Government, national policy and learning disabilities

1. Modernising Learning Disabilities Nursing - Leadership Dr Ben ThomasDirector 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 Compassion Care is our business Competence Commitment Communication Courage

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, CNO6 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: 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 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

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 Strengthening the commitmentThe 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 Determinant 1 Social factors e.g. poverty, poor housing, unemployment, social isolation Determinant2 Genetic & biological conditions Determinant3 Personal health risks & behaviours e.g. self-harm, poor diet, lack of exercise Determinant 4 Communication difficulties & reduced health literacy Determinant5 Access to healthcare provision

20. Learning disabilities nursing –a brilliant career

21. Thank You Contact details: Dr Ben Thomas ben.thomas@dh.gsi.gov.uk