1. Consultant Nurse Learning Disability
Better health - healthier lives: Getting care right for people with learning disabilities
Jim Blair
Consultant Nurse Learning Disability
Twitter @jimgblair

2. Hospitals and health service can be scary places………………………….

3. Parent & Author of Special Parent Handbook
What I would wish for?
Yvonne Newbold
Parent & Author of Special Parent Handbook

4. Need for change
Population who need support Congestion in current services Cost

5. Some statistics
People with learning disabilities are 58 times more likely to die by the age of 50
Women with learning disabilities die on average 20 years younger than women without learning disabilities and men with learning disabilities 13 years younger.
3 people a day dying avoidably in NHS hospitals
YET Less than 50% of NHS hospitals have LD nurses working in them
WE ARE THE CHANGE THAT IS NEEDED

7. Think beyond the norm ACT creatively

8. Learning Disability Lists Alerts on system
Prepare for a person coming in
Make care adjustments
Monitor outcomes and experiences
Improve care

9. Reasonable Adjustments What is reasonable?

10. Make reasonable care adjustments - consider:
T Time – take time to work with the patient
E Environment – alter the environment e.g. quieter areas, reduce lighting and waiting
A Attitude – have a positive solution orientated focus
C Communication – find out the best way to communicate with the patient and also communicate this to colleagues
H Help – what help does the patient need and how can you meet their needs
The TEACH approach was adapted from the one created by Hertfordshire Community Learning Disability Team

11. Enhancing care and experiences

12. Buzzers to ease waiting You can go & come back when You are next

13. Adjusting Care -Think Differently ACT Creatively
Alerts and Lists in the community
Double appointments
Environmental changes e.g. dimmer switches, videos
Information in easy to understand format
Learning disability specific clinics
Health checks and patient held records
Flexible appointment times
No fixed visiting times
Minimising waiting
Increasing support for the person
Hospital Passport
Changing places toilets – clinic alterations / adaptations – environmental reasonable a’s 13

14. patients with learning disabilities slower
The Learning Disability Protocol for Preparation for Theatre and Recovery
Discuss the patient's needs with them and their family/carers.
Use ‘comforters’ to relax the patient pre op and in recovery . 
Document and handover to colleagues.
          
Lower levels of noise and light
Place the patient in a quiet area within recovery
Ensure parents/carers are present and involved.
Gradually recover observing how the patient is progressing and ensuring pain has been assessed and reviewed
If the patient is disturbed or distressed in Recovery please consider:
1. Call an anaesthetist to use sedation to induce a relaxed, sleepier state.
2. Increase levels of sedation as required.
Recover
patients with learning disabilities slower
than those without one

15. Experts by Lived Experiences
Engage people with LD and families in service design, accreditation, delivery, evaluation, evolution and staff training
THEN we will get the culture and care right

16. Central roles of Learning Disabilities Nurses
• Effectively identifying and meeting health needs;
• Reducing health inequalities through the promotion and implementation of reasonable adjustments; and
• Promoting improved health outcomes and increasing access to (and understanding of)

17. Annual Health Checks for people with a learning disability over 14 yrs
Better Care – Healthier Lives
Thoughts, feelings, moods
Any other health problems build into a health action plan and referral options

18. Annual Health Checks for people with a learning disability over 14 yrs
Better Care – Healthier Lives :
Epilepsy
Diabetes
Urine test
Pain
Heart Health
Any other health problems

19. Behind every behaviour change consider a health reason physical or mental health issue

20. What can I do to make care better? How can I make sure it happens?
How I can help make change happen?
What can I do to make care better?
How can I make sure it happens?
What else can I do to effect the change that needs to happen?