03:57am Thursday 19 October 2017

Patients with learning disabilities become ‘invisible’ in hospitals, says study

In one case, a patient who had problems making herself understood was accused of being drunk by hard pressed hospital staff.

It is estimated that one in 50 people in England have some form of learning disabilities such as Down’s syndrome.

Dr Irene Tuffrey-Wijne, senior research fellow in nursing at St George’s, University of London and Kingston University, said: “People with learning disabilities are largely invisible within the hospitals, which meant that their additional needs are not recognised or understood by staff.

“Our study found many examples of good practice, but also many examples where the safety of people with learning disabilities in hospitals was at risk.”

Dr Tuffrey-Wijne, a co-author of the study who works at the Faculty of Health, Social Care and Education, a partnership between the two universities, added: “The most common safety issues were delays and omissions of care and treatment.

“Some examples come down to basic nursing care like providing enough nutrition but other serious consequences were also seen in our study.

“These included delays in clinical investigations and treatment by staff unclear or unaware of what to do in certain situations when patients had trouble expressing their consent or opinions or lacked an understanding about what was required from them.”

The study included questionnaire surveys, interviews and observation with senior hospital managers, clinical staff, patients and carers in all types of areas within hospitals in the NHS.

It found that the main barrier to better and safer care was a lack of effective flagging systems, leading to a failure to identify patients with learning disabilities in the first place.

There was also a lack of understanding by nursing staff about learning disability issues and a lack of clear lines of responsibility and accountability for the care of each patient with learning disabilities.

Specialist nurses such as learning disability liaison nurses and ward managers with specific responsibility to advocate on behalf of patients with learning difficulties were recommended by the report.

The report, Identifying the factors affecting the implementation of strategies to promote a safer environment for patients with learning disabilities in NHS hospitals,  published in the Health Services and Delivery Research journal, also recommended that the NHS investigate practical and effective ways of flagging patients with learning disabilities across NHS services and within NHS hospitals while also providing for procedures to ensure that family and other carers are involved in the care of such patients.

The study was funded by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme.

It was co-authored by Baroness Sheila Hollins, a former president of the British Medical Association and professor at St George’s, University of London and Christine Edwards, professor in Kingston University’s Faculty of Business and Law.

 
Notes to Editors:

 

 

 

1. www.nets.nihr.ac.uk/programmes/hsdr The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk). 

 

2. The National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme was established to fund a broad range of research. It builds on the strengths and contributions of two NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which merged in January 2012. The programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services, including costs and outcomes. The programme will enhance the strategic focus on research that matters to the NHS. The HS&DR Programme is funded by the NIHR with specific contributions from the CSO in Scotland, NISCHR in Wales and the HSC R&D Division, Public Health Agency in Northern Ireland.
 
This article presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

St George’s, University of London, Cranmer Terrace, London SW17 0RE

 


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