Agenda and supporting papers - Plymouth Hospitals NHS Trust

Item 11
• People with learning disabilities are seen to be a low priority.
• Many healthcare professionals understand little about learning disabilities.
• Many healthcare professionals do not properly consult and involve the families and
carers of people with learning disabilities.
• Many healthcare professionals do not understand the law around capacity and
consent to treatment.
• Health professionals rely inappropriately on their own estimates of a person’s quality
of life.
• The complaints system within NHS services is often ineffectual, time-consuming and
inaccessible for people with learning disabilities.
(Death by Indifference, Mencap March 2007)
The report claimed that many people with learning disabilities die in hospital due to the
widespread ignorance and indifference throughout healthcare services, towards their needs
and those of their families and carers. Mencap claim that the inequitable service afforded to
those with learning disabilities by hospitals and other healthcare services amounts to
institutional discrimination.
Earlier this year, a Confidential Inquiry which reviewed the 247 deaths of people with
Learning Disabilities over a two year period concluded that 42% deaths reviewed were
premature; the reasons for premature deaths being delayed investigations or treatment,
inadequate response to changing needs of individuals and inappropriate care for complex
and ongoing health needs.
(Confidential Inquiry into the premature deaths of people with Learning Disabilities 2013)
In January 2013, concerns raised through a Coroner’s inquest (heard December 2012; case
two years old), via a Rule 43 letter, were reported to the Trust Board. The concerns raised
were in respect of adherence to our own operational policy for managing patients with
Learning Disabilities in hospital; in particular around the support of individuals with consent to
treatments and care.
Since then, there have been concerns raised by families of two people with Learning
Disabilities, regarding the lack of consideration of individuals’ complex needs with clinical
decision-making; concerns were raised that staff were not focusing on the needs of
individuals, rather were distracted by their profound disabilities.
As a result of this, a review of the Learning Disabilities Liaison service and the Trust’s Joint
working protocol (2009) was commenced, at that time by the Acting Director of Nursing.
Following an internal review, a preliminary report was reported to the Trust Board in April
(Annex 2).
A Review of the Learning Disabilities Liaison Team with external stakeholders
In order to continue with the good multi-agency working established by the LD Liaison team
and to involve (new) local commissioners in the development of the LD Liaison service, a
review involving a range of external stakeholders has been completed. This included:
• Consideration of the outcomes/findings of the internal review of the LD liaison team
structure, working practices/relationships and implementation of the Joint operational
protocol.
• Feedback from commissioners, community providers and other partners, with respect
to the relationships with the LD liaison team, impact to patients, families and other
service providers.