Hipótesis específica 03:

We need a workforce that knows about the needs of people with learning disabilities, is not afraid of disability, treats people with respect, and works in partnership with persons with disabilities, family carers and with other professions.

NHS Education for Scotland (NES) is working to implement the educational recommendations (16, 17 and 20) from Promoting Health, Supporting Inclusion27_{. Common learning outcomes}

about people with learning disabilities have been set for the nursing common foundation programme across Scotland and new learning materials developed to enable all student nurses to achieve these outcomes. NES is developing learning outcomes for all levels of nurse education which are linked to the Scottish Benchmark Statement on Nursing. These developments should raise awareness of the values required of all nurses, develop specific health knowledge and competencies in learning disabilities nurses and child health nurses, and provide a framework for continuing professional development. NES is also developing a set of health competencies across diverse health needs for support staff. This work should be extended to include other groups of health professionals.

Central to the agenda for the improvement of health within Scotland is the recognition that there needs to be a work force with the skill, knowledge and attitudes necessary to improve and promote health. This requires engagement with people with learning disabilities, their families and paid carers, learning disabilities health specialists working in the NHS, Local Authority professionals, academics, the voluntary sector, local and national government departments and other practitioners working directly with people with learning disabilities. The health outcomes should be geared to health improvement and reducing health inequalities and wherever possible supporting and enabling people with learning disabilities to promote and improve their own health. Both generalists and specialists have important roles to play in improving health, although the contributions and skills required will clearly vary. Most health professionals come into contact with persons with learning disabilities as part of their everyday health role: this may be frequent, but for others it is infrequent. Except for specialist learning disabilities health professionals, preregistration and post registration educational programmes typically have no or very limited reference to the needs of persons with learning disabilities. Many health professionals recognise their limited knowledge and experience of working with people with learning disabilities. This requires strategic review, with a view to identifying and incorporating core learning disabilities issues within educational programmes. It is however also necessary to be clear what education prepares practitioners to do and the level at which they can practice safely and independently.

Education should focus on and equip practitioners and others to develop communication skills, to recognise the wishes of and the common health needs of people with learning disabilities, and when and how to access additional learning disabilities specialist support. Disability equality awareness is important as is awareness of legislative requirements. Programmes for specialist learning disabilities professionals will require a higher level of development of specific competencies and knowledge. In some circumstances, learning can be more effective when undertaken in a multi-disciplinary and multi-professional forum, and potential for such learning opportunities should be identified and utilised. Employing persons with learning disabilities to educate students and professionals can provide a particularly valuable learning experience. In this way, over a period of time, developing respect will replace discrimination.

The Scottish Social Services Council is a new organisation, responsible for raising and developing standards in the Scottish social service workforce. The Council aims to develop a

social care workforce that is competent, confident and able to deliver high quality services that have the confidence of the public, and those who use services and their carers. A national training strategy is being developed which will provide a framework for enhancing the skills and competencies of the social care workforce in a way appropriate to Scottish needs, drawing on existing good practice and compatible with the Scottish Credit and Qualifications Framework.

The care and support of people with learning disabilities is an area of practice where health and social work professionals have a history of joint working and collaboration. This has increased through the introduction of Joint Future31_{. There is a need to support social work}

professionals to continue to develop their understanding of the health issues that impact on people with learning disabilities as well as their capacity to contribute to the wider health improvement of the people of Scotland. Health professionals benefit from understanding the social work contribution to health improvement as well as that of family and paid carers. There is scope for collaboration between NES and the Scottish Social Services Council. This creates opportunities for development of educational material and shared learning between health and social care professionals around wider health improvement and the health needs of people with learning disabilities.

Few, if any, health care professionals have extensive experience and competence to meet the full range of health needs of people with learning disabilities. It is not possible or indeed appropriate to pretend that this can be achieved. The role of learning disabilities specialists is therefore important and they must be enabled to utilise their skills to support others both within and outwith NHS Scotland. It is important that there is an expansion of public health capacity, appropriate to the needs of people with learning disabilities. On-going professional and career development opportunities for specialists in Community Child Health teams and Learning Disabilities Services are necessary.

Directly accessed health care providers working with children, adults or older adults with learning disabilities should also have opportunity to participate in education and practice development initiatives that will better prepare them in their work. Education and support needs to be available locally. Local Community Learning Disabilities Teams may have a role to play to support this, linking with the important work of local area co-ordinators with families and individuals, working across local communities.

The national centres of excellence (Criminal Justice Social Work Development Centre for Scotland, Dementia Services Development Centre, SCLD, Scottish Institute for Residential Child Care, and Scottish Training on Drugs and Alcohol) provide a resource for training and best practice which is informed by research and knowledge of practice needs.