Working with local hospitals

Oxleas’ adult learning disability (LD) services are committed to supporting local acute hospitals to meet the needs of vulnerable patients with learning disabilities.

We have selected a number of useful resources and provided local contact information for our colleagues in acute hospital services:

Useful contacts for those working in the following hospitals:

The strategic nursing lead for all three boroughs (Bexley, Greenwich and Bromley) is:

Lorraine Regan, Nurse Consultant
Tel: 020 8319 7100
Email: lorraine.regan@nhs.net

What is happening locally?

Oxleas’ adult learning disability services have been liaising with local hospitals for a number of years. Some excellent work has been carried out to improve the patient experience of acute care for people with a learning disability. For example:

Learning Disability Awareness Training – provided by local LD health professionals. This is available to all hospitals
Learning Disability Information Packs – local versions have been produced for the PRU in Bromley by the Bromley LD team and in Queen Mary’s in Sidcup
‘Our Health – Our Hospital’ DVD – produced in Queen Elizabeth Hospital, Woolwich. This DVD provides people with an accessible tour of the hospital and its’ services. Copies are available on request.
Hospital Liaison Groups – these have been meeting in Queen Elizabeth and Queen Mary’s sites with a view to developing hospital protocols to improve services for people with learning disabilities – this work is ongoing.
Ward ‘walk arounds’ – in Bromley, the PRU staff & patients have benefited from specialist LD health professionals visiting the wards, introducing themselves and offering support where LD service expertise is required/appropriate.
Hospital Passports – have been adapted (from the ones used in Gloucestershire and recommended by the Department of Health) to support the efficient identification of health/communication needs presented by people with learning disabilities.

Still much work to do!

Despite the improvements in liaison and partnership working between health professionals in each organisation, there is still much work to do to ensure that we have robust local systems in place – so that vulnerable patients are appropriately identified and supported through each stage of care delivery (admission, treatment, discharge and follow up).

This web-page is just part of a series of initiatives designed to promote good practice and joint working between services to ensure the best possible health outcomes for our local learning disabled population using their NHS services.

Why are we being asked to do this?

People with learning disabilities are 4 times more likely to die from something that could have been avoided, when compared to the general population.
People with learning disabilities are more at risk of things going wrong than the general population, leading to varying degrees of harm being caused while in hospital. (Especially for those with higher support needs) National Patient Safety Agency (2004).
26% of people with LD are admitted to general hospitals each year compared to 14% of the general population.

In March 2009, the NHS Ombudman published results from the public inquiry into the deaths of six people with learning disability in acute hospital care. Recommendations from this report state:

…"that all NHS and social care organisations in England should review urgently:

the effectiveness of the systems they have in place to enable them to understand and plan to meet the full range of needs of people with learning disabilities in their areas; and
the capacity and capability of the services they provide and/or commission for their local populations to meet the additional and often complex needs of people with learning disabilities;
and should report accordingly to those responsible for the governance of those organisations within 12 months of the publication of this report."

Additionally, the Care Quality Commission recently published six performance indicators for acute hospitals relating to "access to healthcare for people with learning disabilities".

How we can support you

We have a wealth of resources and expertise available to support people with learning disabilities to get the most from their NHS services. Some of the resources are freely available to download below. In addition to the provision of useful tools/resources etc, we would like to work with you to develop acute services. As mentioned above, we have already provided the names of dedicated professionals interested in improving links with local hospitals.

The recent independent inquiry (Healthcare for All, 2008) highlighted pockets of good practice but ‘believes that good practice needs to be shared and more widely understood’.

We believe it is time to explore how we can do this. Effectively sustaining our good practice, across all areas of service delivery, ensuring that an understanding of the needs of vulnerable people with learning disabilities is widespread and not just for the passionate few.

Personal Health Profiles (PHPs)

Oxleas has been working with primary care services for several years, introducing Personal Health Profiles. We would like to encourage staff to ask for these personal hand held health records and record relevant information where appropriate. For more information, please visit our Personal Health Profiles page.

National Access to Acute (A2A) Network

The A2A Network (Access to Acute) hosts a wealth of useful information to support acute trusts to develop the way they work with people with learning disabilities.

You can access their website by following this link: www.a2anetwork.co.uk

It is also possible to share good practice with other hospitals engaged in this activity around the country.

The National Network meets four times a year in different locations, enabling a wider group of people to join the meetings. Regional groups also exist to spread good practice further.

Mark Bradley
Health Facilitation Coordinator (Adult LD services)
Tel: 020 8269 3349
Email: mbradley1@nhs.net

The following resources have been compiled for you to download, to enhance the level of service you provide for your vulnerable patients: