Wednesday, 4 November 2015

Nurse! Nurse?


This post is the fourth in a week of blogposts looking at what’s happening for people with learning disabilities in England. For a bit of a change today, rather than looking at social care statistics, this blog is about the NHS learning disability nursing workforce in England. Learning disability nurses in both general hospitals and in community health services have been found to be important facilitators for people with learning disabilities getting decent healthcare from health services (see for example Tuffrey-Wijne and colleagues’ open access paper here http://bmjopen.bmj.com/content/4/4/e004606.full or McConkey and colleagues' work on health facilitators http://www.nationalelfservice.net/populations-and-settings/primary-care/introduction-and-uptake-of-annual-health-checks-across-northern-ireland-for-patients-with-learning-disabilities/ ).

So, what’s happening to the workforce of nurses working specifically with people with learning disabilities in England? The Health and Social Care Information Centre, as part of their suite of NHS workforce statistics (see http://www.hscic.gov.uk/searchcatalogue?productid=18858&topics=0%2fWorkforce&sort=Relevance&size=10&page=1#top ), provide monthly information on the number of Whole-Time Equivalent (WTE) nurses in the categories of Community Learning Disabilities nurses and Other Learning Disabilities nurses. The graph below shows this information for the month of May from 2010 through to 2015.




For community learning disabilities nurses, there were 2,571 WTE nurses in May 2010, dropping steadily to 2,003 WTE nurses in May 2015. The picture for ‘other’ learning disabilities nurses (presumably in large part working in general hospitals) is even worse, dropping from 2,916 WTE nurses in May 2010 to 1,754 WTE nurses in May 2015. Overall, this is a drop of 32% in the number of WTE learning disability nurses over 5 years.

In Whole Time Equivalents, less than 1% of this nursing workforce are nurse consultants, 1% are modern matrons, 5% are managers, 92% are ‘other first level’, and less than 1% are ‘other second level’ nurses.

It’s also worth bearing in mind that this workforce information is for NHS services only – we don’t know how many nurses are working with people with learning disabilities in third sector/private services (particularly specialist inpatient services).

Nursing for people with learning disabilities is on the Department of Health’s agenda, with a ‘Strengthening The Commitment’ programme running since 2012 (see https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/309153/Strengthening_the_commitment_one_year_on_published.pdf ) and an announcement of increased numbers of training places. Learning disability nurses are often pushing for leadership positions, and through initatives like @WeLDNurses are trying to create communities of nurses that question their own practice and are open to the experiences of people with learning disabilities, families and others.

However, according to an RCN survey of learning disability nurses in 2015 (unfortunately neither the number not representativeness of the nurses replying to the survey are stated in the article), things aren’t looking good for learning disability nursing in England. Many nurses in this survey report cuts to services (including nursing services), downgrading and pay cuts, and a lack of suitable community services for the people with learning disabilities they’re supporting (see http://www.rcn.org.uk/newsevents/news/article/uk/patient-safety-learning-disability ).

A difficult environment for strengthening the commitment?

Sources

Department of Health (2014). Strengthening the Commitment: One year on. London: Department of Health. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/309153/Strengthening_the_commitment_one_year_on_published.pdf

Health and Social Care Information Centre. NHS Workforce Statistics – July 2015, Provisional Statistics. http://www.hscic.gov.uk/searchcatalogue?productid=18858&topics=0%2fWorkforce&sort=Relevance&size=10&page=1#top

McConkey R, Taggart L & Kane M (2015). Optimizing the uptake of health checks for people with intellectual disabilities. Journal of Intellectual Disabilities, 19, 205-214.

Tuffrey-Wijne I, Goulding L, Giatras N, Abraham E, Gillard S, White S, Edwards C & Hollins S (2014). The barriers to and enablers of providing reasonably adjusted health services to people with intellectual disabilities in acute hospitals: evidence from a mixed-methods study. BMJ Open 2014, 4, e004606 http://bmjopen.bmj.com/content/4/4/e004606.full


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