The future of learning disability nursing: what needs to change?

Sheila Sobrany is President of the Royal College of Nursing and a former course leader in adult nursing at the University of East London. At the LDT and Kingston conference, Sheila spoke about the future of learning disability nursing and what the RCN’s top three priorities are for bolstering this shrinking workforce.

Learning disability nurses are highly skilled healthcare professionals who play a central role in supporting the 1.5 million people in the UK with a learning disability, but there simply aren’t enough of them.

UCAS data shows between September 2009 and January 2024, the number of learning disability nurses employed by the NHS has decreased by 44%, from 5,553 to 3,095. Part of this decrease can be explained by a collapse in the number of universities which are offering learning disability nursing courses.

Since universities are reliant on students choosing their courses to make them financially viable, the perceived lack of desire to train as a learning disability nurse is having a direct impact on the university offering.

Indeed, in 2023, only 2% of all nursing course acceptances were for learning disability nursing. In total, just 405 applicants were accepted into pre-registration learning disability nursing courses, marking a 26% decrease from the previous year and a 36% decrease from 2015.

Sheila Sobrany said this data indicates that there are “significant risks to the specialty” and this risk will undoubtedly have an impact on the future of nursing.

Learning disability nursing is real nursing

Speaking at the LDT and Kingston University conference, Sheila said: “Learning disability nursing is a topic that’s familiar to me. My father was a learning disability nurse, and I am a mother of two children with learning disabilities and one child with neurodiversity. I am also an aunt and a cousin of people with neurodiversity and learning disabilities.”

Sheila clearly recognises the importance of learning disability nurses, and says we need a change in culture and attitudes and improved awareness and education if we are to bolster the workforce.

“Learning disability nursing was first registered as a field of nursing all the way back in 1919, but despite 105 years of heritage, many people don’t know that it exists as a field of nursing. This is a reason why we’re not seeing it taught in many universities, as it should be.

“Throughout its history, there’s always been questions about whether learning disability nursing is ‘real nursing’ and whether it is a true profession and a future profession. We know this is entirely wrong and devalues the significant contribution that learning disability nurses make to those who they work with,” she said.

Sheila highlights that learning disability nursing is the only field of nursing where members have declined consistently over the last five years, and she said the variability in learning disability nurse provision is hugely troubling.

“There are huge regional variations in the availability of learning disability nurse training across the UK and particularly in England. For example, there is no learning disability training in the entire Southeast region of the UK this year. This is really concerning, as it means we don’t have the workforce needed for the future in some parts of the country.”

“Each year, we are seeing learning disability nurse courses cease to run while other courses are at risk due to a low number of applicants,” she added.

Sheila says that while the NHS Long Term Plan has committed to doubling the number of learning disability nurse students by 2030, there are no plans at present which detail how this will be achieved or funded.

“So how have we got here?” she asks. “Culture, attitudes and support for people with learning disabilities has changed considerably over the years. With this comes a significant shift in how services are provided for people with learning disabilities – it is not surprising that the number of learning disability nurses employed by the NHS has continued to decline as a result.”

What needs to change?

To ensure the learning disability nursing workforce is fit for the future, the Royal College of Nursing has identified three priority areas. This includes:

• Focusing on the number of registered nurses in learning disabilities and increasing these numbers: This includes clearly defining and articulating the role and purpose of a learning disability nurse and focusing on community nursing to ensure everyone with a learning disability can access these highly skilled professionals.
• Improving workforce data: This would support consistent regional workforce planning, ensuring all areas on the country are training up the future learning disability nurse workforce and avoiding a postcode lottery of care.
• Attracting prospective students: As well as retaining the learning disability nurse workforce, more works needs to be done to recruit prospective students. Sheila says we should do this by celebrating learning disability nurses and providing career development opportunities through clear pathways.

Sheila says we must also focus on bolstering the general nursing workforce in order to ensure there are enough highly skilled, safety critical professionals to care for the general population.

Nursing staff are “undervalued”

“In the last 20 years, we have seen nursing change beyond recognition,” she said. “At this moment in time, the UK is a challenging place to nurse. Nursing staff are undervalued – there is a lack of recognition, which is reflected in nurses’ pay.”

Earlier this year, the RCN launched a General Election manifesto which made dozens of demands for the new government. This included a substantial pay rise for all nursing staff, ensuring safety critical nurse-to-patient ratios, properly funded mental health support for all nursing staff, eradicating corridor care, and bringing an end to the exploitation of migrant workers.

While the RCN says it is working closely with the new government on these key areas, there is still a long way to go. There are tens of thousands of vacant nursing positions across the UK and significant improvements will have to be made in order to improve the outlook.

Sheila says it is important that nursing staff do not forget how valuable they are, and continue on with hope in their hearts despite the challenges.

“It takes a remarkable person to do what we do,” she said. “We’re highly skilled, compassionate, caring and committed. We’re professionals. We are experts. We are leaders. Nursing is an art and it’s a science, and we embrace both sides.

“We are consistently being asked to do more with less, and that results in ongoing challenges for our profession. But there is hope, because despite all its challenges, nursing is an amazing profession, that’s why we all continue to do what we do, and why we’re so committed to our patients, clients and those that we care for.”

Lauren Nicolle

Lauren is a qualified journalist who writes primarily across the health and social care sectors. She is passionate about exposing the injustices faced by people with a learning disability, with a particular focus on equal access to healthcare.

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