Patient safety
Safety risks for patients with learning disabilities
Despite national efforts to address inequity, the health and care system is not always meeting the needs of people with a learning disability when they are cared for in hospital, says the Health Services Safety Investigations Body’s latest report.
A comprehensive national investigation examining the inpatient care of adults with a known learning disability in acute hospital has found that the needs of learning disability patients are ‘not consistently being met’ when they are in hospital. The report says that there is a strong commitment across the NHS to improve the experience of care for those with a learning disability but that some, ‘persistent and widespread’ safety risks remain. The report also points to multiple studies and reports which continue to evidence poorer outcomes, avoidable illness and premature death for those with a learning disability. The report reveals that current systems
and processes within the NHS are not always designed to enable staff to deliver effective care to people with a learning disability. HSSIB’s investigation found that the biggest safety risks related to: the lack of accessible information that sets out patient needs and enables staff to make reasonable adjustments; and limited support (whether that is through training or within the clinical environment) for staff who are not specialists in caring for patients with a learning disability. For example, in the report, staff with responsibility for assessing mental capacity described how publications are limited in considering the variations of how a person with a learning disability may present and provide limited guidance on dealing with ambiguous situations.
The identified safety issues were illustrated in the patient case examined in the investigation. A 79-year-old male patient was admitted to a hospital unit following a referral from his GP who was concerned about the deterioration of several health problems. The patient’s condition
In the UK, it is estimated over 900,000 adults have a learning disability. Each person with a learning disability will have their own experiences, their own way to communicate and will come into hospital with unique needs, which will require a tailored
set of reasonable adjustments. Clare Crowley, Senior Safety Investigator, HSSIB.
deteriorated 14 days after he was admitted, and he sadly died after suffering a cardiac arrest. In analysing the details of his case, HSSIB identified that during his time in hospital, his needs ‘were not consistently documented or met.’, for example his hearing impairment was not addressed meaning staff were unable to effectively communicate with him. As part of their wider investigation, HSSIB spent time with more than 20 different people with a learning disability and their families and carers. The investigation visited these individuals in acute hospitals, supported living, day centres and their own homes. The investigation saw how each person had different and varying levels of needs. The report says that ‘it was evident that forming long-term friendships, adapting communication and having a regular routine were important to many’ and that carers told them routines cannot be broken,
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