Learning disability nurse shortage is disrupting drugs regimens
Vulnerable patients with complex needs are missing out on medications doses amid specialist nurse staffing gaps in mental health hospitals
Shortages of learning disability nurses mean vulnerable people in mental health hospitals are more likely to miss important medication, said a new report.
The government-funded Health and Safety Investigation Branch, which looks at safety in England’s NHS states learning disability nurses’ specialist skills are vital when administering medication to individuals with complex needs.
But investigators found that when rota gaps need to be filled, learning disability nurses are often replaced by mental health nurses, who don’t necessarily have the appropriate skills and experience for this patient group.
‘The competencies and skills of learning disability nurses and mental health nurses differ when considering how patients are engaged in taking medication,’ said the report.
‘This was rarely considered when using mental health nurses to fill learning disability nurse staffing vacancies.’
Drugs for mental health prioritised over those prescribed for physical conditions
The investigation into medication omissions in learning disability secure units was prompted by the case of Luke, a young man with a learning disability who regularly missed out on being given prescribed medication for physical conditions while an inpatient at a mental health hospital.
It included interviews with Luke, his mother and staff at the two units where he had stayed and a visit to the hospital in question. Investigators visited seven similar places to look at medication rounds and other activities.
Investigators found arrangements that were confusing and frustrating for patients. Medicines to treat physical conditions were often not given the same priority as mental health medications and sometimes nurses did not even offer them.
‘On several occasions the investigation observed nurses recording a prescribed item as refused or declined without having offered it to the patient,’ the report said.
They concluded a lack of registered learning disability nurses was affecting the quality of care provided.
Extent of decline of learning disability nurse numbers
NHS Digital statistics show there were 3,085 leading disability nurses working in the NHS in England at March 2022, down from the 3,214 in March 2021 and 3,252 in March 2020.
RCN professional lead for learning disability nursing Jonathan Beebee said: ‘Without the right nursing staff working in the right settings, patient care suffers. The shortage of learning disability nursing staff is threatening patient safety.’
The report found retention is proving to be a particular problem and says this should be a key focus of efforts. It also recommends settings that use mental health nurses to cover shortages of registered learning disability nurses provide extra training where necessary.
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