31st July 2018
LIDNAN (Learning and Intellectual Disability Nursing Academic Network)/UK Nurse Consultant Network Summit on Learning Disability Nurse Education
FoNS presented the project and its progress at the summit. During the presentation a space was created for participants to contribute to the data by completing a postcard to foNS asking why is learning disability nursing important? 56 returns were collated.
This summit was called to discuss the crisis in recruitment and commitment to learning disability nurse education in England; and to agree appropriate action. Attendance was by network members, relevant people contributing to learning disability nurse education from Higher Education Institutions; NHS England; Public Health England; the Department of Health and other stakeholders. Following the event, action plans have been formulated which will be monitored through LIDNAN and the UKLDCNN.
6th June 2018
FoNS Annual Celebration Event
Celebrate Me was represented as a poster display at the FoNS annual Celebration Event this year. This gave an opportunity to showcase the wonderful artwork created by families, service users and staff from Exemplar Healthcare and Info graphic produced by David Harling, Head of Learning Disability at NHS Improvement. People were excited and very interested to learn more about the projects aspirations. Attendees had an opportunity to contribute their views and experiences via postcard replies at the event.
4th June 2018
Learning Disability Professional Senate
FoNS presented the Celebrate Me project at the Learning Disability Professional Senate. This forum brings together professional leaders from across the UK, to provide a collective voice of specialist health and social care practitioners. The Senate provides cross-professional collaboration, strategic advice and innovation to develop both mainstream and specialist services for children and adults with learning disabilities.
FoNS Reflection-Tweet chat one on learning disability nursing within primary care
On the 22nd May 2018, the Foundation of Nursing Studies guest-hosted with #WeLDNs the first in a series of three tweet chats as part of the #LDCelebrateMe project. The focus of this first chat was to capture a variety of perspectives and experiences of those working in and/or accessing primary care services.
Overall, there was a feeling of energy and enthusiasm from participants, all wanting to contribute to a new narrative about learning disability nursing. The chat saw 56 contributors, of whom the majority were LD nurses (72%) working within a community setting (60%) in the NHS. The hour just seemed to fly!
During the discussion, a series of prompting questions were offered to encourage participants to focus discussions on what is needed to inform the future preparation, work and ongoing development of learning disability nurses within this clinical context.
Participants considered where and how learning disability nurses are making a positive impact. There was no doubt from the responses that they do and do so within a variety of roles. There was a sense that learning disability nursing takes on all aspects of health and social care. An interesting suggestion was noted that sometimes learning disability nurses ‘wear clinical/social hats together’. Tweets shared indicated that the role is extensive, versatile, adaptable, dynamic, holistic and one which spans across the whole of a person’s lifespan.
Is there a need for learning disability nursing to clarify their role in terms of health needs?
A criticism of learning disability nursing could be that the role is too extensive and overlaps other professions e.g. learning disability nursing/social work.
There were suggestions that specific aspects of the role, such as the acute liaison, health promotion and facilitation, are significant in supporting people with a learning disability. As such, improvements in patient health outcomes can be achieved by ensuring the implementation of reasonable adjustments.
The discussion offered many positive examples from practice demonstrating the impact of the role at the interface of care delivery. Such examples included: hospital passports, best interest care plans, annual health checks, outcome measures such as the Health Equalities framework, physical health screening programmes and psycho-education provision for families and individuals.
There was support for the value and impact of liaison and diversion roles which aim to improve the health and criminal justice outcomes for adults and children who come into contact with the criminal justice system. Perhaps further exploration and understanding of such roles would be helpful.
There was a feeling that there is an abundance of anecdotal evidence to support the value of the role, but it raises the question of whether we need to be better at documenting, promoting and publicising what we do. Another perspective offered implied that evidence might be generated more within specific roles such as acute liaison. The role of acute liaison practitioner and the health screening services offered by the learning disability nurse should identify unmet health needs within the learning disability population. An overall evaluation of outcomes from these services would give clearer evidence of need.
It would be interesting to explore how representative this is within the wider remit of primary care?
Is the role of the acute liaison nurse/health screening being seen as more valued than other roles of an learning disability nurse working within a care home setting for example?
In relation to views on sustaining the role there was acknowledgment of the vital contribution which learning disability nurses offer. Popular contributions included:
‘People with learning disabilities may need additional support to access primary healthcare and the RNLD can assist through working with them, their families and primary care teams to make sure that there is equitable access’
‘because we have to do something about the increased morbidity and premature death and primary care need to help change things for the better. Learning disability nurses are often the best reasonable adjustment there is’
‘Unfortunately evidence like the leder-team [Learning Disabilities Mortality Review Programme] report suggests that primary care struggles to meet the needs of people with a learning disability. It would be interesting to see how many deaths have been prevented/avoided by ALNs and RNLDs in primary care’
Others highlighted that sustaining the role supports the implementation of reasonable adjustments, assists in meaningful choice making, co-ordination and collaboration of care. Sustaining the role enables positive opportunities to be created for individuals to have equitable access to healthcare and in doing so reduces the gap of health inequalities. There was a sense that education and support offered is key for individuals with a learning disability for them to be able to seek out their own support in relation to their health and wellbeing. Sustaining the role within primary care would alleviate the risk of diagnostic overshadowing and the over prescribing of medication.
There was a notion that part of the skill set of the learning disability nurse is to help bridge the relationship with other primary healthcare professionals and services. It is important to consider how and what this would look like in practice.
The discussions began to focus on how well the role is understood and this sparked some feeling that there is a general lack of understanding and awareness of the role within primary care. This raises an interesting question that if the profession itself and public do not understand the role clearly, how do learning disability nurses know what they need to strengthen the role? Ideas tweeted proposed promoting the role from school age up to university level and within other professional groups.
To strengthen the role of the learning disability nurse in frontline services, participants proposed the following ideas: further education, use of the green light toolkit to support and improve mental health services for people with autism and learning disabilities, clear articulation of the role and expectations, sharing of training with other professions and within other professional fields such as with GPs. Commissioning services need to understand the role and skills of the learning disability nurse and how they can be involved in development and improvement of services. There is a need for strong leadership at national government level and at a local level to promote and support the role of learning disability nurses.
When discussions focused on the state of current educational provision for learning disability nursing, participants said this varied from ‘great’ to ‘it’s hard to respond’ throughout the country. A question was asked: Will changes occur in light of the new NMC standards for education?
Overall, there is a lack of awareness of the LD nurse role both within education and within other professional groups. One tweet stated:
‘Learning disability nursing is about investing in society. Having a learning disability nursing course sends a powerful message out to all university stakeholders about the value of the
institution and is a great advert for all prospective students; come and study at a university that cares about all people’
Does England need to look at work already undertaken within Scotland, Wales and the Republic of Ireland to see what lessons can be learnt and how the role can be better promoted within England? Is there a need for a new marketing campaign to raise awareness of the role?
The final part of the evening focused on participants’ ‘elevator pitches’ to government and policy makers about the importance of learning disability nursing. These tweets really reflect how important the learning disability nurse role is. Some examples of these are:
‘In history our society will be judged by how well we care for our most vulnerable citizens. In a modern civilized society, we need LD nurses to be the reasonable adjustment that mitigates against poor health outcomes and premature deaths’
‘People with LD are some of the most vulnerable in society, they deserve better, equitable access to health with specialist nurses is a must!’
‘RNLDs across the lifespan. RNLDs needed in children’s services, lots of work to be done around ACEs [Adverse Childhood Experiences] and proactive interventions’
‘LD nurses bring a unique and rare skill set that supports, enables and empowers people with LD to have better health. The impact of poor health in people who have LD is much wider, affecting families and communities, health, social care and education providers’
‘Identify the significant inequalities that our clients face daily and support us in changing this. Our clients are living longer yet you only have to look at CIPOLD [Confidential inquiry into the premature deaths of people with a learning disability] to see how common deaths. We do an amazing job, imagine how amazing we’d be with your support!’
‘Evidence such as mortality review and recent high-profile deaths and Winterbourne view demonstrates that change is not happening quickly enough. RNLDs and disability education need to be embedded within health care education to at least attempt to minimise inequalities’
‘People with LD are part of the electorate too. LD Nursing roles are truly holistic and promoting political engagement amongst LD population is extremely important. We have the means and abilities to promote and support social inclusion’
‘This is a growing population who are living longer and enjoying life, it’s so important that access to health does not continue to be the reason this enjoyed life ends at a much earlier rate than the gen pop – learning disability nurses play a role in being this change’
Share your experiences and views through our Celebrate Me Survey
Our survey will close mid day on Thursday the 19th July 2018-NOW CLOSED
Please share any further comments and feedback through this site.
Please complete our survey on the importance and impact of learning disability nursing. All contributions welcome. Please click on the link below.
NHS Health Education England-Regional learning disability nursing workforce summit events
FoNS will be briefly presenting the Celebrate Me project at all 4 scheduled Health Education England learning disability nursing workforce summits, which are scheduled to take place during May 2018.
We will have an engagement stand at each event so please do come and visit us to find out more about our work and how you can get involved.
The dates for all 4 events are:
- Health Education England-North Region, Wednesday 9th May 2018
- Health Education England-Midland and East region, Thursday 10th May 2018
- Health Education England-South Region, Tuesday 15th May 2018
- Health Education England-London and South East region, Thursday 17th May 2018
24th– 25th April 2018 UKLDCNN (UK Learning Disability Consultant Nurse Network)
FoNS presented the Celebrate Me project and created an opportunity to explore with the network the purpose, aim and aspiration for this work. The network has fully supported and endorsed all project activity going forward.
Positive Choices Conference 2018: ‘Heroes and Champions deserve to live a life free from fear’
FoNS facilitated two ‘whirlwind Cafes’ at the recent positive choices conference which was hosted this year by Trinity College Dublin, on the 19th and 20th April 2018.
Positive choices, is an inspiring and ever expanding network that brings together student nurses, academics and other professionals from all five nations to celebrate all that is learning disability nursing each year at its 2 day conferences. Please refer to the website link for more information: https://positive-choices.com/
Both cafes gave participants an opportunity to explore the value and contribution that learning disability nursing makes and to think about the future of the role. The cafes were facilitated using the ‘six thinking hats’ concept by Edward de Bono. It was a great forum which allowed participants to be early contributors to the data. At the end of each cafe participants shared messages to future prospective student nurses who might be considering learning disability nursing as a career option.
*The Positive Choices, Positive Commitment Dublin 2018 info-graphic was created by Pen Mendonca
Outputs from the ‘Whirlwind Cafes’, Dublin, 19thApril 2018
- More holistic information/Stats to be recorded, a lot of info is missed
- Statistics for LD nursing places at university, how many places are filled, is it people’s perception, loss of NHS nursery (UK)
- Ways to improve number of new entrants to University
- Variety of areas LD nurses can work
- Focus more on HEF, we are making a difference
- Updated stats, stats being easily accessible, more national awareness
- Male/Female ratio, Info that LD nursing exists, info early on about Job opportunities
- Shortage of qualified LD nurses
- Education-Only 1 university in N.I provide 30 places for LD nursing degree
- Holistic care
- Skill teachers
- Less clinical skills
- Holistic practice
- Person centred care
- Transferrable skills
- Forgotten people
- Think outside the box
- Fade away
- Multi thinking
- Unrecognised-Not a real nurse
- Dedicated to empowering people
- Not listened to
- Mixed messages
- Adaptable to different roles
- Unique and needed
- Limited area for practice
- Needs awareness raising of the profession
- Communication skills
- Not recognised as a real nurse
- Being listened to by other health professionals
- Job opportunities
- Loosing LD nurses to general field
- Postcode lottery
- Not enough focus on clinical skills
- Not enough training around Mental Health
- Lack of pay
- Not many Job opportunities
- Lower intake due to funding
- Lack of research
- Limited training options
- Limited funding
- Not respected
- Not being listened to by other health professionals
- Ensure that those with an LD aren’t over looked and under valued
- To lesson the gap between life expectancy between people with an LD and those without
- Would seem more appealing if there was less stigma and more appreciation for LD nurses
- Increase quality of life and standard of living
- Make a positive impact on the quality of life of the person with a learning disability
- More education at young ages-school
- To mix the fields at university for skills/lectures
- Salary increases
- Communication skills
- Defining LD at early stages-to tell people what it is
- To ensure that people with LD are seen and heard in society
- Inclusion of LD nurses in general hospital
- Good promotion not just the enquires
- Promote LD in media. Always hearing about MH
- More creative
- If it was more clinical
- Keep the bursary in England
- Open more services
- Person centred care working across the life span
- Provides opportunities for holistic care for all clients
- LD Nurses are more than just a nurse!
- Raising awareness
- Other nurses to understand LD and gain more experience/knowledge
- Specialist roles
- Wide variety of people we work with
- More skills for acute care
- Remove the stigma that LD nurses are not real nurses
- Care co-ordinators
- Other professionals having a basic knowledge of LD
- Undervalued by other field of nursing
- More universities to offer it
- Show students career opportunities
- LD students to support other students for example social media
- National media campaign to make people aware.
- Informing students (school age)
- Other nursing branches to have more training on LD
- LD nurses to have more training in other branches
- Dual qualification-social work nursing
- Be proud
- One voice use it (Uni of Wolverhampton)
- There are so many opportunities out there for LD nurses
- Take the leap and make a change
- If you can make one person’s life better, it’s all worth it
- Go for it
- Let’s change the world
- Do what you love, and you’ll never work a day in your life
- It is real nursing
- If we don’t support people with a LD who will?Be the change and the voice that people we support need to be heard and seen
- Remember why you want to be an LD nurses especially when times get hard
- Making one-person smile may not change the world but it will change their world
- Act for those who may not be able to ask for themselves
- You will make a change
- Help make a difference-actions speak louder than words
- Go and make a change to a field of nursing that is so rewarding
- Be loud and Proud
- Come to work so make a difference