The Learning Disabilities Mortality Review (LeDeR) programme was established to support local areas to review the deaths of people with learning disabilities, identify learning from those deaths, and take forward the learning into service improvement initiatives.
NHS England have now published the annual report following the reviews and the findings can be described as shocking. If you haven't read the report here is the link:
Health inequalities faced by people with learning disabilities has been well documented. Today, people with learning disabilities die, on average, 15-20 years sooner than people in the general population, with some of those deaths identified as being potentially amenable to good quality healthcare. Mencap has been advocating and riaising the profile of these inequalities through their Treat Me Well campaign. (https://www.hertsbedsot.co.uk/single-post/2018/03/09/Mencap-calling-for-training-to-healthcare-professionals)
From the 103 completed reviews, there were 189 learning points or recommendations identified. The most commonly reported learning and recommendations were made in relation to the need for:
a) Inter-agency collaboration and communication
b) Awareness of the needs of people with learning disabilities
c) The understanding and application of the Mental Capacity Act (MCA).
These recommendations are nothing new. There are similar to the recommendations made in Death By Indifference report in 2007 and the Treat Me Right Campaign by Mencap in 2004. The main arguments in that campaign was more learning disability training for all medical staff and all NHS organisations to comply with the Disability Discrimination Act (DDA). The Confidential Inquiry into premature deaths of people with learning disabilities, 2013 also echo the recommendations from 2004 and 2007 Mencap campaigns.
How in 2018 has very little has changed for people with learning disabilities when accessing healthcare?
As a learning disability occupational therapist, I have delivered training to other primary care AHP professionals about how to work with and communicate with people with learning disabilities and their families. I have spend time on hospital wards and in community services modelling and demonstrating how to adapt the environment and our style of care to ensure we meet the needs of our clients. The statement I always make in my head is...
'My colleagues do not always know how to make reasonable adjustments'
If people are not making reasonable adjustments, changing the environment or adapting their communications they can not reasonably provide good care to people with learning disabilities.
Reflection going forward is ensuring that learning disabilities awareness training is at the heart of practice; continue to demonstrate how to make reasonable adjustment; ensure management are giving time to MDT to reflect on best practice and continue to advocate for people with learning disabilities.