A Discussion of the Treatment of People with an Intellectual Disability Across Healthcare and the Modernization of Learning Disability Nursing
DOI:
https://doi.org/10.6000/2292-2598.2015.03.02.10Keywords:
Nursing Practice, Learning Disability, Health Inequalities, Policy, Professional IssuesAbstract
Aims: A discussion of the treatment of people with an intellectual disability across healthcare and the modernisation of learning disability nursing.
Background: Health inequalities are at the forefront of the collective mind of healthcare professionals and politicians, this paper explores why people with an intellectual disability have more health issues, die earlier and sometimes receive poor care, leading to unnecessary suffering and importantly, how this may change. Learning disability nursing has long been viewed as different and less valued, probably due to dual stigmatisation, or lack of understanding of specialist knowledge and skills required. This essential field of nursing is becoming a rare resource in our battle against health inequalities, yet internationally it is becoming recognised as crucial.
Design: Discussion Paper.
Data Sources: Literature and policy (1971 – 2012).
Implications for Nursing: All nurses need to recognise their role in meeting the health care needs of people with an intellectual disability. Health care managers and commissioners should value the unique contribution of learning disability nurse in addressing health inequalities.
Conclusion: Learning disabled people, their carers and professionals view the role of the learning disability nurse as central for effectively identifying and meeting health needs, reducing inequalities and barriers, supporting decisions around capacity, consent, best interests and advising and educating professionals. Recommendations for commissioning, nursing and services are made.
Summary Statement:
Why is this discussion paper needed?
People with an intellectual disability have shorter life-spans and receive poor healthcare because of the barriers to good health developed in societies constructed by and for people without a disability.
Internationally, the need for learning disability nurses, with their specific knowledge and skills, is being recognised in the battle against early and unnecessary deaths because of discrimination and health inequalities.
Learning disability nurses and ‘Strengthening the Commitment’ lead on improving healthcare for learning disabled people and this paper raises the profile of this important health issue.
What are the key findings?
This discussion paper explores how most of the poor health experienced by people with an intellectual disability is about discriminating healthcare provision and crucially, not because the person has a disability.
People with an intellectual disability have greater health needs than others and despite this, nonspecific health professionals often have scant understanding of their disability and health needs.
Learning disability nursing as a vital resource has in recent years seen posts reducing in the NHS, with actual and commissioned numbers of registered learning disability nurses dropping.
How should the findings be used to influence policy/practice/education/research?
People with an intellectual disability and nonspecific staff often feel they are inadequately educated and lack appropriate skills for quality healthcare provision for learning disabled people; this has to change.
Sir Johnathon Michael (2008) recommendation 1 advises that all health professionals be competent in supporting learning disabled people in a non-discriminatory way - universities and employers urgently need to adhere to this recommendation.
Professionals, learning disabled people and carers state learning disability nurses are vital to acquiring human rights - increased international commissioning for learning disability nurses to enable quality healthcare, education and advice to professionals is pressing.
References
Strengthening the Commitment: The Report of the UK Modernising Learning Disabilities Nursing Review Edinburgh Scottish Government 2012.
Estimating Future Need for Adult Social Care Services for Peaople with Learning Disabilities in England Centre for Disability Research 2008.
Fundamentals of Nursing: Concepts, process and practiceAustralia Pearson Publishing 2012.
News Article MENCAP http://www.MENCAP.org.uk/news/ article/MENCAP-welcomes-government-mandate-nhs-commissioning-board accessed 5 December 2012.
Department of Health. Good Practice in Learning Disability Nursing Department of Health http://www.dh.gov.uk/en/ Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081328
A Vision for Learning Disability Nursing. A discussion Document London UKLDNCN 2005.
Nurse Education: Now and in the future; The Challenges for Nursing in the 21st century Nursing and Midwifery Council. http://www.nmc-uk.org/Get-involved/Consultations/Past-consultations/By-year/Pre-registration-nursing-education-Phase-2/Nurse-education-Now-and-in-the-future/
Death by Indifference; 74 Deaths and Counting. MENCAP http://www.MENCAP.org.uk/sites/default/files/documents/Death%20by%20Indifference%20-%2074%20Deaths%20and% 20counting.pdfn
Healthcare for All. Report of the independent inquiry into access to healthcare for people with learning disabilities. Michael J. http://www.iahpld.org.uk.
Women’s Health: An Evidence Based Review World Health Organisation http://web.worldbank.org/WBSITE/EXTERNAL/ EXTABOUTUS/0,,contentMDK:23261965~pagePK:51123644~piPK:329829~theSitePK:29708,00.html
The Politics of Disablement London Macmillan Education Ltd. 1991.
Institutional Abuse Disability on Equal Terms Wiltshire. Sage 2008.
United Nations Declaration of Rights of Disabled Persons. United Nations http://www.un.org/documents/ga/res/30/ ares30.htm
Better services for the mentally handicapped London HMSO 1971.
Helping Mentally Handicapped People in Hospital A Report to the Secretary of State for Social Services by the National Development Group for the Mentally Handicapped London HSMO 1978.
Normalisation: the whole answer? Making Connections London The Open University Hodder and Stoughton 1989.
A History of Learning Disabilities. Learning Disabilities Toward Inclusion London Churchill Livingston 2003.
Independent, proud and different; celebrating our differences Disability Studies: Past, Present and Future Leeds The Disability Press 1997.
Dimensions of Learning Disability London Balliere Tindall 1997.
Fundamental Principles of Disability. Union of the Physically Impaired Against Segregation London UPIAS 1976.
Making Connections. London.The Open University. Hodder and Stoughton 1989.
Twentieth-Century Definitions of Mental Retardation. In Social Constructions of Mental Retardation. MNDDC http://www.mnddc.org/parallels2/pdf/99-MRI-MLW.pdf
‘Towards an Affirmation Model of Disability’. Disability and Society.
Self-advocacy, Civil Rights and the Social Model of Disability. ESRC Research Grant. Final Research Report www.leeds.ac.ukhttp://www.leeds.ac.uk/disability-studies/projects/selfadvocacy/final report.htm
Death by Indifference MENCAP http://www.mencap.org.uk
Health screening for people with learning disabilities by a community learning disability nursing service in Northern Ireland Journal of Advanced Nursing 10.
Valuing people: a new strategy for learning disability for the 21st London Department of Health 2001.
Treat me Right: Better health care for people with a learning disability http://www.mencap.org.uk
Getting it right together the implementation of recommendations 16, 17 and 20 from Promoting health, Supporting Inclusion Edinburgh NES 2004.
The Human Rights Act C.42.
Equality Act C. 15.
Getting Away with Murder. Disabled People’s Experiences of Hate Crime in the UK. London Scope 2008.
Disability Discrimination Act. London HMSO
International Council of Nurses (2006) Advanced Nursing Practice. Blackwell Publishing Ltd
Six lives: the provision of public services to people with learning disabilitiesLondonThe Stationary Office 2009.
Understanding Disability. A Guide for Health Professionals China. hurchill Livingstone Elsevie 2008.
Health Education England and the Nursing Midwifery Council. 2015. Lord Willis, Interdependent Chair - Shape of Caring Review.