Living the Commitment – a reflection by Joshua Kernohan

November 30, 2015



Three years ago I found myself travelling to a meeting in Leeds for the UK Steering Group for Strengthening the Commitment; the modernising learning disability nursing agenda was in its infancy and there was a real sense of excitement at the opportunities we were presented with to help shape the profession and ready it for the future.


The three years seem to have flown by, and in that time things have changed dramatically, for me personally and in the wider landscape of health and social care. In moving from my role as a student to a qualified learning disability nurse I have been able to see the impact Strengthening the Commitment has had, and the changes it has wrought. It felt, for me personally, as a document with a real sense of momentum behind it and one which has been so successful because of the enthusiasm, creativity and passion of those supporting its implementation at all levels of the nursing profession.


That is not to say that there were not challenges faced at a UK level and within individual countries and while on my own placements I would often come across brilliant nurses who had not yet heard of the report or engaged with it. However, I have continued to see the embedding of the ethos, values and recommendations of Strengthening the Commitment in clinical practice, nurse research and education and in the independent sector. We have many things to celebrate including the high level of engagement with frontline practitioners, the development of future leaders, a growing evidence base and nurses working in new and exciting roles, sometimes working alongside and influencing those from other fields of nursing. Furthermore, we have seen incredible work come from our implementation groups, the UK Learning and Intellectual Disability Nursing Academic Network and the UK Learning Disability Consultant Nurse Network.  Coming into my first clinical post after qualifying, it was really exciting to be working for an organisation that echoed my feelings about Strengthening the Commitment, who had developed their own local action plan, and who had been cited as examples of good practice.


On the 18th June 2015 the UK Steering Group found itself, along with professionals from across the UK, attending theSharing the Success conference in Derby; this was a celebration of all that had been achieved so far, and the event recognised those services and practitioners who had risen to the challenge set by the original report. However, even given the great strides made by learning disability nurses across the UK it was recognised that there was more to be done.Strengthening the Commitment: Living the Commitment was launched at this event and set out the focus for the next phase of our work.


On 29th September 2015 the UK Steering Group put our heads together in Dublin this time, and a five country approach to learning and intellectual disability nursing was realised. In our talks with colleagues from the Republic of Ireland we could see that they were facing some similar challenges to our UK workforce and some different. Our task was then to identify those areas where we felt there needed to be a five country vision, recognising that each implementation group may also have a different and specific set of priorities. We identified four key areas to focus upon over the next three years:

  1. Working across the lifespan

  2. Public Health

  3. Positive Behaviour Support

  4. Leadership

We know that the needs of people with learning disabilities are changing and individuals may have more complex needs and are living longer. Learning and intellectual disability nurses have a clear role to play in supporting people with learning disabilities and their families/carers from birth and through childhood and adolescence, where early intervention may have a positive effect on future needs. We also identified the importance utilising the skills and values of learning disability nurses in the provision of good end-of-life care. While we know of nurses and services providing excellent care to individuals of all ages it was agreed there needs to be a more robust approach to this across the five countries, as there appeared to be a great deal of local variation.


The UK Steering Group considered a public health approach to be integral to the role of learning disability nurses, and at this meeting we discussed exploring the work of the Chief Nursing Officers on Personal Population Health Frameworks as well as embedding public health as a core part of our lifespan approach. As part of promoting health and well-being, work will continue to develop the use and application of Positive Behaviour Support within learning disability nursing. Though each country may have taken a different approach to implementation of PBS so far, the core values and aims remain the same, and this is something we want to develop further. Our work will also consider those people with learning disabilities with mental health or forensic needs, and how Positive Behaviour Support can work with other interventions to promote well-being.


Finally, nurses across the UK have risen to the challenges set by Strengthening the Commitment and have demonstrated the skills and abilities needed by the next generation of nurse leaders. Living the Commitment represents a pledge to continue to mentor and develop individuals in order to be able to advance learning disability nursing further over the next three years and beyond.


At the heart of the report and all of the groups and individuals that contribute to the work of Strengthening the Commitment is a desire to improve the lives and health of people with learning disabilities, by ensuring that the profession of learning and intellectual disability nursing has the capacity and capabilities to support them. I feel that though there is more to be done, we have come a long way in a short time, and I look forward to the next three years.


Joshua Kernohan

UK Steering Group for Strengthening the Commitment.


Look out for:

  • Learning Disability Nurse Research: A Position Paper

  • Positive Behaviour Support Framework (for pre-registration)










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Positive Commitment to Learning Disability Nursing

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