The RCN survey has found that 71% have witnessed cuts to learning disability services and 50% are now concerned for the safety of patients. Almost all of those of those surveyed said there are not enough services in the community to care for and support people with learning disabilities.
According to official statistics, learning disability services in the NHS across the UK have lost 21% (1634) of nursing posts since 2010. The survey has found that in the last year alone, more than two fifths (42%) have seen drops in staffing levels and, as a result, only 10% of respondents say they always have enough time to deliver the right levels of care to their patients.
Worryingly, 64% of nurses say that people with learning disabilities are often in hospital for longer than they should be despite UK wide policy commitments to reduce numbers.
More than half (53%) said that people with learning disabilities are unable to access appropriate care in the right setting and a shocking 95% of those questioned said there simply aren’t enough services in the community to provide sufficient care and support to those who need it.
Without integrated health, social care and housing plans in place, people with learning disabilities are being prevented from living independent lives where, along with support from their families and friends, they are able to manage their own conditions.
In the survey, learning disability nurses were asked to identify the main barriers to delivering the right standards of care and these areas were highlighted:
1. Lack of funding for services
2. Not enough learning disability nurses
3. Not enough services in the community
Nurses too have suffered as a result of the cuts. Almost a quarter (23%) have witnessed cuts to pay, while 35% have seen down-banding in their workplace. 45% reported that conditions and services have worsened over recent years.
Laura Andrews, Professional Lead, Learning Disability Nursing, Hywel Dda University Health Board, said: “As a learning disability nurse who qualified in the 1980s I have been privy to the major changes that have taken place in regard to the care of people with learning disabilities. However, despite the impact these changes may have had, some challenges still remain the same such as equality in access to care and the needs of the younger and older generations living with learning disabilities. The difficulties faced by patients in rural communities also need to be addressed by the development of innovative care pathways that will provide care in the right place at the right time for those in more challenging localities.”
“The recruitment and retention of nursing staff is also a concern; working in South West Wales, I have real difficulty in attracting nurses to this area as training take place in North and South Wales – my health board is in between these areas and many nurses aren’t willing to move once they’ve completed training. We need to train more nurses and respect the very specific, but transferable, skills of the registered nurse learning disabilities (RNLD).”
Rachel Morgan, Health Liaison Nurse (Learning Disabilities), Aneurin Bevan University Health Board, said of the issues: “Although there is a growing body of evidence to support the need for learning disability liaison nurses, particularly in the acute hospitals, there is still a lack of commitment from some health boards to establish these roles - there are still only two health boards in Wales that have Liaison Teams.”
“RNLDs are becoming specialists in a whole variety of areas, and now gaining employment as clinical behavioural specialists, dementia co-ordinators for younger people, MacMillan nurses and of course, as liaison nurses. Whilst we need to embrace change and be flexible to the evolving needs of our client group and the services we work for, we also must ensure our clients are at the heart of all that we do.”