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Ways of Implementing Reasonable Adjustments in Health Care

Ways of Implementing Reasonable Adjustments in Health Care . South West Experience. Learning from Acute Hospital Peer Review. Steven Dymond Independent Co Chair of Cornwall’s Learning Disability Partnership Board & Review Team member Trevor Eardley

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Ways of Implementing Reasonable Adjustments in Health Care

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  1. Ways of Implementing Reasonable Adjustments in Health Care South West Experience

  2. Learning from Acute Hospital Peer Review • Steven Dymond Independent Co Chair of Cornwall’s Learning Disability Partnership Board & Review Team member • Trevor Eardley Organi Associates, Project Manager Review Programme • Christina Anderson Carer & Review Team member • www.swacutehospitalreview4ld.org.uk

  3. South West Peer Review How we went about Different Perspectives Findings Questions But first …………………..

  4. Why a peer review? • Significant health inequalities • Evidence is that experience is mixed and from a low base • Previous focus on primary care • Local leadership • Involvement of people who use the service and carers

  5. Our Aim • Transparent baseline of existing performance for 18 Acute hospitals across NHS South West • Find existing best practice to share • Create partnership capacity, awareness and improvement action

  6. Our approach • Co-production at the centre of the process • Joint PCT / SHA initiative • Project management to plan and co-ordinate • Steering Group • Development of self assessment tool • Briefing events – communications –web site • 18 review- 2 month period involved – 2/3 reviews peer week • Review teams 8-10 people (over 100 involved) • Visits - whole day and evening meeting • Individual site reports • Action plans and regional report

  7. Review focus • Information • Involvement of people with a learning disability and their carers • Reasonable Adjustments • Capacity, Consent, Safeguarding and the Law • Leadership and Management • Fundamental Care

  8. Review Team • Learning Disability Champion • Family carer • Adult Social Care • Independent provider • Third Sector • LINk • Commissioning Lead • Clinician • Director of Nursing • Learning Disability Nurse • Allied Health Professional

  9. A Family Carers Perspective Christina Anderson Family Carer and Review team member Plymouth

  10. Reasonable adjustments is about • Listen to people with learning disability and carers • Respect role of the carer and their knowledge • Staff to know about the Mental Capacity act • Cut the jargon and medic speak • Communication skills – impact on eating, drinking, pain – basic care • People with a learning disability and carers need to be paid to develop and deliver training • Avoid tunnel vision (focusing on own speciality) • Reasonable adjustments captured documented (systems)

  11. Health Champion and person who uses your service • Independent Co Chair of Cornwall’s Learning Disability Partnership • Chair of Cornwall People First • Previously an Advocacy Development Project Officer for Cornwall • Member of the Steering Group for South West Acute Hospital Reviews • Completed several reviews • Participated in a number of follow on events both regionally and nationally. • Passion about co-production , communication and personalisation

  12. Reasonable adjustments is about • More Co-production - Nothing about us – without us • Champions on each ward / shift • Liaison nurse is just 1st step • People with a learning disability paid to develop and deliver training • Clear communication, • letter in easy read format • picture of who I am going to see • easy read map.

  13. Reasonable adjustments is about • Good planning – stick to it •  Different communication methods for different people. • Person centred approach -Understand my network of support • Health passports in all hospitals used by all staff • Access to easy read material -benefits everyone (children, trauma, literacy problems)

  14. Summary of results • Issues apply to all patients - a litmus test • Evidence for commissioners, better quality and productivity • Strong local relationships have been formed • Transparent action plan with LiNKs, Partnership Boards and CQC • Can extend to other local services • learning to share locally and nationally

  15. Impact of Liaison nurse on RAG rating • Liaison Nurse 8/18 trust have one – impact was significant • Access to easy read information as templates was most under developed area - medication, treatments and procedures • Flagging – no consistent ways to identify and remember • Fundamental care –scored well • Capacity , Consent & Safeguarding – 67% actively addressing this • 97% Trusts had reasonable adjustments action plan in place

  16. Key points • More than 50 examples of best practice - EVERY hospital had examples • Liaison Nursing with top level support • Leadership to improve • Accessible information • Flagging systems • Check how you are doing and improving • Involving people and their families

  17. www.swacutehospitalreview4ld.org.uk • www.apictureofhealth.southwest.nhs.uk • www.organiconsulting.com

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