Learning Disabilities: Health and Social Care Access

Earl of Effingham Excerpts

Thursday 26th March 2026 Grand Committee

[The Earl of Effingham (Con)]

My Lords, I thank all noble Lords for their valuable contributions, including the noble Lord, Lord Scriven, and the noble Baroness, Lady Ramsey, for their lived experience of this important issue. Ensuring that people who live with learning disabilities are able to access safe and effective health and social care is a fundamental test of the fairness of our system. Reasonable adjustments are essential to ensuring patient safety and equitable care. However, we know that, regrettably, people with learning disabilities continue to experience poorer health outcomes and face avoidable barriers when accessing services. This is a matter of both access and safety. Where reasonable adjustments are not properly understood or implemented, the consequences can be severe.

When in government, we took important steps to try to address these issues as best we could. The Health and Care Act 2022 placed a clear requirement on providers to ensure that staff receive training in learning disability and autism. The Oliver McGowan code of practice established a consistent standard for training across health and social care. The NHS Long Term Workforce Plan set out ambitious goals to increase learning disability nursing training places by 46% by 2029. The noble Baroness, Lady Hollins, made some constructive challenges of our proposals, and I of course respect the views of an acknowledged expert, as the noble Baroness is.

However, it is now the responsibility of this Government to make good on our previous commitments and push through the further social care reforms that are needed. The Government published guidance last year stating that any adult social care providers arranging staff training between April 2025 and March 2026 would be reimbursed. Will the Minister update the Committee on how many adult social care providers have participated in this scheme and what steps the Government took to ensure that social care providers were aware of the funding available?

Pressing workforce challenges also threaten effective access to social care. Faced with falling student numbers, some universities have been forced to close learning disability nursing courses. In the south-east of England, there is no learning disability nursing course available. Nursing in Practice reported that the domestic supply of learning disability nurse specialists could run out by 2028. While the Conservative’s workforce plan set ambitious targets, the most recent data shows a negligible increase in the number of learning disability nurses of 4% between 2024 and 2025. The Government have committed to publishing a revised NHS workforce plan by spring 2026, so can the Minister now provide a publication date? Are the Government confident that the existing targets remain achievable?

We also have concerns regarding accountability. The removal of the quality and outcomes framework indicator relating to learning disability registers raises important questions. If only a proportion of those with a learning disability are currently captured on the registers, how exactly will the department ensure that all patients are properly identified and supported as they should be?

Finally, I turn to the issue of safety. The insights of the learning from life and death programme are invaluable in understanding the causes of mortality and identifying areas for improvement. The most recent report’s issue with the integrity of its data and delays was most unfortunate. The noble Lords, Lord Scriven and Lord Crisp, mentioned LeDeR. His Majesty’s loyal Opposition suggest that it is fair and reasonable to ask why the Government have not placed the programme on a statutory footing. Through what process will the Government ensure that the report’s findings are consistently translated into improvements in care at a local level?

It appears that many noble Lords are in broad agreement on the importance of this issue. The framework for improvement exists; the challenge now lies in ensuring effective implementation. The noble Baroness, Lady Hollins, highlight this very clearly. We hope the Minister will provide clarity on how the Government intend to bridge the gap between policy and practice to ensure that those with learning disabilities receive the safe and equitable care they deserve.