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Tuffrey-Wijne, Irene; Goulding, Lucy; Giatras, Nikoletta; Abraham, Elisabeth; Gillard, Steve; White, Sarah; Edwards, Christine; Hollins, Sheila (2014)
Publisher: BMJ Publishing Group
Journal: BMJ Open
Languages: English
Types: Article
Subjects: Health Services Research, 1722, health, 1506, 1704, Research
OBJECTIVE: To identify the factors that promote and compromise the implementation of reasonably adjusted healthcare services for patients with intellectual disabilities in acute National Health Service (NHS) hospitals.\ud \ud DESIGN: A mixed-methods study involving interviews, questionnaires and participant observation (July 2011-March 2013).\ud \ud SETTING: Six acute NHS hospital trusts in England.\ud \ud METHODS: Reasonable adjustments for people with intellectual disabilities were identified through the literature. Data were collected on implementation and staff understanding of these adjustments.\ud \ud RESULTS: Data collected included staff questionnaires (n=990), staff interviews (n=68), interviews with adults with intellectual disabilities (n=33), questionnaires (n=88) and interviews (n=37) with carers of patients with intellectual disabilities, and expert panel discussions (n=42). Hospital strategies that supported implementation of reasonable adjustments did not reliably translate into consistent provision of such adjustments. Good practice often depended on the knowledge, understanding and flexibility of individual staff and teams, leading to the delivery of reasonable adjustments being haphazard throughout the organisation. Major barriers included: lack of effective systems for identifying and flagging patients with intellectual disabilities, lack of staff understanding of the reasonable adjustments that may be needed, lack of clear lines of responsibility and accountability for implementing reasonable adjustments, and lack of allocation of additional funding and resources. Key enablers were the Intellectual Disability Liaison Nurse and the ward manager.\ud \ud CONCLUSIONS: The evidence suggests that ward culture, staff attitudes and staff knowledge are crucial in ensuring that hospital services are accessible to vulnerable patients. The authors suggest that flagging the need for specific reasonable adjustments, rather than the vulnerable condition itself, may address some of the barriers. Further research is recommended that describes and quantifies the most frequently needed reasonable adjustments within the hospital pathways of vulnerable patient groups, and the most effective organisational infrastructure required to guarantee their use, together with resource implications.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Emerson E, Hatton C. People with learning disabilities in England. London: Public Health England, 2008.
    • 2. Heslop P, Blair P, Fleming P, et al. Confidential Inquiry into premature deaths of people with learning disabilities (CIPOLD): final report. Bristol: Norah Fry Research Centre, 2013.
    • 3. Emerson E, Baines S. Health inequalities and people with learning disabilities in the UK. Tizard Learn Disab Rev 2011;16:42-8.
    • 4. Michael J. Healthcare for all: report of the independent inquiry into access to healthcare for people with learning disabilities. London: Aldridge Press, 2008.
    • 5. MENCAP. Death by indifference. London: Mencap, 2007.
    • 6. MENCAP. Death by indifference: 74 deaths and counting. A progress report 5 years on. London: Mencap, 2012.
    • 7. Parliamentary and Health Service Ombudsman. Six lives: the provision of public services to people with learning disabilities. HC 203 I-VIII. London: The Stationery Office, 2009.
    • 8. Department of Health. Six lives progress report. London: Department of Health, 2010.
    • 9. Hollins S, Tuffrey-Wijne I. Meeting the needs of patients with learning disabilities. BMJ 2013;346:f3421.
    • 10. HMSO. Disability Discrimination Act 2005. London: HMSO, 2005.
    • 11. HMSO. Equality Act 2010. London: HMSO, 2010.
    • 12. Equality and Human Rights Commission. Your rights to equality from health and social care services. Equality Act 2010 guidance of your rights, volume 5 of 9. Manchester: EHRC, 2010. 18 Dec 2012.
    • 13. Hatton C, Roberts H, Baines S. Reasonable adjustments for people with learning disabilities in England 2010: a national survey of NHS Trusts. Improving Health and Lives: Learning Disabilities Observatory, 2011.
    • 14. Disability Rights Commission. Equal treatment: closing the gap-a formal investigation into physical health inequalities experienced by people with learning disabilities and/or mental health problems. London: Disability Rights Commission, 2006.
    • 15. Disability Rights Commission. The duty to promote equality: statutory code of practice England and Wales. London: HMSO, 2005.
    • 16. MENCAP. Getting it right: a campaign guide. London: Mencap, 2010.
    • 17. Department of Health. Health inequalities: progress and next steps. London: The Stationery Office, 2008.
    • 18. Tuffrey-Wijne I, Giatras N, Goulding L, et al. Identifying the factors affecting the implementation of strategies to promote a safer environment for patients with learning disabilities in NHS hospitals: a mixed-methods study. Health Serv Deliv Res 2013;1-224. doi: 10.3310/hsdr01130
    • 19. Department for Constitutional Affairs. Mental Capacity Act 2005: code of practice. London: The Stationery Office, 2007.
    • 20. Young J, Hood C, Woolley R, et al. Report of the national audit of dementia care in general hospitals 2011. London: Royal College of Psychiatrists, 2011.
    • 21. Francis R.The report of the Mid Staffordshire NHS Foundation Trust Public Inquiry-HC947. London: The Stationery Office, 2013.
    • 22. Improving Health and Lives (IHAL). Reasonable adjustments database. 2013. http://www.improvinghealthandlives.org.uk/ adjustments (accessed 19 Nov 2013).
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