This year‐long study has collected such evidence as is available from companies that there is a positive link between corporate community involvement and human resource issues;…
Abstract
This year‐long study has collected such evidence as is available from companies that there is a positive link between corporate community involvement and human resource issues; and devised new ways to manage, monitor and evaluate community involvement so as to identify and then quantify its impact. The study concentrated on skills development and staff motivation, while also addressing recruitment. It has found firm evidence from both companies and individual employees that community involvement can impact these business issues; however, many of the current evaluation techniques lack rigour and the data are often empirical, not confirmed objectively. Techniques to monitor and evaluate include: a competence matrix to identify specific competences which can be developed and a scoring system to measure the development gain; structured questions for staff attitude surveys, which can contribute to a morale index; various methodologies for cost comparison and cost/benefit analysis to evaluate alternatives; a matrix and scoring system to identify and evaluate the contribution to addressing strategic human resource objectives. Concludes that the contribution from community involvement can be best quantified through balanced business performance measurements that go beyond the bottom line.
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In total, 40% of the deaths of patients with learning disabilities have been classed as avoidable, and there is a known increased risk of harm while inpatients in hospital. This…
Abstract
Purpose
In total, 40% of the deaths of patients with learning disabilities have been classed as avoidable, and there is a known increased risk of harm while inpatients in hospital. This paper aims to look at the current experiences and treatment of people with learning disabilities within a general hospital setting to examine factors that affect their care.
Design/methodology/approach
A comprehensive literature search was conducted of primary research between 2013 and 2019 to evaluate what is known about the quality of care and treatment that learning disabled patients experience within a general hospital.
Findings
The research suggests that people with learning disabilities receive haphazard care in hospital settings, with inconsistent implementation of reasonable adjustments, insufficient arrangements to support family and other carer input, and poor knowledge of learning disability amongst hospital staff.
Originality/value
Previously, reviews focussing on hospital care have mainly focussed on access to health care rather than its delivery. This review has found evidence of significant failings in delivering care to this patient group, identifying a gap of knowledge in this field regardless of policies and laws already in place. There should be stricter monitoring of the Equality Act’s enforcement, along with improved and mandatory training for all general health-care staff. It is crucial that health-care professionals learn from mistakes to improve the care and experiences of learning disabled inpatients.
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Nick Walsh, Tricia Handley and Ian Hall
The purpose of this paper is to address the serious problems that people with intellectual disability face in getting their healthcare needs met in general hospitals by improving…
Abstract
Purpose
The purpose of this paper is to address the serious problems that people with intellectual disability face in getting their healthcare needs met in general hospitals by improving the training of general hospital staff.
Design/methodology/approach
Review of recent developments in models of service provision including the development of intellectual disability liaison nurses and the RAID model in liaison psychiatry.
Findings
There is much scope for intellectual disability liaison nurses and liaison psychiatry services to work together in staff training in general hospitals. There is a clear strategic role for both services in convincing the management of general hospitals to implement such training using economic and quality arguments.
Originality/value
The authors suggest a new model of working to improve the healthcare outcomes of people with intellectual disabilities through effective training of staff in general hospitals.
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Jonathan Michael and Anne Richardson
The Independent Inquiry into Access to Healthcare for People with Learning Disabilities reported in July 2008. Based on a public consultation, a review of research and evidence…
Abstract
The Independent Inquiry into Access to Healthcare for People with Learning Disabilities reported in July 2008. Based on a public consultation, a review of research and evidence and the views of witnesses and stakeholders, the Michael Inquiry concluded that there are risks inherent in the care system for people with learning disabilities and that they are largely due to a failure to make ‘reasonable adjustments’ to services, as required under the Disability Discrimination Act. The Inquiry found evidence of a significant level of avoidable suffering due to untreated ill‐health, and a high likelihood that avoidable deaths are occurring. Although the report highlights examples of good practice there are some appalling examples of discrimination, abuse and neglect. The article makes ten essential recommendations for urgent change across the whole health system and the Inquiry team report contains practical illustrations of how to implement them.
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The development of inclusive education, characterised by both universal momentum and geopolitical differences, has largely omitted children and young people with profound…
Abstract
The development of inclusive education, characterised by both universal momentum and geopolitical differences, has largely omitted children and young people with profound intellectual and multiple disabilities. For this group, access to educational opportunities at all has been slow to be won, and separation for ‘special care’ for their very high support needs is the norm. There have been advances in recognising the human rights and indeed humanity of people with the most profound intellectual disabilities, but the focus of educationalists has often been on how to foster and document fine-grained learning gains and on the specialist nature of the teaching they need. In this chapter, in contrast, the emphasis is on how the spirit of ‘Nothing about us without us’ can extend to children and young people with profound intellectual disabilities such that they are at the heart rather than periphery of the education and research process. The potential for belonging in education and research is illustrated through exploratory work on doing research inclusively with children with profound intellectual and multiple disabilities in two English special school classes. The starting point is seeking to know them from being with them in a particular way. The knowledge shared in the chapter is a mix of big picture state of the art overview and deep intersubjective knowledge/feeling created together with children with profound intellectual and multiple disabilities. The implications for future research in inclusion include the need to start from a different mindset in which belonging and reciprocity inform an asset-based approach.
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Reza Kiani, Arshya Vahabzadeh, E.A. Hepplewhite, Mizrab Abbas, Tracey Finnamore, Sabyasachi Bhaumik and Daniel Satge
The diagnosis and management of cancer in people with intellectual disabilities (PWIDs) are fraught with difficulties. The purpose of this paper is to present a case study to…
Abstract
Purpose
The diagnosis and management of cancer in people with intellectual disabilities (PWIDs) are fraught with difficulties. The purpose of this paper is to present a case study to highlight these difficulties.
Design/methodology/approach
The present case analysis describes the presentation of a 56-year-old man with a profound intellectual disability, who developed recurrent chest infections and died as a result of obstructive pneumonitis.
Findings
Despite a presentation over several years and numerous chest X-rays demonstrating a consistent lung abnormality, it was only on postmortem examination that a right-sided lung carcinoma was detected.
Originality/value
The papers have provided an update on the topic in light of recent legislations and management strategies which need to be applied to clinical practice if any improvement is to happen in the care of PWID.
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Andrew Maine, Michael Brown and Maria Truesdale
The purpose of this paper is to present an overview of the extant literature on diabetes in people with learning disabilities (LD) and discuss implications for policy, practice…
Abstract
Purpose
The purpose of this paper is to present an overview of the extant literature on diabetes in people with learning disabilities (LD) and discuss implications for policy, practice and research.
Design/methodology/approach
The key findings are extracted from qualitative and quantitative studies and recent systematic literature reviews. These findings are discussed in the areas of prevalence, treatments and implications.
Findings
The complex health needs of people with LDs who are diagnosed or at risk of developing diabetes are gaining wider recognition, and recent studies have begun to implement and evaluate potential solutions. Further analysis and alignment between services is required.
Originality/value
Following a dearth of studies on diabetes in people with LD, the past decade has seen a sudden upsurge in large and diverse set of studies. This paper provides an overview on the extent of this study.
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Susannah Baines and Chris Hatton
People with learning disabilities are at risk of poor health and premature death. Due to these inequalities, NHS trusts are required to make reasonable adjustments to their care…
Abstract
Purpose
People with learning disabilities are at risk of poor health and premature death. Due to these inequalities, NHS trusts are required to make reasonable adjustments to their care, such as longer appointment times, with the legal duty on them being “anticipatory”. The paper aims to discuss these issues.
Design/methodology/approach
Secondary analysis of CQC acute hospital inspection reports asking the following research questions: Do CQC inspection reports mention people with learning disabilities? Where issues concerning people with learning disabilities are reported in CQC hospital inspection reports, what issues and reasonable adjustments are reported? Are there any relationships between comments made in the inspection reports and CQC ratings of the trusts?
Findings
In total, 29 of the 30 trust-wide inspection reports (97 per cent) and 58 of the 61 specific site reports (95 per cent) included at least one mention of people with learning disability/ies. Most comments about practices for people with learning disabilities were positive across all CQC inspection output types and across all CQC overall ratings, although the proportion of positive comments decreased and the proportion of negative comments increased as CQC ratings became less positive.
Research limitations/implications
Overall the authors found that CQC inspection reports routinely contained some information regarding how well the hospitals were working for people with learning disabilities. The depth of information in reports varied across trusts, with the potential for CQC reports to more consistently report information collected during inspections.
Originality/value
The report updates and extends a report published by the Public Health England Learning Disabilities Observatory in 2015.
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Gyles Glover, Sebastian Fox and Chris Hatton
The purpose of this paper is to explore the extent of compliance of commissioners and providers of hospital services in England with their duty under equalities legislation to be…
Abstract
Purpose
The purpose of this paper is to explore the extent of compliance of commissioners and providers of hospital services in England with their duty under equalities legislation to be aware of patients with intellectual disabilities as a first step to making appropriate provision for their consequent specific needs.
Design/methodology/approach
National survey of healthcare commissioners undertaken as part of an annual learning disabilities services audit.
Findings
In total, 41.4 per cent of local areas were unable to supply information about numbers of people with intellectual disabilities among those admitted to hospital, 46.7 and 48 per cent, respectively, could not supply this information about out-patient and accident and emergency department attenders. Figures supplied by those able to provide data varied very substantially and overall were so low as to suggest considerable numbers had been missed.
Research limitations/implications
The study is testing what local health commissioners are able to find out from hospitals. The authors do not know the accuracy of the data they reported.
Practical implications
The study suggests approaching half of healthcare commissioners in England have little or no information about the extent of proper adjustment of hospital care for people with intellectual disability in their area. Their responsibility to assure this has been repeatedly asserted by government.
Social implications
The study indicates a need for more work to improve hospital care for people with intellectual disabilities.
Originality/value
This was a government sponsored national study to which local healthcare commissioners were expected to contribute.
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The purpose of this paper is to outline a two-year project designed to reduce health inequalities and improve health outcomes of people with intellectual disabilities using health…
Abstract
Purpose
The purpose of this paper is to outline a two-year project designed to reduce health inequalities and improve health outcomes of people with intellectual disabilities using health services in South London by raising awareness and increasing health staff confidence and capability.
Design/methodology/approach
The project was conducted in two stages. In stage 1, a mapping exercise was undertaken to establish existing intellectual disabilities education and training availability. In stage 2, a network of stakeholders was formed and education and training materials were developed and delivered.
Findings
A formal evaluation of the project is underway and this paper seeks to share information about the project. That said prima facie data appear to indicate that health staff who attended education and training events learned new knowledge and skills that they could implement in their practice, increasing confidence and capability.
Research limitations/implications
Health staff who attended the events appeared to have an interest in intellectual disabilities and wanted to increase their knowledge and skills base. This means that there is a significant group of health staff that the project was unable to reach or who may not know that they need to know about intellectual disabilities. The results of the project have not yet been formally analysed.
Practical implications
Work-based education and training events can have a positive impact on health staff capability and confidence, however, it would appear that only those who already have an interest in the field or recognise its value to their own practice attend such events. To truly capture all health staff intellectual disabilities needs to be visibly included in all health curricula.
Originality/value
This project has not focussed on one profession or one aspect of healthcare and has embraced the values of inter professional and inter agency learning; this has enabled health staff to learn from each other and think in a “joined up” way replicating the realities of providing healthcare to people with intellectual disabilities.