Strengthening The Commitment: The Report of the UK Modernising Learning Disabilities Nursing Review

The report aims to ensure that people with learning disabilities of all ages have access to expert Learning Disabilities Nurses and that their families and carers get the best support and care. It also seeks to make best use of Learning Disabilities Nurses throughout the entire health and social care system and improve the career image of learning disabilities nursing as a whole.

Conclusion and next steps

" The learning disabilities nurse has always been aware of the needs of the whole family and the fact that it continued from childhood into adulthood is very reassuring."
Family carer

The UK Modernising Learning Disabilities Nursing Review involved wide engagement with key stakeholders. It heard the hopes, aspirations and concerns of practitioners, managers, educators and researchers and, most importantly, it heard what qualities people with learning disabilities, their families and carers value most in nurses.

While this report could never capture all the learning that emerged from the engagement process, it has attempted to focus on actions that will have the greatest positive impact for people with learning disabilities, their families and carers, the nurses who care for them and the services who support them.

The foundation for these actions and the developments they represent is the underpinning principles and values base of learning disabilities nursing. It is these principles that have served learning disabilities nursing well and which are cherished by people with learning disabilities, their families and carers.

Learning disabilities nurses now have an opportunity to take their services forward to a new level.

This report has set out recommendations across a wide range of areas that reflect the complexity and the importance of modern learning disabilities nursing. The four countries are now invited to consider these recommendations and progress them as appropriate within their own contexts. Some of the recommendations will benefit from implementation at UK level, and a UK Implementation Group is being set up to support the groups that will be established at country level to oversee the development of action plans and onward progression.

The recommendations are set out in Table 2, which shows which agencies/individuals need to take account of, and respond to, each recommendation.

It is important to stress that while the recommendations are central to the modernisation of learning disabilities nursing in the UK and consequently may receive heightened attention, readers should engage fully with the whole report - there are many key messages that should be considered in addition to the recommendations.

Table 2 Recommendation summary


Action at UK level

Action at country level

Action at service level

Action at education level

Action at commissioning level

Action at individual practitioner level

1. The four UK health departments and the independent/voluntary sector should establish a national collaborative to enable better understanding of, and planning for, a high-quality and sustainable registered learning disabilities nursing workforce across all sectors.

2. Systems to collect workforce data are required in each country, with links across the UK, for workforce planning for future provision of learning disabilities nursing. These should be able to capture information on service provision, educational and research requirements and should cover the independent/voluntary sector.

3. The development of new, specialist and advanced role opportunities should be considered in light of workforce planning, service development and education provision. In particular, this should focus on the roles of non-medical prescribing, psychological therapies and telehealth and in specific settings such as the criminal justice system, mental health services (particularly dementia) and autism services.

4. Each of the four countries should consider aligning their existing post-registration career frameworks for learning disabilities nursing to clearly articulate the knowledge and skills required by learning disabilities nurses at all levels and across all settings. These developments could be utilised across sectors (with appropriate adaptation) to give a coherent career framework.

5. Commissioners and service planners should have a clear vision for how they ensure the knowledge and skills of learning disabilities nurses are provided to the right people, in the right places, and at the right time in a way that reflects the values- and rights-based focus of learning disabilities nurses' work.

6. Commissioners and providers of health and social care should ensure the skills, knowledge and expertise of learning disabilities nurses are available across the lifespan. This should be enabled through effective collaborative working across health and social care structures.

7. Commissioners and providers of health and social care should ensure that learning disabilities nurses are able to collaborative effectively with general health services, including mental health services, to address the barriers that exist for people with learning disabilities to improving their health. This should include proactive health improvement, prevention, whole-family and public health approaches.

8. Commissioners and service providers should ensure that specialist learning disabilities services for complex and intensive needs (including assessment and treatment services across all sectors) employ sufficient numbers of appropriately prepared and supported registered learning disabilities nurses. This highlights the need to support and develop the availability of specialist and advanced clinical skills and knowledge of learning disabilities nurses in all settings.

9. Learning disabilities nurses, their managers and leaders should develop and apply outcomes-focused measurement frameworks to evidence their contribution to improving person-centred health outcomes and demonstrating value for money. This may require a specific piece of work to scope current frameworks.

10. Learning disabilities nurses should strengthen their involvement and links to transformational work, productivity improvement and practice development.

11. Those who commission, develop or deliver education should ensure that all learning disabilities nursing education programmes reflect the key values, content and approaches recommended in this report. They should also ensure that nurses in other fields of practice develop the core knowledge and skills necessary to work safely and appropriately with people with learning disabilities who are using general health services.

12. Updated, strategic plans for pre- and post-registration learning disabilities nursing programmes are necessary for each country of the UK to support flexibility and ensure an efficient and sustainable model of delivery for the long term. This highlights the need for appropriate numbers of places on pre-registration learning disabilities nursing programmes to meet future workforce requirements.

13. Education providers and services must work in partnership to ensure that educational and developmental opportunities for nonregistered staff are developed and strengthened and their benefits are evidenced through appraisal systems, and that educational and development opportunities are available for registered learning disabilities nurses to support their ongoing development, reflecting the needs of people with learning disabilities.

14. Services should provide systems to ensure that learning disabilities nurses have access to regular and effective clinical supervision and that this its impact is monitored and evaluated on a regular basis.

15. Leadership in learning disabilities nursing needs to be strengthened in practice, education and research settings with robust, visible leadership at all levels, including strategic and national levels. Services must ensure all learning disabilities nurses in clinical practice have access to a dedicated professional lead for learning disabilities nursing. In addition to existing leadership and development programmes, a UK-wide cross-sector project to nurture and develop aspiring leaders in learning disabilities nursing will be led by the four UK health departments.

16. Learning disabilities nurses need mechanisms to share best practice and develop the evidence base to continue to advance as a profession. Services must support learning disabilities nurses to participate in appropriate networks. A UK academic network for learning disabilities nursing will be created to support this drive.

17. Learning disabilities nursing research should be extended to ensure practice now and in the future is evidence based and the impact of interventions can be demonstrated. Services and education providers must ensure that all existing and future schemes for clinical−academic careers have appropriate representation of learning disabilities nursing.


Email: John McKain

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