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Better care for people with learning disabilities

Learning Disability Week, 19 to 25 June
People with learning disabilities and a mental health condition are now getting more support to look after their physical health thanks to a team of specialist mental health nurses working in GP practices across Suffolk.

Norfolk and Suffolk NHS Foundation Trust (NSFT) employs four nurses to work across the county to improve care by making sure people who have a learning disability and are aged 14 and above receive annual health checks and are given accessible information.

The nurses also provide training and work with GPs to make reasonable adjustments so that it is easier for people with learning disabilities to get to appointments. This can include allowing extra time and making sure signage is clear and easy to understand.

NSFT’s Primary Learning Disability Nurse Service proved such a success during a year-long pilot that the service has now been permanently commissioned by NHS West Suffolk and NHS Ipswich and East Suffolk Clinical Commissioning Groups. It comes after statistics showed:
• The number of patients on the learning disability register and therefore able to access annual health checks has increased by 13%
• The proportion who have had a health check rose by 37% in practices where the nurses work

The news comes during Learning Disability Week, which runs from 19 to 25 June and this year focuses on raising awareness of the benefits of employing people with a learning disability.

Jacquie Knott, Deputy Service Manager for Acute Learning Disability Services with NSFT, said: “This service has proved a great success since its launch, and is playing a significant role in improving care for people.

“People with learning disabilities face considerable health inequalities. Their health needs are not always identified, which can lead to them being at a higher risk of shorter life expectancy, admissions to acute hospitals, chronic health conditions and poorer physical and mental health than the general population.

“Our nurses work closely with colleagues in GP surgeries to improve care by making sure eligible patients are on the learning disabilities register and able to access annual health checks. These checks are vitally important as they give GPs the chance to check their general health and pick up any undiagnosed conditions. The doctor will then work with the patient and their carer to draw up an action plan to manage any long-term illnesses and reduce unnecessary hospital admissions.

“The nurses also play an important role providing education to healthcare colleagues working in GP surgeries, in turn increasing their understanding of learning disabilities and helping them to better meet the needs of their patients and keep them well in the longer term.

“Although there is still work to be done to reach everybody in Suffolk with a learning disability, all of the feedback we have received so far has been really positive, which shows the service is making a real difference to individuals and their carers.”

Barbara McLean, chief nursing officer, NHS Ipswich and East Suffolk and NHS West Suffolk clinical commissioning groups said: “It is important that we meet people’s overall health needs and do not only focus on their learning disability.

“The pilot project has highlighted the need for improving access to primary care services and making it easier to get a GP or nurse appointment, where health needs can be addressed. This is a really good example of the further improvements that are taking place across east and west Suffolk to deliver the very best care to people living with a learning disability.

“Both CCGs are already working on delivering positive changes to Special Educational Needs and Disability Services (SEND) and will increase overall spending on mental health services to £111 million in 2017/18 compared to £103 million last year.”

Case study -  Tracey Stewart: “Every day is different… it is so rewarding”

A specialist nurse who has dedicated the last 30 years caring for people with learning disabilities has spoken of the enjoyment she gets from a job where “no two days are ever the same”.

Tracey Stewart joined Norfolk and Suffolk NHS Foundation Trust’s Primary Learning Disability Nurse Service as a Learning Disability Liaison Nurse in March 2016.

She now works in around 10 GP surgeries in east Suffolk to make sure people with learning disabilities and a mental health or behavioural condition, receive an annual health check as well as any additional support they may need. In this way their general physical health is monitored and any undiagnosed conditions picked up.

Tracey describes her job as hugely varied. As well as visiting patients and supporting those who need it at health appointments, she will work contacts people on the learning disability register to make them aware of the health checks.

And she ensures that people who have been newly diagnosed with a mental health or behavioural condition are on the register, attends GP practice team meetings and networks with others to raise awareness of the service.

Tracey also trains GPs, newly-recruited police officers, practice nurses and providers such as Mencap, while raising awareness of the necessary adjustments they may need to make to cater for people’s additional needs.

“Our job does exactly what it says on the tin,” said Tracey, who has worked for NSFT since 1983 and qualified as a learning disabilities nurse in 1986. “We act as a conduit and put people in touch with the right service to meet their needs.

“1 or 2% of every GP’s patient population will have a learning disability, and the area is one which has been pushed up the national agenda as NHS England is keen to see more people take up annual health checks. Making sure the right people can access those checks is a key part of my role.

“I also take referrals from GPs and will meet patients and talk about their needs and what we can do to help meet them. For example, I might put a family in touch with respite services which they may previously not have been aware existed.

“I really enjoy it as every day is different but is also so rewarding. I may do something as simple as find a new service for an individual to access but if the family tells me that has made a difference it makes the job worth it. No two days are ever the same, but whenever I look at my diary, I know it’s going to be a good week.

“Some really good things have been happening in the care we provide for people with learning disabilities over the past two years and it really feels like we are really starting to make improvements.”

The service is commissioned by NHS West Suffolk and Ipswich and East Suffolk Clinical Commissioning Groups.

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