has been made may be undone by cuts to services. The Westminster Government needs to stand by its commitment to improve care for people with a disability and protect the frontline services they rely on. If it fails to do so, we fear that the result may be further avoidable deaths of people with a learning disability."
Dr Carter continued:
“While we welcome the recent commitment by the four UK health departments to modernise learning disability nursing, there has nevertheless been report after report and recommendation after recommendation on how best to meet the needs of people with learning disabilities. Therefore, the fact remains without the right staff in the right place to provide care and support, these reports will never deliver the improvements they were set up to produce. We strongly urge the various bodies responsible for commissioning services for people with learning disabilities to ensure they are not forgotten.”
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/learningdisabilities
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”
4  Source: Mencap (http://www.mencap.org.uk/all-about-learning-disability/informationprofessionals/more-about-learning-disability).
 Emerson E, Hatton C (2008) Estimating Future Need for Adult Social Care Services for People with
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.