Learning Disabilities: Transforming Care

Debate between Lord Prior of Brampton and Baroness Emerton

Thursday 9th June 2016 Lords Chamber

[Lord Prior of Brampton]

It is very clear in the NHS mandate that it knows exactly what it has to do. It was NHS England that produced Building the Right Support. There is a lot more governance around the programme now. Every month we will see the numbers of patients in in-patient care settings. The noble Lord will be interested to know that over the last year 185 people who had been in hospital for more than five years have now left hospital and gone into the community. There are signs that things are happening, but I would advise the noble Lord that what is needed is constant scrutiny.

[Baroness Emerton (CB)]

My Lords, I thank the Minister for reminding us how many patients have been removed from hospital, but I declare an interest that goes back to the 1970s, when I was responsible for transferring 1,500 and then another 1,200 patients from hospital through a joint working party involving social services and the health service. It seems that we have discharged patients. The Royal College of Nursing demonstrated in a recent report that, from the nursing point of view, never have so few nurses been trained in mental handicaps. People with learning disabilities have physical and mental requirements, as well as environmental ones. Safe staffing is the issue here. Following on from what the noble Lord, Lord Hunt, said, will the Minister please consider getting out an edict on the importance of looking not just at hospital staff but at community staff?

[Lord Prior of Brampton]

The noble Baroness raises a very important point. It is worth saying that an assurance board monitors the national transformation plan on a monthly basis and comprises local authorities as well as CCGs and others. On the workforce front, which is obviously crucial, it is no good putting money into a system if you do not have the right people to deliver the care. We expect the number of whole-time learning-difficulty nurses to increase from around 3,000 to more than 5,000 over the next five years, so there should be more resource going into this very important area.

NHS: Immigration Rules

Debate between Lord Prior of Brampton and Baroness Emerton

Wednesday 24th June 2015 Lords Chamber

[Lord Prior of Brampton]

The noble Baroness makes a strong point. The drop-out rate of nurses is between 20% and 30%; it varies hugely from one nursing school to another. I am told that the peak of the drop-out rate is after their first clinical placement, which indicates that the way some nursing schools recruit their students is far from satisfactory. I hope that Health Education England will change the way it remunerates some nursing schools to ensure that they recruit the people with the right qualifications, temperament and vocation before they offer them places.

[Baroness Emerton (CB)]

My Lords, the Royal College of Nursing’s underlying concern in its report was the safety of patients due to shortage of nurses. The royal college is greatly concerned that there has been a cutback in training places because of the inclusion of overseas nurses over the last three years. Can the Minister see whether the report will result: first, in an increase of nurses in training back to the level of three years ago; and secondly, in revisiting the levels of safe staffing?

[Lord Prior of Brampton]

As usual, the noble Baroness is more than familiar with the latest developments in the world of nursing. Health Education England is committed to commissioning an additional 23,000 nurses over the next four years. On safer standards of nursing, I know that she has taken a keen interest in the work that has been done around nurse staffing levels in relation to the numbers of patients. It is the Government’s view that the actual decisions about safe staffing should be taken at a local level, based on the acuity of patients on the ward, and should largely be up to the judgment of the ward sister and senior nurses within the hospital.

Health: Palliative Care

Debate between Lord Prior of Brampton and Baroness Emerton

Tuesday 23rd June 2015 Lords Chamber

[Lord Prior of Brampton]

I thank my noble friend for that question. I cannot answer it specifically, but the report prepared earlier by the noble Baroness, Lady Neuberger, and other subsequent reports have stressed the need for nurses to be properly trained. That is true both in hospitals and in community settings. I agree with the sentiments behind my noble friend’s Question but would like to take advice on whether what he is suggesting is indeed incorporated into nurses’ core training.

[Baroness Emerton (CB)]

My Lords, yesterday I was at the Royal College of Nursing, where a lot of work has gone into producing advice on end-of-life care. It has produced a small pocket handbook—and a larger one that goes with it. If the Minister has not seen the handbook, perhaps he would find it useful from the point of view of spreading it through care homes and hospitals. End-of-life care is in the curriculum for nurses but there is always a need for a reminder. These little cards that are to go in the pocket provide the essentials about end-of-life care.

[Lord Prior of Brampton]

My Lords, I thank the noble Baroness for those comments. Over the years I have spent quite a lot of time with nurses who are specialists in palliative care and I have always been hugely impressed by their work. I have not seen the booklet produced by the RCN to which the noble Baroness refers and I would certainly like to do so.