This week saw the long-awaited publication of the latest 'Learning from Lives and Deaths – People with a Learning Disability and Autistic People' (LeDeR) report. As ever, the findings are sobering. People with learning disabilities continue to die, on average, 19.5 years younger than the general population and remain nearly twice as likely to die from avoidable causes. These statistics are not new—they echo what we’ve heard year after year. But what is changing is the crisis engulfing the learning disability nursing workforce, particularly in England.

On the day this report was released, I received news from a university in England entering consultation to close its learning disability nursing programme. This is not isolated. Across the country, we’re witnessing what the Royal College of Nursing has described as “learning disability nurse deserts”. In some regions, no universities offer the degree. In others, student numbers have collapsed. Between 2015 and 2023, the East of England saw an 89% drop in students starting learning disability nursing courses. Nationally, acceptances have fallen by 36% in just eight years.

The LeDeR report makes clear that access to appropriate care is a key determinant of life expectancy for people with learning disabilities. When learning disability nurses are absent, care needs go unmet. People travel long distances for treatment or are denied care altogether. Jackie O’Sullivan from Mencap put it starkly: “Having access to a learning disability nurse can be a matter of life and death.”

Learning disability nurses are the only health professionals specifically trained to meet the health needs of people with learning disabilities at the point of registration. Their expertise is not interchangeable. Substituting them with other nurses, however well-meaning, risks diluting care quality and undermining the rights and dignity of those they serve.

The LeDeR report also highlights areas of progress. There’s been a 10% increase in reviews identifying good practice since 2021. Annual health checks and statutory training in learning disabilities are making a difference. But these gains are fragile without a robust, sustainable workforce.

We must ask: how can we continue to learn from lives and deaths if the very workforce that supports those lives is being allowed to diminish?

The government’s 10-Year Health Plan promises a shift to community-based care and prevention. This vision is welcome—but it cannot be realised without investment in the workforce that will deliver it. Learning disability nurses are central to this transformation.

The RCN is currently undertaking a learning disability nursing review. We want to bring the voices of Registered Nurses in Learning Disabilities into the spotlight to define and celebrate their role in contemporary health and social care. Please look out for ways to take part in this review, which we’ll be releasing soon.

So what more must be done?

Recommendations:

• Urgent Investment in Learning Disability Nursing Education – Remove the link between course viability and student numbers. Ensure training opportunities exist where this workforce is needed.
• Loan Forgiveness for Public Service Commitment – RNLDs giving back through public service in the NHS or independent settings should have student loans written off.
• Regional Workforce Planning and Support – We lack clear data on how many RNLDs are needed per region. Without this, students have no tangible career goals.
• Broaden Career Options and Raise the Profile of Learning Disability Nursing – Many RNLDs work outside traditional roles. We must solidify broader career paths to boost student interest and awareness.
• Embed Learning Disability Nursing in Health Policy – RNLDs must be explicitly included in the NHS England Long Term Workforce Plan and Integrated Care Board strategies. Learning disability nursing must be recognised as a distinct and essential profession.
  
  

The LeDeR report is a mirror held up to our health system. It reflects both our failures and our potential. But mirrors alone don’t change reality—action does. Policymakers, educators, and health leaders must act. Not just to learn from deaths, but to invest in the lives of people with learning disabilities. That begins with investing in the nurses who are specifically trained to meet their needs.