Learning Disabilities Champion Training Module 1

slide1. Learning Disabilities Champion Training Module 1<br>
slide2. Module 1 Why do an LD Annual Health Check?
Why have LD Champions?
The Course
How to organise the Health Check
Step-by-step guide to completing the Health Check
Where do we go form here?<br>
slide3. Why do a Learning Disabilities Annual Health Check? In England, people with Learning Disabilities die 20 years younger than the general population
20-25 yr olds have same multimorbidity as 50-54 yr olds
Increased prevalence of disease
Epilepsy
Constipation
Visual Impairment
Hearing loss, Eczema, Dyspepsia, Thyroid issues, Obesity, Mental Health, Parkinsonism
Reduced prevalence of CHD and COPD
LD patients tend to have reduced continuity amongst GPs and shorter consults
Vulnerability
Patients with Learning Disabilities often have difficulty recognizing and communicating their needs and making timely use of primary care services<br>
slide4. WHY DO A LD HEALTH CHECK? “All the relevant scientific studies consistently report that LD health checks lead to detection of unmet, unrecognised and potentially treatable health needs”<br>
slide5. How has COVID affected our LD population ? Disabled people made up 6 in 10 (59.5%) of all deaths involving the coronavirus (COVID-19) for the period to 20
November 2020 (30,296 of 50,888 deaths). (24/01/20-20/11/2020) (ONS Jan2021)<br>
slide6. Between 24 January and 20 November 2020 in England, the risk of death involving the coronavirus (COVID-19) was 3.1 times greater for more-disabled men and 1.9 times greater for less-disabled men, compared with non-disabled men;

Among women, the risk of death was 3.5 times greater for more disabled
women and 2.0 times greater for less-disabled women, compared with non-disabled women. Looking at people with a medically diagnosed learning disability, the risk of death involving COVID-19 was
3.7 times greater for both men and women compared with people who did not have a learning disability;
after using statistical models to adjust for a range of factors, a raised risk of 1.7 times remained unexplained for both sexes. Patterns in excess COVID-19 mortality risk experienced by disabled people remained largely unchanged between the first and second waves of the pandemic. (ONS 11/2/2021)<br>
slide7. Why have LD Champions? Holistic overview – ?Nurse best placed to do this
Wide variation across practices
Accountability
40% of our LD patients don’t get a health check every year
Wide variability in quality
How are you driving?<br>
slide8. The Course Module 1
Module 2<br>
slide9. How to organise the Health Check Develop an LD team in your practice
Admin lead, GP lead, Practice Nurse (you!)

Arranging the check
Invite patients and send a pre-health check questionnaire
Check how patients wish to be contacted
REASONABLE ADJUSTMENTS
Under the Equality Act 2010 public sector organisations have to make changes in their approach or provision to ensure that services are accessible to disabled people as well as everybody else.<br>
slide10. Before the Health Check What’s happened in the last year?
Action Plan from last Health Check
Remind yourself of Reasonable Adjustments
“Not just screen but INTERVENE”<br>
slide11. COVID 19 Resources Produced in collaboration with people with lived experience to support clinicians and non-clinicians in communicating with people with a learning disability and their family carers:

CovidVaccine film produced in collaboration with Skills for People and Learning Disability England

PHE easy read Covidvaccination leaflet
PHE easy read What to expect after the vaccine leaflet
PHE Easy read adult consent form

These resources, intended to share with SMI and LD patients, have been developed with experts by experience nationally and locally and is really useful information to share with patients before they attend their appointments so they are more prepared for the experience and therefore reduce the understandable anxiety that may prevent people from attending.
If you would like to receive paper copies of any of these leaflets, please email CAPCCG.MHLDCommissioning@nhs.net stating which leaflets and the required number<br>
slide12. The Health Check Open questions to begin
Record all concerns so these can be addressed at the end of the check – gather all info before ‘crossing the bridge’ and discussing management<br>
slide23. Capacity
Communicate
Understand
Retain
Balance
SCR with additional information
significant medical history (past and present)
reason for medication
anticipatory care information (such as information about the management of long term conditions) 
end of life care information
immunisations<br>
slide24. Screen 1 EHC – Education, Health and Care plan
Ask to see Section G of EHC
describes the special health services required to address the child or young person’s needs<br>
slide25. STopping Over Medication of People with a learning disability, autism or both (STOMP) Psychotropic medicines
Psychosis
Depression
Anxiety
Sleep problems
Epilepsy
Behavioural issues
Public Health England says that every day about 30,000 to 35,000 adults with a learning disability are taking psychotropic medicines, when they do not have the health conditions the medicines are for.
STOMP MiXiT<br>
slide26. What we’ve done and why we’ve done it Why LD Annual Health Checks matter
Why you as LD Champions can make all the difference!
How to organise the health check
Step-by-step guide to the Health Check
STOMP<br>
slide27. Where do you go from here? 3 things you’re going to do back at your own practice
Get started!!
MODULE 2
Don’t forget we’re here to help!<br>