Amanda Costello

This autoethnographic chapter begins with a personal journey of change, through the lens of the author's lived experience of supporting a sibling with a brain injury. A learning disabilities nurse, special needs teacher, and leader, she describes her experience of periods of change within service delivery for individuals with learning disabilities. She goes on to address a parallel journey: from caring for people with learning disabilities in long-stay hospitals to a phased move into community care. The chapter ends with a look at how gaps in service provision have arisen and become even wider, causing an increased risk of harm and exploitation.

Our NHS Health England research project has identified learners at risk of not completing their chosen course within the Health and Wellbeing Faculty.
Our evidence suggests learners may not engage with their programme of study and do not always take advantage of the support available to them. Further evidence shows that learners who are experiencing difficulties and struggling with their programme are the most at risk of transient levels of stress and low motivation and engagement. This is due to the perceived pressure of work especially preparing for and completing assessments while developing professional knowledge, skills, and attitudes. Consequently, learners may leave their programme of study, for a range of reasons unknown to the academic team at the time of withdrawal or may experience unsuccessful assessment leading to fail and finish decisions at progression and award examination boards.