Transcript Role of Acute Liaison Nurse

Meeting the Health Needs
of people with Learning
Disabilities
Plan
• Discuss the health needs of people with learning
disabilities.
• Barriers they face in accessing healthcare
• Role of Acute Liaison Nurses
Health Inequalities
• Start early in life and continue into Adult hood
• Thought to be, in part, due to barriers they face in
accessing health services
• Shorter life expectancy
• Life expectancy for people with Down’s syndrome
increasing
• Mild learning disability >
• Moderate to severe Learning disability, mortality rate is 3
times higher than that of the general population.
Health and People with Learning Disabilities
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Cardiac Disease
Respiratory Disease
Helicobacter Pylori
Cancers
Epilepsy
Mental Illness
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Health and People with Learning Disabilities
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Sensory Impairments
Dementia
Dysphagia
Diabetes
Gastro-oesophageal reflux disease
Constipation
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Health and People with Learning Disabilities
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Physical Disability
Osteoporosis
Women’s health
Oral health
Barriers to accessing healthcare
• Communication Difficulties
• Inflexible services
• Lack of education/preparation that assists individuals to
negotiate GP practices
• Lack of education for Primary Care/Acute Hospital staff
• GPs are unfamiliar with services for people with learning
disabilities
• GP systems / appt slots
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Barriers to PLD Accessing Services
• Limited development of information
leaflets/documentation about people with learning
disabilities and associated health needs
• Assumptions made about ability to consent and / or
comply with treatments, lack of knowledge about MCA
• Social Exclusion of people with learning disabilities
• Low expectations of health both of the individual and
their carer
• Waiting times
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Current documents and guidance
• Valuing People, DOH (2001)
• Valuing People Now: a new three-year strategy for
people with learning disabilities, DOH (2009)
• Healthcare for all (2008)
• Death by Indifference, Mencap (2007)
• Mental Capacity Act (2005)
• Six lives report
• Equal access
Recommendations
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Flexible non-discriminatory services
and reasonable adjustments:Accessible information
Easy to access environment i.e. physical environment
and signage
Menu’s
Appointment times and letters
Feedback
Inclusion in service developments
Acute Liaison Nurse Service
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5 Acute hospitals within Surrey.
Royal Surrey Hospital- Kathryn Fisher
St Peters and Frimley Park- Nicola James
Epsom General and East Surrey Hospitals – Lynne
Ramnanansingh
• We also provide support to Surrey patients going into
Ashford and St Heliers.
Role of Acute Liaison Nurse
• Attempt to ensure that people with learning disabilities have access
to all the information they need in relation to proposed treatment
• Make sure the hospital staff have the information they require in
order to provide effective care and treatment for someone with a
learning disability.
• Co-ordinate between the person with learning disabilities/ family
carers / paid care staff/ and the hospital to ensure that their needs
are met.
• Plan hospital admissions and provide
training to acute staff regarding the client’s needs.
• Advising on capacity, consent,
Mental capacity act procedures.
Initial Aims
• To promote the role.
• Implement training sessions for acute staff.
• To build relationships with social services, community
teams and acute staff.
• To review policies and pathways in the acute setting to
reflect the needs of people with learning disabilities.
• To review accessible information.
1 Year on
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Focus particularly on problem areas identified
Build links with primary care
Provide training to palliative care staff / hospice staff
Set up service user groups
SALT pathway
Pre-op assessment
Ongoing Work Plan
• Identify link nurses in each clinical area.
• Provide 1 days full training for link nurses
covering Learning Disability awareness, health
needs of people with learning disabilities,
communication, behaviour support,
safeguarding.
• CQUIN
• Commence Learning disability steering group.
• Extend induction training (ESH)
Ongoing Work Plan
• Flagging
• Ward based training sessions (EGH)
• Focus on Accident and Emergency and acute
admissions wards.
• Review feedback questionnaires.
• Continue to work on accessible information with the
communication people.
• Developing work based competencies for acute nursing
staff.
Good Experiences
• The hospital passport
has been embraced by
many care providers and acute areas.
• Support from senior hospital staff.
• Palliative care at ESH
• Pre-op assessment at Epsom
• Training sessions are always well
received
• Ward links.
Challenges
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Referrals
Accident and Emergency Depts.
Challenging outdated practice.
Education slots
Working over two areas i.e. Epsom and St. Heliers,
Surrey and Sussex
• Feedback
Summary
• Progress is evident
• Feedback is needed from service users, paid care staff
and family carers about their experience to allow further
development of target areas
• As the role progresses need to review man power
Lynne Ramnanansingh
Learning Disability Acute Liaison Nurse
Epsom Hospital
Telephone : 07717850309
Pager Number:07699723474
[email protected]