Strengthening the Commitment: Living the commitment

4 Our commitment to the future agenda: living the commitment

In the three years since the publication of Strengthening the Commitment, the UK has lived through a period of prolonged austerity; seen ever-increasing public expectations and the rise of social media that moves information at the blink of an eye. The NHS continues to be in the throes of public reform which will see health services delivered within integrated health and social partnerships and in some parts of the UK an increasing mix of statutory and private provision.

The UK-wide Steering Group is committed to continuing its work to ensure that learning disability nurses build on Strengthening the Commitment while responding to the challenges of the new health and social care context. We need to meet the needs of people with learning disabilities, their families and carers in 5, 10, 15 years from now. We need to find creative ways for learning disability nurses to collaborate with other professionals and agencies in integrated settings whilst at the same time retaining all that is unique and special about what they offer. We need to make sure that learning disability nurses continue to add value and have impact and that their individual contribution remains valued within a multiprofessional and multi-agency context.

The spirit and thrust of Strengthening the Commitment remains as relevant today as three years ago. New and emerging challenges require a renewed, refreshed, refocusing of Strengthening the Commitment to make sure that we are responsive to the needs of people with learning disabilities and continue to strengthen the learning disability nursing profession. We have identified four key action areas for cohesive and collaborative action across all four countries. From these the UK Steering Group will set out a framework of priority actions and associated milestones for 2015-2018.

1 Strengthening the unique role and contribution of learning disability nurses

• Learning disability nurses add value to people's lives and we will celebrate and vocalise the contribution they make so it is evident to health and social care professionals, commissioners of services and to the public.
• Learning disability nurses play a key role in identifying children with learning disabilities as early as possible and then in supporting them and building resilience among children and young people with learning disabilities. In 2012 the IHAL estimated that there were 236,000 children in England with severe, profound and multiple, moderate learning disabilities or autistic spectrum disorder. This indicates the scale of the challenge to local authorities in providing adequate services for these children. The highly successful Health Equalities Framework is to be adapted and will be rolled out in line with individual country's implementation plans for children and young people's services, so that the health outcomes of learning disability nurses' contributions can be measured.
• Programmes to transform care and services for people with learning disabilities together with new staffing models will reduce the need for in-patient beds and enable learning disability nurses to deliver safe, compassionate and competent care across all settings.
• People with learning disabilities experience unacceptable health inequalities that put them at risk of disease and premature death. Many of the determinants of poor health can be mitigated by appropriate preventative measures such as better screening, targeted information, advice and support and reasonable adjustments to ensure people get good quality healthcare. Learning disabilities nurses play a major part in reducing inequalities and their role in public health will be expanded and strengthened to ensure they make their vital contribution to reducing health inequalities among people with learning disabilities.

2 Strengthening leadership among learning disability nurses

• Learning disability nurses are in leadership positions throughout government departments, higher education institutes, the criminal justice system, the independent and voluntary sector, and within health and social services. Their influence is evident in decision and policy making across the four countries in leading change and innovation, and demonstrating the care and treatment that people with learning disabilities should receive. Strong leadership at all levels including clinical leadership is critical to making things happen and we will continue to develop leaders to be highly visible and involved in current economic, political and social issues.
• Learning disability nurses will continue to increase awareness amongst commissioners and non-nursing managers of the benefits of learning disability nursing in terms of delivering measurable outcomes. Leaders in learning disability nursing will demonstrate their impact on improving health outcomes for people with learning disabilities.
• Work will continue to ensure learning disability nurses fulfil a key leadership role and bridge the gap between primary and secondary health services for people with learning disabilities. They ensure that reasonable adjustments are made and support healthcare staff as they work with people with learning disabilities.

3 Regulation, revalidation, workforce and the professional development of learning disability nurses

• Learning disability nurses will be supported to respond to the opportunities and challenges of revalidation, including continuing the development of models of support for learning disability nurses working in all settings and in isolated roles. The potential of reflective practice and clinical supervision to be embedded in day-to-day practice will be explored as a key element of revalidation.
• The standards embedded in the pre-registration learning disabilities nursing curriculum equip nurses with the confidence, attitudes, awareness and leadership capabilities to enter practice with a group of individuals who often have complex care needs. We will continue to deliver and develop the curriculum to make sure that students have a wide experience of learning disabilities and have the necessary skills to contribute to the care of people with learning disabilities.
• Nurses emerging from programmes from all fields of nursing should have a sound insight into how to care for people with learning disabilities who will engage with health services across their life span and across all their healthcare needs. The work started in the four countries to integrate learning disabilities within all nursing programmes in higher education institutions (HEIs) will be driven forward and strengthened.
• Education provision should be developed with co-production at its heart where people with learning disabilities, families and carers contribute fully to the development, delivery and evaluation of nursing programme curricula.
• Resources should be targeted so they have the greatest impact and projects that are innovative and which progress the educational agenda will be supported. Flexible delivery options and support within HEIs will be developed.
• Recruitment to learning disability nursing needs to continue to be strengthened and encouraged. To respond to this, learning disability nurse leaders and practitioners will continue to demonstrate their role in improving people's lives, the variety of settings in which they work and their contribution to reducing health inequalities.

4 Quality improvement, impact and assurance

• New models of care have been developed and will continue to be implemented across all four countries. These models aim to improve the support for and care of people with learning disabilities so they can live with the respect and dignity of any other human being.
• The use of the Health Equalities Framework is already being considered by the four countries and in some instances being rolled out at local level. This will enable the outcomes of learning disability nurses' contribution to be measured and their added value demonstrated.
• Research and investigation into learning disability nursing, and by learning disability nurses, will continue to expand so that a robust evidence base can be further developed. This will contribute to innovative ways of demonstrating the positive impact that learning disability nurses have on healthcare outcomes.
• The strong foundations laid by the Learning and Intellectual Disabilities Nursing Academic Network (LIDNAN) will be reinforced, work streams reviewed, and networks and communication enhanced across all learning and intellectual disabilities nurses working in higher education.
• Learning disability nurses will work with people with learning disabilities, carers, employers and commissioners to ensure that regulation is robust and meets the needs of people with learning disabilities.

Learning disability nurses welcomed and embraced Strengthening the Commitment and the range of innovative developments that have been taken forward has been impressive. This report celebrates these achievements whilst recognising that there are many other examples across the UK of learning disability nurses doing exemplary work to ensure people with learning disabilities are treated with compassion, dignity and respect and have the right care, at the right time in the right place.

We also recognise that the job is not yet done and this report also sets out our commitment to the future agenda. Every learning disability nurse plays a vital role in continuing to do the best we can to meet the needs of people with learning disabilities, their family and carers and continuing to develop learning disability nursing as a strong and vibrant profession.