Hampshire LD Partnership Board 9 January 2012
Health:
1 How can you ensure people with a learning disability have enough support to access the health care they need?
E.g. GP appointments, screening, support to attend clinics/chemo if they only have “supporting people support”.
2 When are you going to fund sufficient “staff time” to support people going into hospital, and training and support for GP surgeries?
3 Community health care staff, from reception in GP surgeries to consultants often need more training and support to help people with LD access good quality health care?
4 Pediatric & Dental Care are not covered in the Big Health Talk. Why is this?
5 Dental care is not given a high priority, how can this be improved?
6 How can we make sure that annual health checks are given?
7 How do we ensure that medical services for people with learning disabilities are consistent across GPs, dentists & hospitals?
8 Can planning for serious medical interventions, when needed, be added to annual health check?
9 Forms & documents are not always accessible for people in the health care system. How can this be improved?
10 How do we make sure that the appropriate & consistent support is available during a medical crisis, including help from familiar people, such as regular support workers?
11 Hospital Passports are good but aren’t always done when someone is admitted to hospital, meaning that their care needs aren’t always known on the ward. Can this be improved?
12 Learning disability liaison nurses are a good idea, but they are spread thinly, which means that sometimes people don’t have the support that they need until they have been in hospital a number of days. Are more liaison nurses planned?
13 Optician – Are eye Test/Glasses free to people with Learning Disabilities – some people have to pay – via Hospital free? What are the rules?
14 Do optician have easy read eye test? How do they communicate? Are they given any training?
Dentist
15 Free if on some benefits, what benefits how to people know? Is there an easy read guide?
16 How are people with Leaning Disabilities supported to access NHS Dentists?
17 How can we up-skill local dentists to provide local care for people with LD in wheelchairs?
Statement - everyone seems to have a good dentist around Gosport (same with chiropodist)
GPs
Statement - most are OK. Sometimes have to wait – Yes we have Annual Health Checks in Winchester.
Sometimes need receptionist to be more aware –
18 Can we ask if GP surgeries offer learning disability training by Community Liaison Nurse to all their staff? Including Practise manager and all receptionists? Liaison nurses are not well known.
19 How can we work with GPs to keep to appointment times? can we flag up people with LD on their computer screen? Same thing with answer machines – people with LD do not like them!
20 For people who cannot do on-line booking, what are GPs surgeries doing to ensure than reception and telephone is answered quickly by a person?
21 How can we help surgeries,which not so good, to become good? How can we spread the good stuff?
22 How can we advertise widely “capsules” with the Green cross in the fridge?
23) What training to GP’s and Staff in Hampshire surgeries have, to ensure that the make “reasonable adjustments” to ensure that people with LD can access Health care?
24) Is the training on-going to ensure that new staff are trained?
25) If the training is delivered, who does the training? Are people with a learning disability involved?
26) When a new GP is appointed at a surgery and patients are “transferred” to his/her list, are those patients informed of their change of GP?
27)Do all GP surgeries send letters to people with learning disabilities in “Easy Read”? If not why not?
28)Will GP surgeries be asked to do away with automated answer-phone messages which are difficult for people to understand and use, this is taking away some peoples independence?
29) Many people with a learning disability also have a mental health issue or behaviour that may challenge and require support from a specialist health professional, e.g.physiatrist, physiologist, learning disability nurse .
Under the new commissioning arrangements how will you ensure that every person who needs this service will have access to it, and that they will not have to wait six months for an appointment?
30 Since “Death by In difference” and a further Mencap report highlighting the preventable deaths of people with a learning disability in hospitals, and the introduction of Hospital Liaison Nurses, (not all hospitals in Hampshire have one)
and some hospitals are only covered with a very part time post, hospital care has improved.
How will you ensure that more resources are allocated to cover all Hampshire Hospitals equitably (24/7) to ensure that there are no more “needless” deaths of people with learning disabilities because Hospital staff do not have the specialist skills to support the person with a learning disability?
31) How will each CCG ensure that each GP or at least one GP in each surgery has the expertise/ skills to treat people with complex needs and/or challenging behaviour?
32)How will GP practises and the Hospitals involve Family Carers/support staff, who know the person with the learning disability “best”, to ensure their patients gets the most appropriate care and support?
33)Will Annual Health Checks continue to be offered?
34)Safeguarding – What training do Ambulance and A&E staff have when treating “vulnerable” people and unexplained injuries or repeated visits, regarding the reporting mechanism for possible physical abuse?
How do Hospital ensure that a patients “Hospital Passport” is in the file by the patients bed?
35 Do health professionals receive appropriate training to work with people who have complex needs?
36 Can services be flexible enough to cater for the needs of those who have complex needs?
37 Can there be a better understanding that tests that people may be afraid or upset by what could be carried out/planned so that they happen at the same time – a coordinated approach?
38 Why don’t health professionals receive more through training to work with those who have complex needs?
39 Can people who have LD be given more time and understanding by health professionals?
40 Where can people get information about health issues when they have difficulty reading or understanding?
41 Can support worker have better training so that they can understand what a health professional is saying and then work with the individual to support them with their health needs?
42 How is the LD liaison nurse notified when someone who has LD is admitted to hospital?
43 Why are we not able to work in partnership when a dual diagnosis is presenting issues? Why do they not recognise it? No responsibility taken by anyone.
44 Why such a waiting list for all services? (care management, doctors, specialist health team)
45 Why is hydro pool not use all the time at SGH?
46 How do we know that a person is getting the right health check? Should be a standard procedure for everyone.
47 Who helps me to stay fit and healthy? (people are not supported properly).
48 What training do hospital staff have to work with people with a learning disability?
49 Big health check: why not connecting it to opticians and dentists? – routine medical review????
50Can we have a list of GPs who do health checks? And if not, why?
51) Is it a breach of the Data Protection Act to display a Patients name for all to see at the Surgeries?
52) Are health checks becoming a statutory requirement in GP surgeries? If GP’s surgeries do not have the facilities do they have arrangements with other GP surgeries so that people can be signposted/referred rather than have to do it for themselves.
53) Can the process between reception and getting to see the doctor be made more simple? (ie: number colour coded and name of the doctor).
54) How can you please advertise widely LD liaison nurses? As it seems that not many people know about it
55) Will the Partnership Board continue to positively influence the commissioning of appropriate Health Services for people with learning disabilities as the responsibility to deliver these services transfers to the new Clinical Commissioning Groups (C.C.G.s). If so, how will this be achieved?
56) How can the Partnership Board help to encourage all G.P. surgeries to sign-up to the annual health check scheme for people with learning disabilities?
57) Will the Partnership Board work with Health Providers to ensure that the Mencap Getting it Right charter is adopted across all County Health Services for the benefit of everyone with learning disabilities?
58) Are Local Authorities and Health working together to improve the transition to adult services particularly for people who live with complex or profound disabilities?
59) Young people are still not carrying through communication tools they have used in school through to adult services. Why is the need for communication tools not part of the supported self-assessment?
60) It appears that people who would benefit/need ongoing OT and Physiotherapy input are finding this difficult to access – particularly those with complex and profound disabilities. Should this not form part of the supported self-assessment and the indicative budget as a preventative activity that improves quality of life and health?
61) How can it be made easier for people with LD and physical disabilities to receive ongoing physiotherapy to support them to remain as active, independent and pain free as possible?
QUESTIONS FROM LIG REPS TO GUESTS AT THE MEETING
1) Talking directly to the person: how can we make sure this happens? It is good this happens more than half the time - it would be good if it happened most of the time.
2) Understanding: more than half the people said they understood what their doctor told them but sometimes people with learning difficulties do not always realise that they do not understand. This could be bad for their health. How can we make sure people do understand properly?
3) Dentists: In one group of people 6 out of 7 said that they did not visit a dentist because they did not like it. These were all people with a mild learning disability that lived either alone or with family with limited support. How can we encourage these people to get dental treatment?
4) Hospital Admissions: A very large number of the people had been in hospital (75%). Why do so many people with learning disabilities need hospital treatment?
- Is it because they have more serious illnesses needing hospital treatment?
- Is it because they do not receive treatment early enough in illnesses so they end up needing hospital treatment?
5) What can we do to make sure that people with learning disabilities get treated early in illnesses?
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