‘Systematic lack of inclusion’:
Mencap calls for urgent government action to tackle healthcare
inequalities faced by people with a learning disability during COVID
E
ven before COVID-19, people with a learning disability experienced shockingly high levels of health inequality – they were more likely to die avoidably and die younger.
Despite this - and evidence early on that people with a
learning disability are disproportionately affected by COVID- 19 - Mencap’s report published today documents the stream of failures to protect one of the most marginalized patient populations in the country. And with news this week that not all people with a learning disability will be prioritised for the COVID-19 vaccine - despite people with a learning disability having died at over 6 times the rate of the general population – the report’s findings are more pertinent than ever. Mainly detailing the situation in England, the report includes results from a survey of learning disability nurses conducted at the height of the pandemic. It highlights the significant obstacles people have faced to accessing healthcare. Some people were told they would be denied life- saving treatment, and others had vital support removed, while some were discharged too early from hospital.
In some instances, people with a learning disability were told that they may not receive life-saving treatment: The National Institute for Care Excellence (NICE) quickly changed original guidance in March this year which conflated support needs with frailty, resulting in Do not attempt cardiopulmonary resuscitation orders (DNACPRs) being placed on some disabled peo- ple’s records. However Mencap says that damage had already been done. Some GPs are report- ed to have told patients with a learning disability that they were unlikely to be offered ventilation and encouraged them to consent to DNACPRs. Even now, Mencap is still receiving reports that DNACPRs are being placed on people’s records without their consent. Some hospitals failed to provide adequate care while government guidance on visiting
resulted in the removal of critical support: Reasonable adjustments – like more time during a medical appointment or being permitted to wait in a quiet area - are vital for people with a dis- ability. Making reasonable adjustments is a requirement of the Equality Act 2010, a law that remained in place throughout the pandemic, but despite this many people have found them- selves unsupported with adjustments being limited during the COVID crisis. For someone with a learning disability who may face difficulties communicating, having the right person there to provide support is crucial. Yet the original official guidance was interpreted in different ways - even within the same hospital setting – often leaving people with a learning disability without vital support and at risk of worse health outcomes. In one case support was denied even when travelling to hospital in an ambulance. Reduction in access to learning disability nurses: Some acute learning disability nurses
were redeployed to other units. Learning disability nurses are crucial in ensuring people get the vital healthcare support they need, as well as providing support to other healthcare profession- als. 11% of acute learning disability nurses surveyed by Mencap said they or a team member had been redeployed; for community based learning disability nurses it was 34%. Inappropriate discharge from hospital: Discharge guidance has meant that in many cases
18 Ability Needs Magazine
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