Shortage of specialist nurses could leave people without support needed to access fair healthcare

PEOPLE with learning disabilities are being denied fair access to health and care because of a growing crisis in specialist nursing, the Royal College of Nursing has warned.

A major new RCN review says health and care services across the UK are failing to consistently meet the needs of some of society’s most vulnerable people, despite legal duties designed to protect them.

The report, Safety, Equity and Expertise: A UK review of learning disability nursing, warns that shortages of specialist nurses mean some patients are being overlooked, excluded or harmed when mainstream services are unable to properly adapt to their needs.

The RCN says learning disability nurses play a vital role in helping patients who may struggle to communicate symptoms, understand treatment, attend appointments, or cope with busy hospital and healthcare environments.

Their work includes supporting patients and families, helping services make reasonable adjustments, preventing health problems from escalating, and ensuring people with learning disabilities receive safe and appropriate care.

Workforce under pressure

Figures analysed by the RCN show the number of learning disability nurses employed by the NHS across the UK has fallen sharply over the past 16 years.

Numbers dropped by 33%, from 7,083 nurses in 2009 to 4,768 in 2025.

The college has also raised concerns about the future workforce, with fewer than 500 students enrolling on learning disability nursing courses across the UK in 2025. Over the past decade, the number of students accepted onto courses has fallen by around 40%.

In Wales, the RCN says almost 1,000 registered learning disability nurses live in the country, but fewer than 500 whole-time equivalent nurses are employed within NHS Wales.

The organisation has also highlighted a 32% decline in nursing roles across independent and social care providers, warning that course closures, an ageing workforce and ongoing vacancies are threatening the future of specialist support.

Health inequalities

The RCN says the shortage is particularly concerning because people with learning disabilities already experience significant health inequalities.

The latest Learning from Lives and Deaths report found the median age of death for people with a learning disability was just 62.5, compared with around 82 for the wider population.

Campaigners have long warned that people with learning disabilities can face barriers when accessing healthcare, including difficulties explaining symptoms, services failing to adjust communication, and health concerns being missed.

Under the Equality Act 2010, healthcare providers have a legal duty to make reasonable adjustments to ensure disabled people are not disadvantaged when accessing services.

The RCN says learning disability nurses are often central to making sure those rights are delivered in practice.

‘People deserve better’

RCN Chief Nursing Officer Professor Lynn Woolsey said the findings should serve as a warning.

She said: “We cannot continue this path where learning disability nursing is consistently undermined. It’s a profession that is central to the safety, equity and human rights of people with learning disabilities.

“Yet the learning disability nurse workforce is in absolute crisis, with workforce numbers falling while university student numbers also collapse.

“Their skills are too vital for this to be allowed to continue. The expertise of learning disability nurses has been poorly understood, inconsistently recognised, and insufficiently protected within health and care systems.

“People with learning disabilities deserve better. Learning disability nursing must be recognised by health leaders as the safety-critical profession it is and workforce planning must reflect their value and importance.”

Call for action in Wales

RCN Wales Executive Director Nicola Williams said learning disability nurses are essential in supporting vulnerable people and tackling inequalities.

She said: “Learning disability nurses play a vital role in supporting some of the most vulnerable people in our communities and helping to tackle the significant health inequalities they continue to experience.

“People with learning disabilities have the same right as everyone else to safe, effective and equitable health care.

“Yet this report highlights serious concerns about the future of the specialist workforce that is so often central to making that happen.

“We cannot allow learning disability nursing to become an afterthought. The Welsh government, health boards and education providers must work together to protect and grow this vital workforce so that people with learning disabilities receive the care, support and advocacy they deserve.”

The RCN is calling for long-term workforce planning, improved training opportunities, and action to increase the number of specialist nurses entering the profession.

Cancer treatment targets missed again as opposition says Plaid must share responsibility for health service performance

NHS WALES is facing renewed pressure after the latest performance figures showed waiting lists rising, cancer treatment targets being missed again and more patients waiting over 12 hours in emergency departments.

The figures come as the Welsh Government announced an additional £145m for NHS Wales, including £100m to reduce waiting times and £25m for new surgical hubs.

In April, performance against the 62-day target for patients starting cancer treatment fell to 56.7%, well below the 75% target.

In Swansea Bay, just 48.4% of cancer patients began treatment within the target time.

Treatment waiting lists also increased, with 680,003 patient pathways recorded in April. The estimated number of individual patients waiting for treatment stood at 536,500.

Two-year waits rose to 3,694. In England, the comparable figure was 191.

Emergency care also came under further strain in May. The proportion of patients spending less than four hours in Welsh emergency departments fell to 64.4%, against a target of 95%.

A total of 11,066 patients waited 12 hours or more before being admitted, transferred or discharged, up from 10,287 in April. The target is zero.

Ambulance performance remained under pressure. For red calls, the median response time improved to nine minutes and 12 seconds, but the 90th percentile increased to 22 minutes and 39 seconds, meaning response time targets were still not met.

Welsh Conservative criticism

The Welsh Conservatives said the figures showed a “worrying backslide” in NHS performance and accused Plaid Cymru of sharing responsibility for the state of the health service.

Natasha Asghar MS, Welsh Conservative Shadow Cabinet Secretary for Health and Social Care, said: “These figures show a worrying backslide in NHS performance in Wales. Cancer treatment times have fallen, waiting lists have risen, two-year waits are up and more patients are being left waiting over 12 hours in emergency departments.

“Plaid Cymru cannot escape responsibility for this. They propped up the previous Welsh Labour Government by backing their budgets and are now in Government themselves. Patients across Wales need action, not more talk of improvement.

“Whilst any extra funding for the NHS is welcome, £145m will not be enough unless it is accompanied by urgent reform, a comprehensive workforce strategy and real delivery for patients.

“The Welsh Conservatives have been clear that the Welsh Government needs to declare a health emergency in our NHS. We need more beds in our hospitals, a robust NHS workforce and a serious plan to cut waiting lists and to support our emergency departments.”

Funding announced

The Welsh Government says the extra £145m will support work to reduce waiting times and improve access to treatment.

Of that, £100m has been allocated to reducing waiting lists, while £25m will be invested in new surgical hubs.

Health leaders have welcomed the additional funding, but warned that money alone will not solve the pressures facing hospitals, GP services, social care and emergency departments.

The latest figures are likely to increase pressure on ministers to show clear progress before the winter, when demand on the NHS is expected to rise further.

Welsh Government response

The Welsh Government said the figures related to April, before the new administration took office, and showed that both treatment waiting lists and the longest waits had increased.

Health and Care Minister Mabon ap Gwynfor said too many people were waiting too long for treatment, and said emergency care performance was not yet at the level patients and staff should expect.

He said: “Our focus is clear — cut waiting times, prioritise those who have been waiting the longest, improve access to services and build an NHS that can keep up with demand in the long term.

“To bring waiting times down and keep them down, we need to change the way the NHS works — making sure patients move through the system more smoothly, from their first referral all the way to treatment.

“We’ve got a plan to do this, working with the fantastic NHS staff right across Wales. The £145 million we’re announcing today will be important in tackling the waiting list and waiting times and helping people be seen quicker.”

The Welsh Government said £100m would be used to help reduce waiting lists and waiting times, £25m would be invested in new surgical and diagnostic hubs, and £20m would go towards essential maintenance across the NHS estate.

NEW funding of £145 million has been announced for NHS Wales as ministers seek to cut waiting times, improve hospital facilities and increase capacity across the health service.

The package, announced as part of the Welsh Government’s Supplementary Budget for 2026 to 2027, includes money to reduce waiting lists, develop surgical and diagnostic hubs, and carry out essential maintenance across the NHS estate.

Health leaders and nursing representatives have welcomed the investment, but warned that money for buildings, equipment and waiting list initiatives must be backed by a wider plan for staffing, primary care, community services and social care.

The Welsh NHS Confederation said the additional funding was welcome, but called for a “whole-system” approach to health and care.

Its director, Darren Hughes, said: “NHS leaders in Wales welcome this additional funding for the NHS to reduce waiting times and make essential maintenance across the NHS estate.

“We also welcome the Health and Care Minister’s focus on developing a long-term strategy to address waiting times. We agree that a long-term solution is required to build sustainable capacity and drive whole-system improvements.”

Mr Hughes said strengthening primary and community care would be essential, including programmes designed to move more services closer to people’s homes.

He added: “Alongside improvements in primary care, we must also prioritise the social care sector.

“We would also welcome a broader and more balanced approach to how NHS and social care performance is measured and published. Focusing solely on waiting times does not provide a complete picture, and there needs to be more comprehensive data published across the breadth of the NHS and social care services.”

The Royal College of Nursing Wales also welcomed the investment, but warned that new facilities alone would not reduce waiting lists unless there were enough appropriately trained staff to run them.

Nicola Williams, Executive Director of RCN Wales, said investment in surgical and diagnostic hubs and essential maintenance had the potential to reduce delays, improve patient experience and increase NHS capacity.

But she said: “Buildings and equipment alone will not reduce waiting lists.

“Delivering sustainable improvements depends on having the right, appropriately trained and skilled workforce in place, and nurses will play a pivotal role in the provision of safe, effective and efficient care.”

RCN Wales said nursing staff across Wales were reporting rising patient complexity and demand, missed breaks, and difficulty providing the level of care patients need.

The union also raised concerns that newly qualified nurses had faced uncertainty about securing permanent employment, despite continued pressure on services.

Ms Williams said Wales could not afford to lose the talent and commitment of a generation of nursing graduates.

She added that any move towards strengthening primary and community care must be matched by investment in the nursing workforce needed to deliver those services.

The announcement will now raise questions about how much of the funding will reach west Wales, and whether Hywel Dda University Health Board patients will directly benefit from any new surgical or diagnostic hub.

No specific locations for the proposed hubs have yet been confirmed.