Needs of learning disability patients ‘not consistently met’ when in hospital, report shows

The health and care system is not always meeting the needs of people with a learning disability when they are cared for in hospital, according to a new report.

The Health Services Safety Investigation Body (HSSIB) conducted a national investigation examining the inpatient care of adults with a known learning disability.

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The resulting report found that despite a commitment across the NHS to improve the experience of care for those with a learning disability, ‘persistent and widespread’ safety risks remained.

The HSSIB highlighted multiple studies and reports which continue to evidence poorer outcomes, avoidable illness and premature death for those with a learning disability.

The report said that current systems and processes within the NHS were not always designed to enable staff to deliver effective care to people with a learning disability.

The investigation found that the biggest safety risks related to:

  • The lack of accessible information that sets out patient needs and enables staff to make reasonable adjustments
  • Limited support, whether that is through training or within the clinical environment, for staff who are not specialists in caring for patients with a learning disability

Staff with responsibility for assessing mental capacity described how publications were limited in considering the variations of how a person with a learning disability may present and provided limited guidance on dealing with ambiguous situations.

The report set out eight key findings and made four safety recommendations, focused on providing guidance relating to the learning disability liaison workforce, how to assess mental capacity in practice, and standard information for the health and care passport. The report also recommended continuing to assess care provision via the annual learning disability survey.

There were three suggested actions for Integrated Care Boards to aid improvement at a local level.

Clare Crowley, senior safety investigator at the HSSIB, said: ‘In the UK it is estimated over 900,000 adults have a learning disability. Each person with a learning disability will have their own experiences, their own way to communicate and will come into hospital with unique needs, which will require a tailored set of reasonable adjustments.

‘What our investigation shows is that where systems and processes do not support staff overall, an ‘unrealistic reliance’ is placed on individual staff members working within hospital wards. We heard from staff that they are trying their best for their patients but don’t always have the time to meet needs in the way they would like and are not always equipped with the specialist skills and knowledge they need to assess and care for people with learning disabilities.

‘The reference case we looked at and the conversations we had with those who have lived experience highlight just how important person-centred care is. If needs are not met, it can cause distress and confusion for the patient and their families and carers, and raises the risk of poor health outcomes and in the worst cases, harm. The recommendations we have made are aimed at reducing the safety risks, tackling inequity in care, and supporting the delivery of safe care to people who may be at their most vulnerable.’

Image: Erik Mclean

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