Shortage of learning disability nurses risks being medications

The shortage of learning disability nurses is affecting the “quality and style” of patient care and the means by which mental health nurses are being used.

The findings suggest that a number of retained learning disability nurses, as it appears, are being recruited and qualified by the number of those currently matched.

“If learning disability nurses are retained, there is a loss of that specialist training and specific skillset that they possess”

David Fassam

In its latest report, The Healthcare Safety Investigation Branch (HSIB) explored the factors that contribute to medication omissions in patients with learning disability safe units.

The investigators determined that learning disability nurses and their specific skills were “critical” to the proper administration of medication to patients with complex needs, and therefore lacking these staff could result in patients not receiving the drugs they needed.

The HSIB inquiry was based on a patient named Luke, who is 31 years old and has a learning disability.

Luke was detained in a medium secure ward for 21 months before moving into a low-security unit at the same hospital, where he stayed for a further 11 months. Both units were “highly designed” for patients with learning disabilities.

During his hospital stay, there were “many periods” when he was not prescribed physical health medications.

Investigating why this happened, the HSIB visited the hospital and found there was a “general shortage” of learning disability nurses on both wards.

“A lack of nurses with the skills needed to care for patients with learning disabilities, a communication with a direct impact on quality and style of care received by Luke and the patients during the investigation,” the report said.

It added, “This is probably the most important thing when it comes to communicating with patients when the medication rounds.”

In addition, investigators found that it was “common” for registered mental health nurses to fill learning disability nurses.

The report highlighted that the “competencies and skills of learning disability nurses and mental health nurses differ when they are engaged in taking medication”.

“The shortage of learning disability nursing staff is threatening patient safety.”

Johnathan Beebee

But when it comes to researching, it is rarely used when there is a shortage of mental health nurses.

The report highlighted the number of learning disability nurses on the “Nursing and Midwifery Council” who have remained static at around 17,100 for three years from 2018 to 2020.

Analysis from the HSIB revealed that recruitment of learning disability nurses and the number of those who qualified was “improved”.

However, it is staff that are “almost leaving as fast as people are being recruited and qualified”.

In 2020, the NHS England and NHS Improvement launched the All-England Plan for Learning Disability Nursing, which aims to recruit, retain, develop and pursue the profession.

However, senior investigators from the investigation heard that the “most challenging element of the plan” was to stay.

The report makes a list of key recommendations to help address the situation, including calling on NHS England and NHS Improvement to ramp up retention efforts.

In addition, it is recommended that the organization use the cover learning disability nurse gaps to “review their clinical model and conduct training needs analysis”.

This would help identify the skills and training needed to ensure that mental health nurses have “relevant communication methods and strategies” to assist patients with learning disabilities, it added.

Commenting on the report, David Fassam, National Investigator at HSIB, said that “the shortage of learning disability nurses may contribute to their medication.”

“Patients benefit from seeing nurses who are consistently at times medicated and handed out,” he said.

“If learning disability nurses are retained, there is a loss of that specialist training and specific skillset that they possess.”

The investigation, which included site visits to different areas of England, also found that “design, layout and décor of wards affected the behavior of patients and the‘ atmosphere ’of wards”.

As well as responding to the report, Jonathan Beebee, a learning disability nurse for the Royal College of Nursing, said: “All nursing staff want to do their best to deliver their patients and care, but this report shows the shortage of learning Disability nurses are directly impacting the quality of patient care. ”

He added: “Without the right nursing staff working in the right settings, patient care suffers. The shortage of learning disability nursing staff is a threatening patient safety. ”

In the meantime, Jim Blair, independent consultant nurse learning disabilities, stressed that there was “a real urgent need to increase the numbers of learning disabilities and improve the lives of people with learning disabilities”.

An NHS spokesperson said the retention was a “priority”, with “flexible working options listed and the continued rollout of mental health and wellbeing programs”.

“Work is already ongoing to improve student retention of learning disability nurses, including better training, a focus on medication management and a new learning support fund for student nurses,” she added.

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