• Discuss the health needs of people with learning disabilities.
• Barriers they face in accessing healthcare
• Role of Acute Liaison Nurses

• 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
• Cardiac Disease
• Respiratory Disease
• Helicobacter Pylori
• Cancers
• Epilepsy
• Mental Illness
4

Health and People with Learning Disabilities
• Sensory Impairments
• Dementia
• Dysphagia
• Diabetes
• Gastro-oesophageal reflux disease
• Constipation
5

Health and People with Learning Disabilities
• 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
7

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
8

• 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

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

• 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.

• 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.

• 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.

• 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

• 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)

• 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.

• 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.

• Referrals
• Accident and Emergency Depts.
• Challenging outdated practice.
• Education slots
• Working over two areas i.e. Epsom and St. Heliers,
Surrey and Sussex
• Feedback

• 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

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