1. 4 Countries Project: Modernising Learning Disability Nursing Dr Ben Thomas Director of Mental Health & Learning Disability Nursing 16 December, 2011

2. MLDN: Aims & Aspirations To modernise and enhance the image, profile and contribution of learning disability nursing and ensure learning disability nurses use and develop their specialist knowledge and skills to maximise their contribution to providing the best possible health outcomes for people with learning disabilities

3. The new proposed English health system NHS NHS Commissioning Board Monitor (economic regulator) Clinical commissioning group Department of Health Public Health England (part of DH) Social care (in local authorities) Local authorities (via health & wellbeing boards) CQC (quality regulator) Providers

4. The English context Population of England 51.2 million 1,980,000 people who have a learning disability ( 2% population) 900,000 adults 177,000 known users of services 298,000 children Only 20% known to services Increase in prevalence & complexity of need

5. The English policy context

6. NHS OUTCOMES FRAMEWORK Domain 1 Preventing people from dying prematurely Domain 2 Enhancing quality of life for people with long- term conditions Domain 3 Helping people recover from episodes of ill health or injury Domain 4 Ensuring that people have a positive experience of care Domain 5 Care in a safe environment and protecting them from avoidable harm

7. Valuing People Now: a strategy for people with learning disabilities treating people as individuals equality, dignity & rights opportunities & responsibilities independent living choice, control & inclusion receive healthcare they need A full life through work, education, housing & social activities - still more to do!

8. Nursing care for people with learning disabilities Inadequate, unsafe care and treatment Inadequate care by nursing staff Unsafe discharge arrangements Poor complaint handling Failure in nursing care Failure to live up to human rights principles of dignity and equality

9. Learning Disability Nursing 1995 – 12,504 in NHS 2009 – 6,600 in NHS 54% reduction (1,000 per year) Increasing vacancy factor 1,7% in 2009) 700 student commissions per year 4/500 register with NMC

10. Compromised Workforce Higher Education Issues Challenges with recruitment Filling commissions High attrition Financial incentives Placements Field of practice Issues Level of/or uncertainty of career opportunity Absence of leadership at all levels Increased prevalence and complexity of need in people with learning disabilities Development and validation of new roles Data/ Intelligence Issues No modelling for retirement Unreliable data sets Third sector absent from strategic decision making Conflicting data sets Workforce Issues Complex field of practice Plurality of providers and stakeholders Loss of experienced practitioners Aging profile of workforce The 4 major factors compromising the future contribution of learning disability nursing to the health and well being of people with learning disabilities.

11. Consultative process four work streams

12. Work so Far Examination of Literature and Policy Calls for Contributions Visits to practice sites, HEIs Focus groups & workshops Presentations at forums and conferences

13. MLDN: Aims & Aspirations Clearly set out the added value that learning disability nurses bring to a wide range of organisations & services and disseminate areas of good practice and strengths of learning disability nurses

14. MLDN: Aims & Aspirations Explain the conditions necessary to enable learning disability nurses to fully realise their potential in improving the experience and outcomes of care Identify and analyse the gaps in practice highlighting the necessary developments required to address these gaps

15. MLDN: Aims & Aspirations Prioritise areas for development linked to legislative, policy and professional agendas that reflect existing and future models of care and population trends in both specialist and generic services Identify the key priorities and the organisational, educational and developmental strategies that will support and enable the profession to realise its full potential

16. Modernising the learning disability nursing workforce Promoting the profession – modern positive image & attractive career choice Monitoring the profession – knowing where nurses work Profiling the profession & the benefits of learning disability nursing Restating the values & principles of learning disability nursing

17. Impact A re energised and refocused workforce Enhanced profile To ensure that learning disability nurses use and develop their specialist knowledge and skills to achieve best possible health outcomes for people with learning disability and their families

18. Thank You Contact details: Dr Ben Thomas Ben.Thomas@dh.gsi.gov.uk