40 years in the NHS: making a difference in learning disability with Mel Coombes MBE | Talking #TeamCWPT blog

Staff at CWPT are dedicated to providing the best possible care and support to our community across Coventry and Warwickshire. Giving a voice to those who are the most vulnerable within the community is at the heart of everything they do.

As a provider of learning disability services, CWPT has hundreds of staff who constantly go above and beyond to make a difference in the lives of our patients with a range of learning disabilities, while supporting their families and carers.

As some of #TeamCWPT celebrate over 40 years in NHS, read about how they are all united in a common purpose: supporting the most vulnerable in society to have the opportunity to live the best life possible in this 3-part blog series.

In part 1 of this blog series, we're spotlighting the journey of  Mel Coombes MBE, CWPT's Chief Executive Officer who started her career in the NHS as a learning disability nurse.

An early experience volunteering with children with learning disabilities led Mel to apply for nursing. Witnessing the reaction of some parents to a little boy with learning and physical disabilities that Mel was supporting was a shocking eye opener. The realisation that the little boy "didn't have a voice and that there are many vulnerable people in society that are not valued and can't have a voice" changed the course of her life.

Mel started her career when institutional care was still a significant part of learning disability nursing, where there were examples of patients remaining in long-term institutional care for reasons that seemed unnecessary. "I particularly remember one woman who had been placed in an institution for being an unmarried mother. She had been there for so long it was impossible to imagine how she might manage in the community."

Mel describes this as an interesting time in nursing as the shift from inpatient to community-based care began. "My first job was in a residential respite setting. I was newly qualified and so it felt challenging, but I learnt a lot. I really wanted to get into community nursing as the focus was moving to getting patients out of hospitals to settle in the community." Mel worked as a staff nurse in Birmingham while also completing a diploma in health care.

Mel had always been interested in looking at 'the bigger picture' in health care, thinking about how policies and procedures can help to improve the care that we give. Her passion for influencing developments led her to become a general manager for specialist services in North Warwickshire where she was responsible for community and respite care, whilst still maintaining a caseload. It was at this point that The Lodge was built where, again, the focus was on keeping people out of hospital settings.

The Valuing People Strategy for Learning Disability in the 21st Century was launched in 2000, to help people with learning disabilities live full lives. New nurse consultant roles were created as part of this strategy, of which 6 were launched nationally. Mel became one of the first nurse consultants in the country. "It was a fascinating role. You had the opportunity to interface with patients while shaping the role yourself. I got to experience working at a national level which was really exciting. There was a lot of work, but you got to be very creative."

Mel continued to leave a legacy for a new generation of nurses by working with Coventry University to put together the training course for learning disability nurses, in conjunction with Worcester University. "I really wanted this course to be shaped by people with learning disabilities. It was so important to me that their voices were heard within the training. 90 service users were involved in the development of the course which allowed us to demonstrate the importance of co-production and co-training in health education."

When she won the Nurse of the Year Award in 2004, Mel made sure that people with learning disabilities who had been involved in her work attended the award ceremony with her.

Becoming Chief Nurse gave Mel a fantastic insight into an even boarder range of issues that impact patients and staff. During this time as Chief Nurse, nursing associate roles were being piloted to bridge the gap between healthcare assistants and registered nurses, and Mel was part of the initial pilot to launch this initiative. "This was pioneering. We were able to really shape change and focus on the ethos of the team."

Throughout this time, Mel continued to make sure that patients, carers and staff were not forgotten, driven by the desire to continue developing opportunities for our workforce to ensure that learning disability and mental health nurses were not left behind. She chaired the National Mental Health and Learning Disabilities Nurse Directors Forum and, being passionate about making a difference, Mel was happy to be an activist if necessary. She was able to work creatively with the CQC to change standards. She also worked closely with the Royal College of Nursing and Health Education England to develop a competency framework for mental health nurses which, again, was co-produced with nurses and service users.

It is no wonder then that Mel was awarded an MBE in 2021, as well as being awarded an honorary doctorate from Coventry University. "It was a great honour. I was incredibly proud because it was in recognition of nursing, supporting nurses and patients that we care for."

In everything she does, Mel strives to bring honesty, transparency, fairness, proportionality and genuineness. When reflecting on her career and why she does what she does, Mel said:

I want to engage people in my passion. People can affect change themselves but it is important that we support them to do that. Our job is to support people to live the best lives possible whether they are our patients or our staff. We need to ensure we raise profiles of those who need our services so let's be ambitious and let's make the difference.