How GPs Support People With Learning Disabilities

Practice Nurse Debbie breaks down what GP practices can do to support patients with learning disabilities, from assessments to promoting inclusion and independence.

Hello, my name is Debbie and I'm a Practice Nurse in London. Today I'm going to be talking about how GP practices are able to support people with learning disabilities.

What Is A Learning Disability?

First of all, we need to make sure we're not confusing it with a learning difficulty. I'm going to read what the Value in People 2001 statement says what a learning disability is.

According to Value in People 2001, it's the reduced ability to understand complex information or learn new skills and the reduced ability to cope independently starting from childhood and has lasting effects on development throughout adulthood.

This is not a learning difficulty, but a learning disability and it's more cognitive, and we're going to be talking about that today.

Assessments

Within a GP practice, a lot of things are done annually or biannually, meaning that every year we need to make sure we are meeting certain targets, not just for learning disability patients, but diabetes patients, asthma patients, etc., and making sure that we are doing regular checks.

Now, the issue that mainly arises with learning disability patients is that when they are unwell or there is an issue, they are less likely to voice it out. I have many patients that are like that, and their parents come in worried because maybe their hearing is reduced or they've got a cut on their toe and Mum or Dad have just seen it but the patient would say, "Oh, it's been there for a long time."

They're just less likely to voice out their concerns, hence why, as a GP practice, we need to make sure we are doing a head-to-toe assessment of these patients to make sure that we are not missing anything, and the parents and the patient is satisfied with the care being provided.

What Does This Include?

As I said, a head-to-toe assessment. Now, mainly the GPs are doing these assessments. Nurses can also be present; nurses can also do the assessment, but in my practice, GPs mainly do the full assessment.

This includes checking the weight, blood pressure, blood tests, annual blood tests, checking the urine, medication reviews, things like their vaccinations, making sure that it's up-to-date annually, that's flu jabs, and any other vaccinations that they may need.

Checking their lifestyle: do they work? Are they at home, or are they studying at the moment? Whatever the situation is. Smoking, drinking, good water intake, checking their feet, checking behind their ears, and with consent, checking the groin area, making sure that there's no infection, things like that. Just ensuring that there is a head-to-toe assessment.

Speaking To Patients & Promoting Inclusion

As healthcare professionals, it's so important, especially when these patients come of age and they're much older, that even when they come with their parents or their carer, whoever it may be, we are speaking to the patient directly.

Also just making sure that they feel included in the care that's being provided, even with little children as well. Making sure that they are able to voice out, because it all starts in childhood, and if they feel comfortable with healthcare professionals at a younger age, as they get older, they'll feel a lot more confident and comfortable to share any healthcare needs that they have, or even social needs.

It's very important that we're promoting independence when it comes to having a learning disability. A learning disability doesn’t rule out independence… what's important is that we are empowering these patients and making sure that they feel included in their care.

Double Appointments

In my practice, something that we do and that is very important is that these learning disability appointments are double appointments. This means that we are able to take our time.

Remember, having a learning disability can have an effect on the way complex information is relayed, meaning that it's important that we're able to speak in slower terms or more understandable terms. If we feel like we are rushing the appointment, everything becomes ineffective. So, it's very important that there is a double appointment slot.

Assessing Capacity

What's also important is capacity, making sure we are assessing capacity. As we know, as part of the Mental Capacity Act, we do not assume there is lack of capacity. Someone may have capacity in one area and not have it in another area.

I'll give an example. I had a patient who has a learning disability, and he came in for his blood test. He came in alone, he was fine, and I could see that on his alerts he was also due a flu jab.

I said, "Oh, you are also due a flu jab. Is that something you'll be interested in?" And he said, "I have to speak to my mum about that because I am not sure."

Me asking him made sure that he was involved in the decision. I could have easily said, "Okay, I'm going to call your mom and ask."

He came to the appointment alone for his blood test and I was able to explain what the blood test was for. So, he understood that part. But when it came to the flu jab, he felt like he had to ask his mother. Patients will do that in the case of they may come in for one thing and understand that, but when it comes to something else, they may not be fully aware.

Next Of Kin

Another thing that making sure that on the system there is a next of kin or there is a carer; there's someone that we're able to reach out to if in case they need help during the appointment, or they've come alone.

Independence

It's very important that we're promoting independence when it comes to having a learning disability. A learning disability, at least not for everybody, doesn't rule out independence.

It simply means that there is an aid that is needed. There is something that's help that is needed in making certain decisions or doing certain things. But what's important is that we are empowering these patients and making sure that they feel included in their care.

Our learning disability annual reviews are very important in GP practices, and we are always here to make sure that the need is being met in the community for these patients.

Thank you for watching.