1. Modernising Learning Disabilities Nursing - Leadership Dr Ben Thomas Director of Mental Health & Learning Disability Nursing

2. Government, national policy and learning disabilities
Norman Lamb MP –MS (CS)
Local Government HWB
Adult Social care
Safeguarding
Mental health
Physical & learning disabilities
Third sector
Prison Health Services

3. National nursing leadership
Viv Bennett
Director of Nursing and Government Principal Advisor on Public Health Nursing
Department of Health
Jane Cummings
Chief Nursing Officer
NHS Commissioning Board
NHS Outcomes
Leadership
Implementation & delivery
Public health
Adult social care

4. Our Vision - developing the culture of compassionate care
Care is our business
Compassion
Competence
Communication
Courage
Commitment

5. Our values and behaviours are at the heart of the vision and all we do
Care
Compassion
Competence
Delivering high quality care is what we do. People receiving care expect it to be right for them consistently throughout every stage of their life.
Compassion is how care is given, through relationships based on empathy, kindness, respect and dignity.
Competence means we have the knowledge and skills to do the job and the capability to deliver the highest standards of care based on research and evidence.

6. Our values and behaviours are at the heart of the vision and all we do
Communication
Courage
Commitment
Good communication involves better listening and shared decision making - ‘no decision about me without me’.
Courage enables us to do the right thing for the people we care for, be bold when we have good ideas, and to speak up when things are wrong.
Commitment will make our vision for the person receiving care, our professions and our teams happen. We commit to take action to achieve this.

7. Delivering the vision Maximising health and well-being outcomes
Working with people to provide a positive experience of care
Delivering high quality care and measuring impact
Building and strengthening leadership
Ensuring that we have the right staff with the right skills in the right place
Supporting positive staff experience

8. Jane Cummings, CNO 6 Cs of Nursing
NHS Change Model
Leading
change
Compassion
Courage
Competency
Communication
Care
Commitment
a shared purpose to the vision
Making sense of it all to bring

9. National policy and nursing developments
Vision and values
Purpose and functions
Organisational design
Driving through change
Improving and measuring health outcomes
Maximising the contribution of nurses

10. NHS OUTCOMES FRAMEWORK
2012/13
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

11. Nursing and Care Quality Forum
Best practice must be common practice!
People first
Values and culture
Skills, knowledge and time to care
Leadership
Sally Brearley

12. Learning Disability Nursing
1995 – 12,504 in NHS
2011 – 5,189 in NHS
54% reduction (1,000 per year)
Increasing vacancy factor 1,7% in 2009)
600 student commissions per year
4/500 register with NMC

13. The 4 major factors: Compromised Workforce Higher Education Issues
Challenges with recruitment
Filling commissions
High attrition
Financial incentives
Placements
Compromised
Workforce
Workforce Issues
Complex field of practice
Plurality of providers and stakeholders
Loss of experienced practitioners
Aging profile of workforce
Data/ Intelligence Issues
No modelling for retirement
Unreliable data sets
Third sector absent from strategic decision making
Conflicting data sets
I believe that a unique interplay between four major factors; Higher Education issues, workforce issues, along with poor data and ‘intelligence’ issues, and field of practice issues collectively threaten and compromise this specialist workforce.
So to conclude the issue of the plurality of service models in which learning disability nurses now practise along with workforce, education, career and leadership issues need to be urgently addressed to ensure that efficient use is made of our knowledge and skills, and I repeat without this it is difficult to see how a compromised workforce can be avoided in the short to medium term (Gates, 2011).
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 13

14. Learning Disabilities Nursing
Strengthening capacity
Strengthening capability
Strengthening the quality
Strengthening the profession

15. Strengthening the Profession
Promoting the profession
Leadership & management
Research & evidence
Strong leadership and networks will be crucial to ensuring the recommendations from this report are taken forward.
Existing networks for learning disabilities nurses across the UK continue to provide a powerful platform from which to celebrate, promote and develop our unique contribution. These have tended to be developed mainly for NHS staff. So, a key step is for the learning disabilities nursing profession to embrace members from all sectors to create a critical mass of leaders working together to effect change and advocate for the profession and those they serve.
The report recommends a UK-wide cross-sector project is set up to nurture and develop aspiring leaders in learning disabilities nursing and a recommendation to create a UK academic network to share best practice, develop the research and evidence base and support implementation of the recommendations.
Strengthening the commitment The report of the UK Modernising Learning Disabilities Nursing Review

16. Ely Hospital 1969

17. Where we are now Changing patterns of service provision
Services without nurses in a leadership role
Nurses managed by other disciplines
Nursing issues not identified and addressed
No clear opportunities
Lack of opportunities

18. Where do we want to be Strong leadership Drive forward the profession
Modernised workforce
Develop clinical leadership
Clear career pathway
Succession planning

19. Determinants of Health (In)equalities as outcome measures
Social factors
e.g. poverty, poor housing, unemployment, social isolation
Determinant 2
Genetic & biological conditions
Determinant 3
Personal health risks & behaviours
e.g. self-harm, poor diet, lack of exercise
Determinant 4
Communication difficulties
&
reduced health literacy
Determinant 5
Access to healthcare provision
People with learning disabilities have poorer health than non-disabled people
DH emphasised that Primary, Acute and Specialist NHS trusts must meet the health needs of people with learning disabilities
DH working with Nurse Consultants in Learning disabilities to develop a set of outcome measures that Trusts and Commissioners can use to determine that health inequalities are addressed and that health outcomes improved
The proposed outcome measures based on the determinants of health inequalities from the Improving Health and Lives: Learning Disabilities Observatory
It is the impact of each of these determinants on the health of people with learning disabilities that provides the focus for the development of outcome measures
A measurement scale has been developed and will be ready for testing in the Spring
For further information contact Dr Ben Thomas

20. Learning disabilities nursing – a brilliant career

21. Thank You
Contact details:
Dr Ben Thomas