27 / 01 / 2009
NHS East of England
Southend University Hospital is a Foundation Trust that employs 4,500 staff, serving an increasingly diverse community in South-East Essex and the surrounding area. Now in its second year as an FT, the trust is placing an increased emphasis on equality and diversity as part of its core business strategy.
The hospital identified a need to change the way it provided services for patients with learning disabilities. This followed feedback from patients, their carers and interest groups, through the Patient Advice and Liaison Service (PALS), as well as complaints and informal links which showed that the hospital's approach did not always result in a positive experience for this group.
At the start of the review, the admissions process only focused on the patient's clinical condition and which often meant that all staff could potentially be caring for patients with a learning disability but on an infrequent basis. As a result, they found it difficult to meet the more complex communication needs of this patient group and their carers.
The hospital set up a staff working group involving ward staff, discharge teams, lead nurses, managers and PALS staff. It also involved the neighbouring mental health trust. The group developed an action plan that would enable the trust to focus on providing specialist communication skills for one team in one ward - the Hockley ward, that covered both medical and surgical cases. This one ward would be the 'preferred' place of admission for patients with a significant learning disability to ensure that these patients receive the additional focused attention to meet their needs.
Going forward, the hospital is hoping to develop the availability of this level of care in more areas.
Following the review and agreement on the main action plan, the group worked with other staff to implement the following changes:
- Patients with learning disabilities are admitted to the Hockley ward, unless their presenting condition requires particular specialist support eg. cardiac
- Staff on the Hockley ward have all received training, to develop their appreciation of the needs of patients with learning disabilities and best practice in communicating with the patients, their carers and families. Staff have also attended learning disabilities day centres
- An alert to our patient administration system identifies when a patient with learning disabilities is attending the hospital. If an admission is required, staff at admission points make an assessment of the patient's communication needs with the help of a newly created assessment form and the Communication Book
Following the initial training for staff on the Hockley ward, the hospital is now developing a learning disabilities teaching programme for general nurses throughout the hospital that comprises four two-hour sessions. This aims to improve nurses' communication skills for patients with learning disabilities in other areas such as A&E.
An overall policy on care of patients with learning disabilities is currently being ratified and will cover key areas such as awareness, admission, meaningful assessment, discharge and communicating with patient and carers.
Feedback from staff that have been trained shows that they are now more able to meet these patients' communication needs. The hospital is now seeking more formal feedback from patients and their carers on the new approach, as well as continuing to consult with community groups. This will be used to inform further service developments.
Alison Kelly, Patient Liaison Manager, Southend University Hospital.
Tel: 01702 435555 ext 6883
Denise Flowers, Lead Nurse for Medicine, Southend University Hospital
Tel: 01702 435555 ext 6165