In Britain, we think our healthcare system is one of the best in the world, and we are a society that values life and upholds human rights. Yet people with learning disabilities are statistically likely to die 26 years earlier than their peers, in many cases from causes that are avoidable. Factors such as delays in diagnosis and treatment, gaps in service provision, breakdown in communication and organisational dysfunction contribute to these early deaths. Previous reports, including the Confidential Inquiry into the Premature Deaths of People with a Learning Disability (CIPOLD, March 2013) have recommended a range of improvements within the healthcare system to address these health inequalities. Sadly, the most recent report from the Learning Disability Mortality Review (May 2018) indicates that there is much still to do. Consequently, it is encouraging to find examples of good practice in healthcare settings – which is what a Changing Our Lives review team found when they reviewed King’s Mill Hospital (part of Sherwood Forest Hospitals Trust).

As part of the drive to improve the care and support people with learning disabilities receive within the healthcare system, NHS Improvement produced Learning Disability Improvement Standards for NHS Trusts https://improvement.nhs.uk/resources/learning-disability-improvement-standards-nhs-trusts/ . They commissioned Changing Our Lives to use these standards to review Sherwood Forest Hospital and the care it provides for people with learning disabilities and/ or autism when they go into hospital. We spent two full days at the hospital observing the environment and the way staff work, talking to staff in different departments, talking to people with learning disabilities and family carers who have been in the hospital and reading information produced by the Trust. A number of areas of good practice were highlighted, including:

  • The role of the Trust’s Learning Disabilities Specialist Nurse, Ruth Harrison, is well established within the hospital. She works closely with staff from across all of the departments and at all levels. She provides direct support in clinical situations but also works at a strategic level to develop improvement plans and monitor progress.
  • The hospital is using the expertise and experience of staff in the respiratory ward to make sure that people with learning disabilities and/or autism who have a lot of health needs receive consistent and coordinated support.
  • The use of a specific care pathway for people with learning disabilities, which supports staff when a person with a learning disability and/ or autism comes into the hospital.
  • Increasing numbers of staff with a good knowledge of the Mental Capacity Act. They are thinking more about how they help people to make their own decisions about their health care.
  • The use of an electronic flagging system in the hospital which makes sure that people with learning disabilities and/ or autism are flagged and can be cared for appropriately and safely.
  • Departments in the hospital are actively thinking about how they can make their areas less frightening for patients with learning disabilities.
  • Senior decision-making staff are committed to improving support for patients with learning disabilities.
  • Learning disability champions in the Trust give support, guidance and advice.

Suzanne Banks, Chief Nurse at Sherwood Forest Hospitals said: “Treating patients with compassion and respect is vitally important to us as Trust, and we are proud of the steps we have taken in the last few years to improve the care and experience of our hospital for people with learning disabilities and/or autism.

We were delighted to have the opportunity to demonstrate this to Changing Our Lives, and are pleased that the report recognises much of the good work that we have done. We’re also grateful for the practical suggestions of ways in which we can continue to improve – and will be taking these suggestions forward in the coming months.”

The report also highlighted some areas in which the hospital could consider doing more. These include: further improving staff awareness of the Mental Capacity Act; reintroducing a Learning Disability Steering Group; and additional support and training for Learning Disability Champions.

Jayne Leeson, CEO of Changing Our Lives said:

“It is sadly still the case that people with a learning disability have poorer physical health than the general population, often through avoidable causes including not getting adequate healthcare. So it is really encouraging to find so many positive examples of reasonable adjustments and good practice at Sherwood Hospital; staff and managers are clearly working hard to ensure that people with learning disabilities receive equal access to good healthcare, just like everyone else.

Their plans for the future and commitment to continually improve the way they do things should result in better health outcomes for people with a learning disability living in the local area.”