People with learning disabilities are often being denied their human right of fair access to health and care, the Royal College Nursing (RCN) says today as it releases a sobering new report into the state of learning disability nursing across the UK.
It comes as the College highlights new analysis of NHS data showing the learning disability nursing workforce has shrunk dramatically over the last 16 years, falling by 33% from 7,083 nurses in 2009 to 4,768 in 2025. Meanwhile, the pipeline of future nurses is also under severe pressure, with fewer than 500 students enrolling on learning disability nursing courses across the UK in 2025.
The review, Safety, Equity and Expertise: A UK review of learning disability nursing, says that the clear legal duties on health and care systems to provide equitable access to care to the estimated 1.5 million people with a learning disability in the UK under the Equality Act 2010 aren’t being reliably met due to a crisis in the nursing workforce.
A lack of learning disabilities nursing (LDN) expertise across health and care, including in mainstream services and in key leadership roles, mean vulnerable people are receiving a level of care which often fails to adequately take into account their needs, the College says.
The College cites that LDNs expertise in developing in-depth knowledge of individuals over time which allows practitioners to work in partnership with their patients and support maintaining good health, prevent deterioration and reduce avoidable hospital admissions. They are critical to ensuring people with learning disabilities aren’t excluded, overlooked or harmed due to mainstream health and care services not being able to meet their needs.
Despite this, learning disability nursing in Wales faces significant workforce pressures. While almost 1,000 registered learning disability nurses live in Wales, fewer than 500 whole-time equivalent nurses are employed within NHS Wales. Combined with a 32% decline in nursing roles across the independent and social care sectors, the RCN warns that course closures, an ageing workforce and persistent vacancies are putting the future sustainability of the specialist workforce at risk.
The review calls for health and care workforce planning to be field-specific, with action taken to stabilise the LDN education pipeline and grow in line with the needs of the population.
The RCN’s analysis of NHS workforce statistics shows that the number of learning disability nurses (LDNs) employed by the NHS across the UK has fallen by 33% since 2009. However, with just 490 LDN students enrolling on courses in 2025, the College warns severe gaps in services could potentially widen. Overall, the last decade has seen a 40% fall in the number of students accepted onto LDN courses.
The latest Learning from lives and deaths – people with a learning disability and autistic people (LeDeR) report shows the median age of death of just 62.5 for people with a learning disability, compared with around 82 for the general population.
Within the RCN’s recent Last Shift Survey of nursing staff working across the UK, they found testimony from LDNs saying they felt devalued and their patients were being failed.
In response to the RCN’s publication of the review, RCN Chief Nursing Officer Professor Lynn Woolsey, said:
“The findings of this review must be a warning that we cannot continue this path where learning disability nursing is consistently undermined. It’s a profession that is central to the safety, equity and human rights of people with learning disabilities.”
“Yet the learning disability nurse workforce is in absolute crisis, with workforce numbers falling while university student numbers also collapse. Their skills are too vital for this to be allowed to continue. The expertise of learning disability nurses has been poorly understood, inconsistently recognised, and insufficiently protected within health and care systems. Their contribution is repeatedly undermined and ignored in wide workforce planning and service delivery.”
“This must change if we are to close the current inequity in care suffered by some of society’s most vulnerable people. People with learning disabilities deserve better. Learning disability nursing must be recognised by health leaders as the safety-critical profession it is and workforce planning must reflect their value and importance to individuals across society.”
RCN Wales Executive Director Nicola Williams said:
“Learning disability nurses play a vital role in supporting some of the most vulnerable people in our communities and helping to tackle the significant health inequalities they continue to experience.”
“People with learning disabilities have the same right as everyone else to safe, effective and equitable health care. Yet this report highlights serious concerns about the future of the specialist workforce that is so often central to making that happen.”
“We cannot allow learning disability nursing to become an afterthought. The Welsh government, health boards and education providers must work together to protect and grow this vital workforce so that people with learning disabilities receive the care, support and advocacy they deserve.”
ENDS
Notes to Editors:
You can read the review here: Safety, Equity and Expertise: A UK review of learning disability nursing | Publications | Royal College of Nursing
The Royal College of Nursing (RCN) is the voice of nursing across the UK, including around 35,000 members in Wales. The RCN promotes the interests of nursing and patients on a wide range of issues and helps shape health care policy.
For more information, contact the RCN Wales communications and media team on 02920 680 769 or mediawales@rcn.org.uk.
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