• Rollout of initiatives leads to improved health outcomes for patients with learning disabilities
• Mencap visited Learning Disability Nurses to see first-hand the difference they are making at the hospital and in the community
• Disability History Month provides opportunity to reflect on journey so far and highlights the work still to be done

Learning Disability Nurses are shining a spotlight on the game-changing initiatives being rolled out at Bolton NHS Foundation Trust to improve access to healthcare for patients with learning disabilities.

The Trust recently invited the charity Mencap, who work with organisations to make positive change for people with a learning disability, to hear firsthand about the work taking place.

It followed an interview with Dame Carolyn Fairbairn, Mencap’s Chair of Trustees, on Radio 4’s Woman’s Hour, where she detailed her sister’s tragic death in hospital that was avoidable.

In an ever-changing healthcare landscape, nursing teams in Bolton have worked tirelessly to adapt the care they provide for some of the most vulnerable patients.

In 2019, a new pathway was launched for people with learning disabilities to access health investigations that they need.

It allows complex patients who experience anxiety, stress or needle phobia to be placed under sedation to progress routine diagnostic tests such as blood tests or X-rays.

Jainab Desai, Learning Disability Nurse at Bolton NHS Foundation Trust, said:

People with learning disabilities can experience extreme health inequalities, and we were concerned patients were missing really important health tests because of the fears and barriers they experience.

“This new pathway allows us to change that. I’m really proud of the difference it’s making as we’re now able to diagnose conditions and provide appropriate treatments much sooner, leading to far improved health outcomes and potentially saving lives.

Bolton NHS Foundation Trust works with staff across hospital and community sites to improve understanding and encourage teams to make reasonable adjustments to their services, including extending appointment slots for breast cancer screening for those with learning disabilities to help them become familiar with the clinical setting and staff.

Other initiatives introduced include:

• A new Enhanced Care and Support Team: Dedicated staff work with vulnerable patients to build trusted relationships to help administer medication, carry out personal care, and improve their stay to ensure they return home sooner and safely.
• Education and Training: Bespoke training is regularly delivered to staff, including Newly Qualified Nurses, Doctors and security.

The visit coincided with the start of Disability History Month, which highlights how far society has come in addressing inequality and stigma, but also resets the focus on the work that still needs to be done.

For nearly two decades, Jainab, who joined Bolton NHS Foundation Trust in 2006, has worked with colleagues on a mission to improve understanding and learn from history.

When I first joined many didn’t know what a Learning Disability Nurse was. Changes were happening but not quickly enough, and this was resulting in delayed diagnosis and treatment.

“But Bolton is a special place and people soon started to listen, the Trust understood how important it was to make rapid changes that started with education and training for all.

“People are really invested in recognising learning disabilities, there is a passion to learn how they can adapt their services to offer more personalised care.

“We have come a long way, but as the journey continues it is important we revisit history to learn and evolve and that’s why Disability History Month is so important.

Rebecca Whitham’s brother was born with a learning disability in 1989; he has flourished thanks to dedicated care and support from Bolton’s health providers.

Rebecca now works for the Trust as a Learning Disability Nurse:

I have seen the real difference proper care can make, and Bolton champions collaborative working to improve outcomes.

“We can face challenging admissions, but by making reasonable adjustments to our services and adopting person-centred care we can go some way to tackle health inequalities for our patients.

Martina Kingscott, Assistant Director of Nursing, said:

Jainab and her colleague Rebecca are a true inspiration and a credit to nursing. Their dedication to patients shines through every single day.

“Eighteen months ago we had the vision to bring services together so they could work more closely on improving care and support for some of the most vulnerable patients.

“I’m so proud of the significant improvements the team have already began to make by removing some of the barriers those with learning disabilities face and improving their health outcomes.

Brad Fox, North Regional Activism Coach at Mencap, commented:

We have made a lot of ground in improving health pathways for patients with learning disabilities, and we’re working closely with NHS Trusts to create positive environments where patients’ voices are heard.

“It’s great to hear how the hard work and dedication of teams at Bolton NHS Foundation Trust is transforming access to healthcare and meeting the needs of those with learning disabilities.

For information and advice about learning disabilities, visit the Mencap website.