Learning Disability Week - Tackling health inequalities
“The partnership board exists to give people with learning disabilities a meaningful platform to voice their experiences and opinions. And to ensure that those responsible for deciding policies and services hear those voices.
“It’s a vehicle to make sure that people and their real needs and wishes are placed at the centre of designing services.
“We know that access to health services for people with learning disabilities can be a postcode lottery in England, and now the NHS is bringing in a standard to even out the disparity in what’s been provided.”
West Berkshire’s Learning Disability Partnership Board (WBLDPB) works closely with everyone involved in the health service in the region, from the Clinical Commissioning Group (CCG) who decide which health services are needed and oversees their provision, to the doctors, nurses and other health professionals working across Reading, Wokingham and West Berkshire.
Here, partnership board officer Alex Osterritter describes the work happening to reduce the stark health inequalities for people with learning disabilities.
In addition to being the facilitator of the Partnership Board, The Advocacy People was also commissioned by Berkshire West CCG to run a Learning Disability (LD) Health and Wellbeing project. Among the aims of this project will be to try and make sure all people with learning disabilities are registered as such with their GP, to increase the take-up of the LD annual health check, and to contribute to improving the services that people with learning disabilities receive when they attend their local surgery, clinic or hospital. We also want to learn what activities and groups people enjoy and what kinds of new initiatives they’d feel would enrich their lives.
The four Primary Care Networks (PCNs) in West Berkshire run 11 GP practices, and they’ve decided to do some focused work on learning disabilities and mental health inequalities. The PCNs and the CCG came to us to ask for support in running a Health and Wellbeing event for LD adults and the people who support them.
We put on the Health and Wellbeing drop-in event in Newbury College so that we could bring people with learning disabilities together with all sorts of health professionals to have informal conversations. It was the chance to carry out physical health checks and speak with people about their mental health and wider wellbeing.
It was also the opportunity to ask people with learning disabilities, their parents, carers and support workers about their experiences of accessing health services, and to find out what is being done well, as well as what could be done better. And it gave us the chance to ask people ‘What makes you feel happy in life?’ and ‘What other things would make you happier?’
We wanted to let people know that over the age of 14, everyone with a learning disability should be receiving an annual health check. We’re encouraging teenagers to go along with their parents so that they get accustomed to it, as then it’s more likely they’ll feel happy to carry on with the checks once they become adult.
The annual health check is about both mental and physical health and it enables the GP to pick up on anything that has changed year on year.
The NHS has produced a video all about the LD annual health check here
The idea is to reduce inequalities. Adults with learning disabilities generally have a lifespan of 20 years less than the general population. Partly because learning disabilities are associated with other underlying health issues, but also because of inequalities in accessing health services.
What we want is for the annual health checks not to be a postcode lottery. The NHS is now bringing in this standard because across England there’s been such a disparity in what’s been provided. Now GPs everywhere will have to reach at least the bronze standard.
As well as the annual health check, people should also receive a personal Health Action Plan, put together by the GP with their input.
GPs are now going to be judged not only against the number of annual health checks they do, but also the quality, and this includes producing the health action plan. This is an easy-read document that the person can take away and share with their carer, relative or support worker.
Reasonable adjustments are a pivotal part of improving access for those with learning disabilities. It’s partly about staff in surgeries changing their approach, and it’s also about individual patients and their carers having confidence in the sorts of adjustments that they can legitimately ask for.
We’ve worked with local GPs and they’re now changing the training. We want the system to highlight that somebody has a learning disability at the point of contact, so that the receptionist has it flagged up. And then whenever that person calls in, they’ll be asked ‘is there anything we can do to make that appointment more comfortable for you?’ And after that conversation there will be a flag on that person’s record, describing what specific things that person needs in order to access the surgery and health professionals.
Especially where disabilities are not visible, there may be various reasonable adjustments that neither the surgery nor indeed the person themselves had been aware of, that could really make a very big difference to their wellbeing, and longer-term their health outcomes, as well as to making the practice as inclusive as possible.
It’s a reasonable expectation that a person’s appointment be adjusted to suit their needs – for example, they could have a longer appointment, or they could request that they wait in their car until their appointment time and be called straight in, so that they don’t have to sit in a busy, noisy waiting room. There may be other adjustments to help them process the information given in the appointment.
We’ve been talking about reasonable adjustments and accessibility for as long as I can remember – this initiative is going to be a massive, and let’s hope a very positive change.