The specialist learning-disability nurse workforce is in “absolute crisis” with the number of specialist nurses falling by a third across the UK since 2009, leaving many vulnerable adults with inadequate care, according to a report by the largest nursing union.

The Royal College of Nursing review revealed that the number of learning-disability nurses employed by the NHS has fallen from 7,083 in 2009 to 4,768 in 2026. As a result of these falling numbers, 1.5 million people with learning disabilities were not being provided with their legal right to equitable access to health and care services.

This failure in care has mainly been attributed to the chronic lack of specialist learning-disability nurses available across the UK, with this gap expected to widen in the coming years. Only 490 learning-disability nursing students had chosen to study the specialism in the UK, according to the analysis. This was a 40% reduction over the past decade in the number of students accepted on to these courses.

Prof Lynn Woolsey, the Royal College of Nursing’s chief officer, said the review’s findings were a “warning that we cannot continue this path where learning-disability nursing is consistently undermined”.

“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,” Woolsey said.

She added: “The expertise of learning-disability nurses has been poorly understood, inconsistently recognised, and insufficiently protected within health and care systems. Their contribution is repeatedly undermined and ignored in wide workforce planning and service delivery.”

The review found that specialist nurses felt devalued by the healthcare system, while not being given the resources to provide thorough care to their patients.

One nurse told the review that working within a small learning disability service in a rural area was challenging due to a lack of understanding of their patients’ needs by senior management. Another said that difficult shift patterns and demands on the staff meant they were unable to deliver the level of care they would have ideally been able to.

People with learning disabilities across the UK face significantly poorer health outcomes than the general population, including a reduced life expectancy of about 20 years. Those with learning disabilities from minority-ethnic and more deprived backgrounds face even worse health outcomes, reduced access to preventive care, and higher rates of avoidable death.

The nursing union has called on the government for learning-disability nursing to be explicitly recognised and protected as a safety-critical profession, and for a coordinated UK-wide programme of professional and policy work to be adopted to sustain the profession.

Jon Sparkes, the chief executive of the learning disability charity Mencap, said: “Learning-disability nurses are too often the only people making sure someone is properly heard, understood and supported in healthcare settings.

“But far too many people are going without that support when they need it most, because services are overstretched, unavailable at key times, or simply don’t have enough specialist nurses. If we are serious about tackling health inequalities, we must urgently protect, invest in and grow this vital workforce.”

The Department of Health and Social Care has been approached for comment.