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Celebrating 100 years of learning disability nursing

​A leading specialist nurse from Norfolk and Suffolk NHS Foundation Trust (NSFT) will be at the House of Commons next week to take part in an event to celebrate the centenary of learning disability nursing.

Sue Bridges, Nurse Consultant (Learning Disabilities / Autism), has been invited to the reception, which is being hosted by Health Education England, by Dave Harling, Head of Learning Disability, NHS England and NHS Improvement.

Last year, she won the Learning Disability Nurse Award category of The National Learning Disabilities & Autism Awards.

“It’s an honour and a privilege to be invited to the House of Commons on 21st June, which will be the focal point of the centenary celebrations of learning disability nursing and falls in Learning Disability Week,” she said.

“I will be representing all the 111 learning disability nurses at NSFT who undertake a variety of different roles. In fact, the majority of them do not work directly with service users who have a learning disability. However, the skills they have developed are highly transferable which means many of them are working successfully for us in other areas.

“In addition, we have a network of about 200 ‘Green Light Champions’ across Norfolk and Suffolk who support people with learning disabilities who have mental health problems.

“Learning disability nurses today focus on person-centredness, individualised and holistic care, acting as advocates for those who do not get heard. Now that we know so much more about the health inequalities of people with learning disabilities, learning disability nurses have never been more needed.”

Learning disability nurses work to provide specialist healthcare and support to service users, parents and carers, to help them live a fulfilling live. They have excellent communication and interpersonal skills as well as patience and resilience.

At the House of Commons, Sue, who is one of the country’s 25 learning disability nurse consultants, will meet MPs and Baroness Sheila Hollins, who has long campaigned to improve the care of people with a learning disability.

NSFT staff and service users will take part in a public event at The Forum, Norwich, to celebrate 100 years of learning disability nursing. “Learning disabilities: a journey of discovery and reflection” is being organised by the UEA’s School of Health Sciences, and takes place 10am-4pm on Friday, 21 June and the following day.

They will be talking about the Green Light Toolkit, which enables adjustments to be made to ensure that service users with a learning disability receive healthcare in the same way as everyone else. In addition, they will play the STOMP card game, which raises awareness of a national campaign, supported by NSFT, to stop the over-medication of people with a learning disability, autism or both.

Members of the public who go along will also be able to learn about learning disabilities and autism, find out about local services and explore the range of professional careers in learning disability support. Attendance is free.

The centenary is being held this year because it was in 1919 that the UK’s first learning disability nurses were registered as “mental deficiency nurses”.

The term “mental deficiency nursing” was used until after the Second World War when it was replaced by “mental subnormality nursing” and then renamed “mental handicap nursing” in the 1970s. “Learning disability nursing” became the accepted term in the 1990s.

There are staff working at NSFT today who qualified as a “Registered Nurse for the Mentally Handicapped” (RNMH), a job title which has been replaced by “Registered Nursing Learning Disability” (RNLD).

Although NSFT employs learning disability nurses in both counties, the Trust is commissioned to provide learning disability services only in Suffolk. In Norfolk, community learning disability services are provided by Norfolk Community Health and Care NHS Trust and inpatient services by Hertfordshire Partnership University Foundation Trust.

NSFT’s learning disability community teams are based in east Suffolk (Ipswich), west Suffolk (Bury St Edmunds) and in Lowestoft (Oulton). There are adult and learning disability CAMHS (Child and Adolescent Mental Health Services) teams in each locality which support people with a moderate to severe learning disability who have mental health or challenging behavior.

A learning disability liaison service works closely with primary care in Suffolk, offering advice, consultation, training and occasional joint assessments to adults with learning disabilities who have complex needs, ensuring people have annual health checks and access to good physical health care.

Walker Close in Ipswich is the location of the inpatient assessment and treatment service for Suffolk. It provides six specialist beds for adults with moderate to severe learning disability who have challenging behavior or a mental health need. An intensive support team is also based there which works in the community with service users, parents, carers and social care teams to prevent admission to hospital.

The Green Light Champions include staff working in all areas of NSFT, service users and staff in other organisations, such as Suffolk Community Services and Norfolk Community Health and Care NHS Trust.

Suffolk learning disability nurse case study: Andy Madel
It took Andy Madel many years to find his true vocation in life but after 10 years as a learning disability nurse, there is no looking back.

Andy, who will be 50 this summer, is a staff nurse in NSFT’s adult learning disability assessment and treatment unit in Walker Close, Ipswich, which consists of two wards for adults.

Although he still does pool shifts for the Trust’s adult mental health wards, he sees his future very firmly with our learning disability service.

Andy said: “My first experience of someone with a learning disability was as a teenager playing football in the road with a boy who had Down’s syndrome.

“I first started to care for people with LD when I was working in the private sector as a community support worker on an independent living project.

“I soon realised that I wanted to join the NHS and successfully applied for a healthcare assistant post at Walker Close in 2003, qualified as a RNLD [Registered Nurse Learning Disabilities] in 2009 after three years and I’ve been at Walker Close ever since.

“I thoroughly enjoy working with people with learning disabilities and, as with all branches of nursing, I find it very rewarding to help people get through difficult times and contribute to their recovery and often an improvement to their quality of life. There’s an altruistic sense with nursing that you’re doing something worthwhile.

“People are admitted to the ward because they are unwell, primarily with mental health or behavioural issues, and when they are improving we often help them to learn new skills, enjoy life again and become more independent.”

Looking ahead, Andy is focused on contributing to the ongoing development of the inpatient service at Walker Close and the further integration of Positive Behaviour Support (PBS), where active support of the person combines with an understanding of their behaviour as a form of communication to develop an environment and approach that helps them more effectively.

Norfolk learning disability nurse case study: Rachel Petty-Cook
The skills that Rachel Petty-Cook used while working for six years as a learning disability nurse are invaluable in her current role as a PMA [Prevention of Management and Aggression] practitioner.

“I know from my experience as a learning disability nurse that people communicate in multiple ways,” said Rachel, who is based at Hellesdon Hospital and fills one of the Trust’s 13 PMA practitioner posts.

As well as teaching staff how to manage challenging situations, her role includes supporting clinical teams in West Norfolk and the Suffolk Adult Learning Disability Service in Walker Close, Ipswich.

“People are often surprised that as a PMA practitioner, I question the notion of restraint,” said Rachel. “If you reflect on why someone is behaving aggressively, you can often de-escalate them through understanding the reason for the behaviour.

“I share this knowledge with our staff caring for patients so that they can proactively manage a situation to keep everyone safe.”

Before embarking on nurse training, Rachel had worked in retail while volunteering with supporting the homeless. This led to a two-year community care course and she then worked three years for a charity which supported people with a learning disability into work.

Rachel, who is 53, qualified as a learning disability nurse in 1998 at the age of 32 after three years of training at the UEA.

She then spent six years working at Little Plumstead Hospital, near Norwich, and became interested in PMA while attending a PMA course at Hellesdon Hospital and learning of a need for PMA practitioners with a background in learning disability nursing.

Her ambitions for the future are to continue supporting staff and teams as a PMA practitioner, content in the knowledge that her work is making a difference.


NSFT works collaboratively and in partnership with service users who have a learning disability in order to learn from their expertise and lived experience about how services can be improved, a concept that was inconceivable as recently as 30 years ago. Below is a case study about how service user James Massey has been helping the Trust.

Service user case study: James Massey
James Massey is an “expert by experience” who works closely with NSFT to help make improvements for patients with a learning disability.

Having spent 18 of his 38 years in a variety of hospitals, James, who has a diagnosis of learning disability and autism, has a wealth of experience to draw on and share.

Now living in supported accommodation in Lowestoft, he has for the past three years been a member of the Waveney Learning Disability Service Users and Carers Forum, and is its current Deputy Chair.

The Forum is an opportunity for service users to share their experiences, to be involved in the development of services and for healthcare professionals to seek views on topics like being in hospital or particular medications.

James, who cannot read well, is also a member of the Trust’s Easy Read Group. One of the projects he has been involved in is producing an Easy Read reminder card for service users to bring along to consultant appointments.

“Learning disability nurses are important because they believe in you and help you speak up, loud,” he said.

Sue Medley, Learning Disabilities Specialist Nurse, said: “When I qualified as a ‘Registered Nurse for the Mentally Handicapped’ in 1991, it was unthinkable that we would work closely with service users.

“However, they have so much to offer and after almost 30 years I still often find they give a perspective I would never have considered.

“I’ve known James for many years and we have a mutual respect for each other, in exactly the same way that I do for any other colleague.”

Sue added that James’s involvement in the Forum and Easy Read Group has helped to improve his mental health wellbeing.

Caption: Andy Madel is pictured in the adult learning disability assessment and treatment unit at Walker Close, Ipswich

To read more and see further case studies, visit our special ​Learning Disability Nursing pages.

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