Working together to improve the patient experience

1. Working together to improve the patient experience Allyson Kent – A2A Chair Allyson.kent@humber.nhs.uk www.a2anetworks.co.uk

2. A2A • Purpose: to support networking and sharing of good practice amongst professionals who have a role in supporting people with learning disabilities to access healthcare services in general hospitals settings

3. A2A - priorities • Increasing number of ALN’s - Map • Hospital passport • MCA - app • Training • Support to family and carers • Promote use of accessible information • Promote sign up of getting it right charter • Databases of A2A leads • Develop/review risk assessments in use • Flagging of LD • Auditing and reporting

4. What’s working, what’s not? • Patient with learning disabilities • Family or carers • The nurse • The hospital • Key challenges • Areas to change…. If I could

5. Patient – working well • Acute liaison nurses • Passports • Flagging systems • Fast tracking • Patient pathways into medicine etc • Pre-assessment • LD nurses working into acute hospitals • Quiet area to wait • Likes and dislikes • Time with person • Daily contact from matron • Letters sent giving details of ALN’s

6. Patient – what’s not • Knowledge of MCA • Admissions out of hours/weekends • Extra time • Reasonable adjustments • Working in silo’s • Discharges • Working with people with complex needs • Not seeing the person, only the diagnosis

7. Family & Carers – working well • Acute liaison nurses • Passports • Carers strategy • Guidelines • Carers badge • Reclining chair

8. Family & Carer – what’s not • Expectations that family and cares can always stay • Newly qualified/junior doctors not always listening, asking, understanding of LD • No funding arrangements to pay for additional care • Being left for hours without a break or an offer of food and drink

9. Clinician – What’s working well • Recognition of role within the Trust • Review of patient journey’s to learn the lessons and inform of reasonable adjustments • Strong links with senior managers • Responsive to needs of people with learning disability • When medical staff refer

10. Clinician – What’s not • Operational v strategic roles • Mental Capacity Act • Specialist support in paediatric – None adult • Late referrals

11. Acute Hospital – Working well • ALN’s/Learning Disability working in general hospitals • Passports

12. Acute Hospital – What’s not • ALN’s only working 9-5 Monday to Friday – no cover evening and weekends • ALN’s are not in every hospital

13. Key Challenges • Knowledge and understanding of MCA, DOLS, DNACPR • Values and attitudes of staff • Making reasonable adjustments • Managing unplanned care • Providing person centered care • Meeting the persons, ‘everyday needs’ • No ALN’s evenings or weekends • Lack of accessible information/Signage • Diagnostic overshadowing • Delayed or unsafe discharges • Pressures of cost savings

14. Things to change if I could… • Consistent use of MCA • ALN’s in every hospital • LD awareness for surgeons, doctors and consultants • Champions on every ward • More awareness of reasonable adjustments • Better access to additional support – who pays • Link flagging to primary care – IT systems – awareness of LD • All information made accessible • Eye health training for all • Flagging in place – standard • Fast tracking for all • Access to calm areas • Comfy chairs for carers • Better acute commissioning • Easy read letters for all

15. Any Question’s • Allyson Kent • Allyson.kent@humber.nhs.uk • Tel 07899 965724 • www.a2anetworks.co.uk • A2A on facebook • Twitter – @a2allyson