HEALTH FACILITATION IN WALSALL FOR ADULTS WITH A LEARNING DISABILITY

Health Action Planning

  The Government White Paper "Valuing People": A new strategy for the 21st Century (DOH 2001) has set aims and objectives to ensure that people with a learning disability have the same right of access to mainstream health services as the general population and for all to have a Health Action Plan.

  A Health Action Plan is a personal plan about what a person with learning disabilities can do to keep healthy. It will list what help an individual with learning disabilities needs to keep healthy and safe. It will help access the services and support needed to maintain good health.

  Walsall Health Facilitation and Community Nursing Team have developed a Health Action Plan filofax. This A5 ring binder folder has easy read, pictorial pages which act as an excellent communication tool. This Health Action Plan fax will is of extreme benefit if a person with a learning disability needs to go into hospital, visit their GP or have their medication reviewed. It contains useful information which allows empowerment for the individual, but does not act as a hand held record, protecting confidentiality issues.

  The filofax's are portable and robust. They can be easily updated and reviewed. Information can be completed by the individual, family carers, professional carers, and all health and social care professionals.

  The filofax's have been very well received by service users and health and social care professionals.

Health Fair—Hope 4 Health

  This marvellous, pioneering event took place at Walsall Town Hall on Tuesday 23 January 2007.

  "Valuing People": A New Strategy for Learning Disability (DOH 2001) outlines a new vision for our learning disability population. The White Paper challenges discrimination, aims to reduce health inequalities and improve the health of this vulnerable client group.

  The aim of the Health Fair was to bring health advice and information to this client group in an enjoyable, informal, informative format.

  The event attracted contributions from a wide variety of participators, from primary care, secondary care, private and voluntary sectors.

  The event was particularly successful for us as we saw evidence from other health professionals working outside learning disability who took time to look at their health advice, information and literature and adapt it into easy read, accessible formats for this client group.

  Evaluation of the event was done in several formats including video footage, and a speaking wall. Feedback from service users was very positive.

  A DVD presentation has been produced from the event.

  We hope to make this an annual event.

"Your Health" CD/ROM

  We have designed a CD/ROM "Your Health" as a health education, health promotion tool. The CD has been designed and produced specifically for people who have a learning disability. The format is in easy read format and is very pictorial. There is a full audio voice over, which is performed by people who themselves have a learning disability.

  If accessed on line the CD provided options to access further information and links to other health promotion sites.

  The CD covers subjects on what is healthy and good for you, what is unhealthy or bad for you and describes several health conditions such as cancer, diabetes and heart disease.

  The CD can be used very effectively in group settings or individually by service users.

  The CD is available for service users and health and social care professionals. Evaluation of this tool has been very positive.

Down's Syndrome and Dementia Screening

  Due to research highlighting the increasing connection between Down's syndrome and dementia, Walsall Learning Disability Team felt strongly that we needed to provide a means of assessing individuals with Downs Syndrome. We used the Adaptive Behaviour for Down's Syndrome Questionnaire (ABDQ) tool devised by Prof V Prasher, Birmingham University.

  Initially we identified how many adults had Downs Syndrome in Walsall. We then offered baseline screening to this entire population group. The screening was offered on a consensual basis.

  The baseline assessments look at 15 areas of activities of daily living skills. We also incorporated a detailed physical health screen.

  The assessments will then be repeated every five years for adults aged between 18-35 years and every three years for adults over the age of 35. This will detail any changes in physical health or cognitive ability. Any identified deterioration can then be efficiently highlighted and acted upon appropriately. Walsall has begun to draft a Dementia Strategy from this work.

Improved uptake to breast screening services by women with a learning

  Evidence has shown us that uptake to breast screening by women with a learning disability is poor. Our project was initiated because women with learning disabilities are living longer and fuller lives and should have access to breast screening on the same basis as other women.

  Government reports and practice documents have emphasised the need for primary healthcare teams and learning disability teams to work together to provide good quality healthcare for people with a learning disability.

  Strategies such as routine screening for preventable conditions including breast and cervical screening occur far less frequently for women with learning disability than for the rest of the population. Studies have shown that women with learning disabilities are screened significantly less than the general population, although there is strong evidence to show that this population group have a significantly higher number of health needs, notable complexities of health needs and extensive unmet health needs.

  Walsall integrated learning disability team have implemented innovative strategies to promote good practice in increasing the uptake to breast screening for women with a learning disability.

  The main aims of this project were to:

—  provide women with good, accessible information to enable them to make their own decisions about whether to accept an invitation to breast screening;

—  ensure that they were invited for screening in an appropriate format;

—  for them to know what to expect when they attended for their screening so that it was a positive experience;

—  to understand the consequences of screening or not screening; and

—  to understand breast awareness and the need to be aware of changes in their own bodies.

  This project undertaken by the Community Nursing and Health Facilitation team has been supported by the DH Pacesetters programme.

  The project undertook several approaches:

—  Awareness training with breast screening staff.

—  Identifying service user group.

—  Easy read literature and easy read invitation letters.

—  Health education/health promotion groups for women with learning disability in Walsall.

—  Promoting physical access and environmental issues.

—  Preparation and effective communication.

—  Evaluation of our service.

  This innovative programme has demonstrated excellent collaborative working and evidence good clinical practice. There has been excellent engagement between staff from the primary and secondary care teams and we are able to demonstrate that our healthcare is being provided in partnership.

  Together we are able demonstrate that we are achieving excellence in caring and that we are moving towards measuring our patient's experience through the increased take-up to breast screening by ladies with a learning disability living in Walsall.

TESTIMONIES

" . . . The Walsall and Sandwell Breast Screening department have recently been involved with increasing the uptake rates for ladies with learning disabilities from the Walsall area. This work has involved close liaison between the staff from the breast screening unit, office and a community nurse form the learning disability team, Lesley Richards.

The breast screening clerical officers have been working with Lesley to allocate dedicated sessions and time slots for each of the clients. Pre familiarisation visits and demonstration visits have been facilitated by our lead health promotion radiographer Kerry Crabtree who has provided positioning demonstrations of the mammogram examination to the ladies. This proved to be a very successful idea and most clients returned for their mammograms without any problems. The unit will continue to provide these dedicated sessions with these ladies and encourage a close working relationship between the health health promotion radiographer and the PCT learning disability team . . .".

Julianne Baker

Acting Superintendent Programme Manager

Walsall & Sandwell Breast Screening Unit

"Walsall's initiative under the DH Pacesetters programme has led to the development of my role in collating data on the current and historic uptake to breast screening as well as importantly supporting ladies with a learning disability with appropriate education and support on breast screening. My remit includes working closely with the breast screening unit at Walsall Manor Hospital by booking adequate appointments and providing 1:1 support with breast screening. Introducing pre familiarisation visits prior to breast screening appointments has proven to be invaluable in facilitating the screening process. Currently there is a 100% success rate in the attendance of this client group to breast screening.

Lesley Richards. RNLD

Community Nurse in Health Facilitation

Walsall Teaching Primary Care Trust

"My role as Health Facilitator is to identify and reduce health inequalities for adults with a learning disability living in Walsall. My aim is to challenge discrimination, enable access to mainstream health services and improve overall health for this vulnerable population group. The initiatives and protocols we have implemented through the Health Facilitation process to breast screening have proven to be a great success. Clear, comprehensible information has been made available to patients, and we have forged excellent collaborative working. The patient experience has been promoted and together we have demonstrated excellence of care.

Julia Kelly, RNMH

Health Facilitator

Walsall Teaching Primary Care Trust