#WeLDNs - Tuesday 30th November 2021 8:30pm (GMT Standard Time) Accessing acute services

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 Chat Details

 

Hosted by WeLDnurses using #WeLDNs

Admission to hospital can be a scary or worrying time for anyone. But for someone with learning disabilities this comes with increased complexities. Bright, clinical areas, beeping machines and complex medical terms can be extremely overwhelming, especially if local funding or covid rules mean that your family/ carer can’t be with you throughout admission.

The acute liaison role has grown over the years with more and more hospitals employing at least one learning disability nurse. The role varies between settings with similarities such as supporting an individual and their families/ carers, ensuring equal access to healthcare thus improving experience, delivering training for hospital staff as well as strategic and operational tasks. 

The Annual LeDeR report time after time highlights the need for these specialist nurses to be within all acute settings, backed up by the commitment made in the NHS Long Term Plan for reasonable adjustments to be made for all people with learning disabilities to reduce health inequalities. 

The learning disability improvement standards highlight key support which should be available for someone with learning disabilities to ensure equal access to healthcare. The corresponding benchmarking project explores these themes annually with more Trusts signing up to take part in the data collection. 

The hospital passport is a key document championed by many learning disability nurses containing vital information about the individual. It should be used in conjunction with discussion with the patient and those who know them best. But are we still seeing issues with staff not familiarising themselves with the hospital passport, numerous versions with different information causing confusion? 

In 2013 we held a chat on access to acute services, 8 years on we want to revisit the topic to explore if things have changed, discuss current best practice and share current experiences.





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 Evidence Based Practice

 

https://static1.squarespace.com/static/5e6a1113644c5d56972524fb/t/5fce0bcb7ae85b53b2b880f4/1607338959224/Final+Learning+Disability+Liasion+Nursing+Report+Full__+20201111+%282%29.pdf


https://www.leedsth.nhs.uk/a-z-of-services/learning-disability/about-me-easy-read/

https://phw.nhs.wales/services-and-teams/improvement-cymru/our-work/learning-disability-health-improvement-programme/health-profile/health-profile-for-professionals/

https://pamis.org.uk/services/digital-passports/




 Chat Summary

 

Across the hour a number of questions were asked on supporting people with learning disabilities (LD) to access acute services. There were a range of attendees including student nurses, LD nurses from different roles and range of experiences, academics and parent/ carers. 

Themes rising from the questions were LD liaison nurses, training, reasonable adjustments, sharing information, appropriate documentation and robust systems.

LD acute liaison nurses were identified as coordinating and ensuring that support was in place for a patient with learning disabilities when accessing acute services. It was acknowledged however that not all hospitals have an acute liaison nurse in post which can cause difficulties. It  was also discussed how the role is often an undervalued and overstretched one, with a plethora of responsibilities being held under the title including patient facing care, training of staff as well as strategic work.

Training included ensuring that all staff have training and awareness of how to support patients with learning disabilities, facilitate reasonable adjustments and understand staff responsibilities. With the Oliver McGowan mandatory training being introduced within the next year for all health and social care staff it is hoped that some of these training gaps will be addressed. It was also highlighted that training needs to cover understanding and use of the hospital passport whilst also clearly explaining patient pathways and specific hospital systems. Discussion was also had around non specialist staff being trained as LD champions and being a point of contact within a hospital.

‘Reasonable adjustments’ is a crucial and often used phrase within an LD nurse’s vocabulary. Inevitably it was discussed as a main requirement to support a patient with learning disabilities to access acute care. Contributors highlighted that reasonable adjustments must be tailored to an individual’s needs. Examples of adjustments given included adapting the environment such as lower lighting or increasing appointment time.

Within the chat it was also clarified that the patient and people who know them best must be consulted to ascertain what adjustments and support are needed. Conversation was also had about the availability of tools and aids, such as a sensory trolley, communication aids or easy read information. Participants found that this varied greatly, with some sharing information via Trust internet pages or recommending external sources such as an Easy Read Facebook group.

Information sharing was another theme that came up throughout the chat. This starts with listening to patients and those who know them best to make use of knowledge and expertise. Once support needs and crucial care information is collated this must be documented and shared appropriately across all those working with the patient, including across services.

Within the chat there was much discussion on the hospital passport or equivalent documentation such as grab sheet or one-page profile. The general consensus was that a hospital passport is a key document however it must be up to date and used appropriately by staff. The passport should contain enough information to inform care delivery such as likes, dislikes, information on activities of daily living and baseline observations. It should also include communication preferences and how to support when happy, sad or in pain. Concerns were raised however as to who is responsible for curating and updating these documents. 

The possibility of a national passport was discussed with the majority of participants agreeing that this should be in place ensure consistent care throughout all settings. This led onto discussion of a digital passport, with suggestion of it being available via an app or linked to the NHS app so it can be easily updated and shared throughout the patient journey. Development of a national passport would mean national guidance, further ensuring continuity and consistency.

All of the above must be supported by robust systems being in place; identifying a clear pathway with supporting policies and guidance. If these are engrained staff may not be so reliant on the LD nurse, with minimal staff support required. 

One clear barrier to supporting with access to acute care is that there isn’t currently a national flagging system in place. Contributors to the chat were able to identify independent systems within their hospitals which often require manual input rather than corresponding with a GP register or other system. There appears to be lots of positive independent work or projects taking place to combat these issues by working in collaboration with services, however the main issue arising was that systems do not talk to each other so information can often be missed with patients only having a flag in place if they are already known to the hospital. There were also obvious disparities between platforms used and how they draw or share data.

This chat hour flew by and touched on great ways that patient’s with learning disabilities are being supported to access acute services. It was also highlighted that systems in which we work need to change, with greater emphasis on consistency and continuity. It is important to note that many LD nurses find there isn’t time to do additional projects or service development due to direct clinical work and other responsibilities of the role.

Queries were raised on whether there should be national guidance and clarification on how many LD nurses should be in place in an acute setting. Should a national database of all LD nurses be collated so patients can contact for local support prior to admission?

How do we overcome barriers such as with IT and information governance if national flagging or passports are developed?

It has provided us with lots of food for thought, and queries that we’d love to further discuss in the future.

A huge thank you to all involved, and don’t forget – if you’re interested in hosting a chat with us please get in touch either via twitter (@WeLDNurses) or email (ldnurse12@gmail.com).





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 #WeLDNs transcript

 
@WeLDnurses
30 November 2021 20:30
Good evening everyone, welcome to tonight’s chat! Let’s get started with a round of hello’s! #WeLDNs
@WeLDnurses
30 November 2021 20:30
RT @salsa442: Ready to talk all things acute for people with learning disabilities? Join in 3mins time via #WeLDNs
@ross_6479_RNLD
30 November 2021 20:30
RT @WeLDnurses: Good evening everyone, welcome to tonight’s chat! Let’s get started with a round of hello’s! #WeLDNs
@florenceella
30 November 2021 20:30
RT @WeLDnurses: Good evening everyone, welcome to tonight’s chat! Let’s get started with a round of hello’s! #WeLDNs
@ross_6479_RNLD
30 November 2021 20:31
@WeLDnurses Evening all, #waves #weldns
@DrAnthea
30 November 2021 20:31
@WeLDnurses Hello from rainy Blackpool #weldns
@WeLDnurses
30 November 2021 20:31
@ross_6479_RNLD Evening Ross! #WeLDNs
@EmLD90
30 November 2021 20:31
@WeLDnurses Hello #WeLDNs https://t.co/ODY9RUjeGO
@WeLDnurses
30 November 2021 20:31
@DrAnthea Evening! Thanks for joining us ?? #WeLDNs
@samabdulla
30 November 2021 20:31
@WeLDnurses Evening from a damp Edinburgh #WeLDNs
@salsa442
30 November 2021 20:31
Hi everyone, Sal here waving ??from Leicester #WeLDNs
@CharleeB3010
30 November 2021 20:32
@WeLDnurses Good evening everyone! #WeLDNs
@WeLDnurses
30 November 2021 20:32
@EmLD90 Good evening Emma! #WeLDNs
@drliberty
30 November 2021 20:32
@WeLDnurses Evening from windy Gloucestershire #weldns
@WeLDnurses
30 November 2021 20:32
@samabdulla Hi Sam! #WeLDNs
@WeLDnurses
30 November 2021 20:33
@salsa442 Hey Sal! ???? #WeLDNs
@WeLDnurses
30 November 2021 20:33
@drliberty Thanks for joining us! #WeLDNs
@florenceella
30 November 2021 20:33
@WeLDnurses Evening all! #WeLDNs
@WeLDnurses
30 November 2021 20:34
So, let’s get started! What do you think should be in place to support someone with learning disabilities to access acute care, whether that be emergency or planned admission? #WeLDNs
@HannahScrivene2
30 November 2021 20:35
@WeLDnurses Hi everyone.. Been a while since i joined a tweet chat! :) #WeLDNs
@WeLDnurses
30 November 2021 20:36
@HannahScrivene2 Great to have you with us! #WeLDNs
@salsa442
30 November 2021 20:36
I always prefer dedicated acute liaison nurse posts,robust pathways,policies for supporting people with LD to access services,good understanding of reasonable adjustments,enhanced care where required,Hospital passports #WeLDNs https://twitter.com/weldnurses/status/1465781336237654026
@salsa442
30 November 2021 20:37
@HannahScrivene2 @WeLDnurses Great to have you back! #WeLDNs
@EmLD90
30 November 2021 20:37
@WeLDnurses Reasonable adjustments. Staff to have some LD awareness. Hospital passports. Communication aids if needed. Grab sheet with important information. If staff are unsure on how to support then them being honest and willing to learn #WeLDNs #EBP
@samabdulla
30 November 2021 20:37
@WeLDnurses I think with everything it depends on the person. In an ideal world we should be able to give a service an indication and *they* should organise any needed adjustment #WeLDNs
@getmebetter
30 November 2021 20:38
@WeLDnurses A suitable environment, reasonable adjustments and a workforce who have the right approach and skill set to deliver individualised care. Supported by an Acute Liaison MDT. #WeLDNs
@salsa442
30 November 2021 20:38
@EmLD90 @WeLDnurses The LD awareness training is so important, and I do like a grab sheet for emergency admissions, really useful for ED staff and triaging #WeLDNs
@DrAnthea
30 November 2021 20:39
@WeLDnurses I think an acute ld liaison nurse based in hospital that can lease with community teams if the person is known or raise an alert if not and who can act as a go between if needed #weldns
@WeLDnurses
30 November 2021 20:39
@salsa442 @EmLD90 Do you guys have a go to template for a grab sheet? #WeLDNs
@HannahScrivene2
30 November 2021 20:39
@WeLDnurses Reasonable adjustments tailored to the individuals needs.. that might be having a side room.. lights being turned down.. taking time.. seeing if an LD liason nurse is available. #WeLDNs
@CharleeB3010
30 November 2021 20:40
@samabdulla @WeLDnurses Do you not wonder if a key professional (Nurse/SLT/Physio/OT) who's understanding of LD is broader would be beneficial? #WeLDNs
@salsa442
30 November 2021 20:40
@DrAnthea @WeLDnurses I agree, the Acute liaison nurse role is so important in so many ways and seems to work best when based in the hospital #WeLDNs
@EmLD90
30 November 2021 20:41
@salsa442 @WeLDnurses I've heard about them but not seen any yet but would love to see a templete. #WeLDNs
@salsa442
30 November 2021 20:41
@WeLDnurses @EmLD90 I think I still have a copy on my PC at work - remind me to hunt it out! #WeLDNs
@WeLDnurses
30 November 2021 20:41
This leads nicely to our next question! Do you think there are enough acute liaison roles within hospitals to access for support? #WeLDNs https://twitter.com/salsa442/status/1465782881393987589
@ross_6479_RNLD
30 November 2021 20:42
@WeLDnurses All of the things people are saying here, the more we can do the better I think, I also think liaising with people who know the person well and making use of all their knowledge and experience is key too #weldns
@samabdulla
30 November 2021 20:42
@CharleeB3010 @WeLDnurses ALDLN or other are so important right now and will always be so, but they should be for the most complex not a place to shift responsibilities from acute staff. #WeLDNs
@WeLDnurses
30 November 2021 20:42
Can anyone else share templates that they use for a grab sheet? #WeLDNs https://twitter.com/emld90/status/1465783062684438542
@samabdulla
30 November 2021 20:43
@CharleeB3010 @WeLDnurses Im also not a huge fan of single points of contact and expertise in teams (see champions programmes) because there is inevitably a void if they move on. #WeLDNs
@WeLDnurses
30 November 2021 20:43
@samabdulla @CharleeB3010 This is a great point well made Sam! #WeLDNs
@salsa442
30 November 2021 20:43
I think it’s still too patchy, some hospitals have great teams while others struggle, every acute trust needs a dedicated ALN in my opinion #WeLDNs https://twitter.com/weldnurses/status/1465783150144020480
@ross_6479_RNLD
30 November 2021 20:43
@WeLDnurses Not in my experience, would be good to have more for sure #weldns
@DrAnthea
30 November 2021 20:44
@WeLDnurses No, seems like an undervalued role and often when there is a liaison nurse they often have other roles as well so can’t give the time needed, also bigger hospitals may need more than one liaison nurse, I’d like to see it in MH hospitals too #weldns
@samabdulla
30 November 2021 20:44
@salsa442 We are lucky enough to have three WTE across my local board, but I’m sure they’d say they could use more eh @KnoxMartha #WeLDNs
@HannahScrivene2
30 November 2021 20:44
@WeLDnurses No there aren't and sadly i dont think enough Learning Disability Nurses work or are employed on general wards in hospitals either ?? #WeLDNs
@CharleeB3010
30 November 2021 20:45
@samabdulla @WeLDnurses Totally agree champions are ace! #WeLDNs
@EmLD90
30 November 2021 20:45
@WeLDnurses As a student LD nurse I've not seen any advertised jobs relating to this. I hope at some point that I come across this role and learn more about it #WeLDNs
@drliberty
30 November 2021 20:45
@WeLDnurses No - for two acute hospital’s we have one - also a need in community hospitals and minor injuries in my humble opinion #weldns
@ross_6479_RNLD
30 November 2021 20:46
@WeLDnurses They are such a stretched resource often they aren’t able to help in the way they’d want to, can also be conflicting views of the role #weldns
@WeLDnurses
30 November 2021 20:46
So how about knowing of an admission - Are you aware of a flagging system to highlight admission of someone with learning disabilities? #WeLDNs
@samabdulla
30 November 2021 20:47
@EmLD90 @WeLDnurses Check out this! https://static1.squarespace.com/static/5e6a1113644c5d56972524fb/t/5fce0bcb7ae85b53b2b880f4/1607338959224/Final+Learning+Disability+Liasion+Nursing+Report+Full__+20201111+%282%29.pdf #WeLDNs #EBP
@CharleeB3010
30 November 2021 20:47
@WeLDnurses I'm not sure. Is there any indication nationally of liaison roles in trusts? Leeds has a fairly large varied MDT (nurses SLT and Physio) but not sure what is out there nationally #WeLDNs
@samabdulla
30 November 2021 20:47
@EmLD90 @WeLDnurses The work of Brown and MacArthur is a bit older but still very good. Talks about establishing the role. #weldns
@WeLDnurses
30 November 2021 20:48
Great sharing of #EBP #WeLDNs https://twitter.com/samabdulla/status/1465784495202783242
@DrAnthea
30 November 2021 20:48
@WeLDnurses We have a flagging system and get an email daily when people are admitted or are in hospital wards but not A&E, sometimes people are flagged who don’t have ld too and I’m sure people are missed so it’s not perfect but it helps #weldns
@salsa442
30 November 2021 20:49
Again I’d say there’s real disparities here,depends on the platforms used by hospitals and how they draw data. Where I am there is a flagging system but each flag needs to be manually added once consent is gained… #WeLDNs https://twitter.com/weldnurses/status/1465784250498793480
@HannahScrivene2
30 November 2021 20:49
@WeLDnurses Is it linked with the flagging system that GP registers have by any chance? #WeLDNs
@samabdulla
30 November 2021 20:49
@WeLDnurses A great idea, if it’s used properly and if the persons disagnosis is known. I would love them to communicate with primary care too, but… am I being too hopeful ?? #weldns
@CharleeB3010
30 November 2021 20:49
@WeLDnurses Yup there's a hospital system that is linked through IT magical stuff but we (Royal We) are working with wards, community teams, parents, carers, GPs etc to get people flagged as quickly as possible. Grape vine can be quicker than magic IT #WeLDNs
@WeLDnurses
30 November 2021 20:50
Unfortunately this seems to be the case for many experiences shared this evening! #WeLDNs https://twitter.com/salsa442/status/1465784972745351170
@WeLDnurses
30 November 2021 20:50
@samabdulla A boy can dream right? #WeLDNs
@salsa442
30 November 2021 20:50
@samabdulla @WeLDnurses If only! #WeLDNs
@EmLD90
30 November 2021 20:51
@WeLDnurses From placement experience working with a community team I know they are alerted if someone with a LD is admitted and they are on their case load. however I don't know how this process is done via the hospital end #WeLDNs
@ross_6479_RNLD
30 November 2021 20:51
@samabdulla @WeLDnurses I keep hearing whispers of this coming to pass in my area….#WeLDNs
@samabdulla
30 November 2021 20:51
@salsa442 @WeLDnurses Imagine, systems across trusts, across LAs, across directorates. What a world #WeLDNs
@florenceella
30 November 2021 20:52
@HannahScrivene2 @WeLDnurses That would be great!! In my experience Systems just don’t talk to each other…! #WeLDNs
@samabdulla
30 November 2021 20:52
@ross_6479_RNLD @WeLDnurses #WeLDNs https://t.co/UaGF3mD1xG
@HannahScrivene2
30 November 2021 20:52
RT @florenceella: @HannahScrivene2 @WeLDnurses That would be great!! In my experience Systems just don’t talk to each other…! #WeLDNs
@CharleeB3010
30 November 2021 20:52
@samabdulla @salsa442 @WeLDnurses What, working together? #WeLDNs https://t.co/3Zjp5hTnvN
@WeLDnurses
30 November 2021 20:52
Great example of joint working! #WeLDNs https://twitter.com/charleeb3010/status/1465785187300691978
@salsa442
30 November 2021 20:53
@CharleeB3010 @samabdulla @WeLDnurses Imagine that! #WeLDNs
@HannahScrivene2
30 November 2021 20:53
@florenceella @WeLDnurses I would have thought it would make it so much easier if this was the case... saves you having to input it manually! But then obviously doesnt allow for people with LD who come in who arent on their GP register #WeLDNs
@CharleeB3010
30 November 2021 20:53
@WeLDnurses It has taken @getmebetter a lot of graft to get to that point, they're an ace team #WeLDNs #biasedbutnotreally
@getmebetter
30 November 2021 20:54
@WeLDnurses National guidance would be supportive. For example X number of Acute Liaison Clinicians per bed available. @ldnursedave this is highlighted by the NHS benchmarking questions isn't it? #WeLDNs
@WeLDnurses
30 November 2021 20:55
So hospital passports have been mentioned already, but what information do you think a hospital passport should include? #WeLDNs
@HannahScrivene2
30 November 2021 20:56
@WeLDnurses Now i think about it.. when i worked with a liason nurse for a day, once she was told by a ward they had someone with an LD, i think she had to input it manually onto the system and her case load ?? #WeLDNs
@CharleeB3010
30 November 2021 20:56
They need to be #Coproduced with PWLD and ward staff inputting to increase by in from both sides. #WeLDNs https://twitter.com/WeLDnurses/status/1465786578819821570
@WeLDnurses
30 November 2021 20:57
Coproduction is so key here #WeLDNs https://twitter.com/charleeb3010/status/1465786942637977608
@samabdulla
30 November 2021 20:57
@WeLDnurses They are tricky documents but along with a great summary of key information it should have enough in to inform care delivery #WeLDNs
@bethaniik
30 November 2021 20:58
The same with us. We are flagging individuals as they are known to us and there is work on going between primary, cldts, GPS to get up to date correct registers to flag on the hospitals systems. Its a shame there's too many systems between the diferent health boards. #WeLDNs https://twitter.com/CharleeB3010/status/1465785187300691978
@salsa442
30 November 2021 20:58
Really important to have the urgent info,diagnoses,medication,allergies,baseline obs,reasonable adjustments,capacity issues, communication,this is all so important when triaging emergency admissions, also need info on all ADLs to support inpatient experience #WeLDNs https://twitter.com/weldnurses/status/1465786578819821570
@WeLDnurses
30 November 2021 20:59
This sounds like great information to include! #WeLDNs https://twitter.com/salsa442/status/1465787421807755266
@drliberty
30 November 2021 20:59
@WeLDnurses Up to date, accurate information #weldns
@HannahScrivene2
30 November 2021 20:59
@WeLDnurses Likes and dislikes, prefered name, allergies, health conditions/meds, communication needs, mobility, any important equipment needed, what helps make them feel happy/better when they are scared or upset #WeLDNs
@bethaniik
30 November 2021 21:00
@WeLDnurses Unfortunately we are not always alerted to someone's admission just from the flagging. I attend a daily huddle which helps identify anyone admitted with an LD, however this is if they are known, flagged and the staff have recognised this. ????#WeLDNs
@salsa442
30 November 2021 21:01
@drliberty @WeLDnurses I’ve found this is a challenge, who curates the passports and ensures they’re up to date? #WeLDNs
@CharleeB3010
30 November 2021 21:01
@HannahScrivene2 @WeLDnurses names of parents / care staff too #WeLDNs
@WeLDnurses
30 November 2021 21:01
Hospital passports have been around for a while now, and there’s been some excellent examples of what they should contain, but do you find them a useful tool? #WeLDNs
@HannahScrivene2
30 November 2021 21:02
@salsa442 Ooo yeah baseline obs is a great one.. especially as they may have ranges outside of the norm.. #WeLDNs
@WeLDnurses
30 November 2021 21:02
This is a great question - who is responsible for updating the passport? #WeLDNs https://twitter.com/salsa442/status/1465787981848100872
@samabdulla
30 November 2021 21:02
@WeLDnurses Annoyingly, we are probably the wrong crowd to answer that, what say you @wenurses and @WeStudentNurse #weldns
@WeLDnurses
30 November 2021 21:02
This is vital information to share #WeLDNs https://twitter.com/hannahscrivene2/status/1465788226514395141
@salsa442
30 November 2021 21:02
I’ve always found them useful if they’re well filled in and up to date. The quality of completion is key! Would be interested to know if anywhere has a section where acute services can update regarding new diagnoses/illnesses/acute episodes of care? #WeLDNs https://twitter.com/weldnurses/status/1465788027763105798
@WeLDnurses
30 November 2021 21:03
We’d love to hear your views! @WeNurses @WeStudentNurse #WeLDNs https://twitter.com/samabdulla/status/1465788322949779464
@getmebetter
30 November 2021 21:03
@WeLDnurses As a mirror to a passport, we encourage our Acute Liaison clinicians to share their profile too. https://www.leedsth.nhs.uk/a-z-of-services/learning-disability/about-me-easy-read/ #WeLDNs
@CharleeB3010
30 November 2021 21:03
@salsa442 @drliberty @WeLDnurses This is so difficult to keep on top of! #WeLDNs
@salsa442
30 November 2021 21:03
@HannahScrivene2 Exactly why baseline obs so important on the passports in my experience #WeLDNs
@HannahScrivene2
30 November 2021 21:03
@WeLDnurses The person themselves, family and carers, anyone involved in their care really should be involved and included to ensure its holistic and person-centred #WeLDNs
@WeLDnurses
30 November 2021 21:04
This is a fantastic idea!! Do other Trusts do something similar? #WeLDNs https://twitter.com/getmebetter/status/1465788582954684416
@DrAnthea
30 November 2021 21:04
@WeLDnurses I’ve looked at hospital passports to get an idea of people’s needs if we are getting rereferals to see if something has changed, also good for if people are changing care company for example like a more detailed one page profile but sometimes it feels like a tick box #weldns
@CharleeB3010
30 November 2021 21:04
@WeLDnurses Conversely, as a Liaison LDN they're fab. As a community nurse they were a necessary pain due to them being time consuming and not necessary something I was targeted to complete but necessary nonetheless #WeLDNs
@ross_6479_RNLD
30 November 2021 21:05
@salsa442 @drliberty @WeLDnurses And depending on how they are developed will depend on if the right stuff goes in, ive found some people fill them in because they have to and then put their interpretation in rather than what would be really helpful, I think the process needs to be more robust IMO #weldns
@salsa442
30 November 2021 21:05
@CharleeB3010 @drliberty @WeLDnurses Isn’t it just,even keeping tabs on who has a passport- wouldn’t it be great if the hospital passport could be on an app? Hand held device,easy to update as health needs change,could be edited by the healthcare provider assessing/treating the person #WeLDNs
@WeLDnurses
30 November 2021 21:05
Our last query on passports…. Should there be a national hospital passport, and what would this look like? #WeLDNs
@salsa442
30 November 2021 21:06
@ross_6479_RNLD @drliberty @WeLDnurses How can we make it so? Should community LDNs be supporting this? GPS? #WeLDNs
@WeLDnurses
30 November 2021 21:06
An app or electronic version for use on a hand held device sounds like a game changer! #WeLDNs https://twitter.com/salsa442/status/1465789129405480961
@CharleeB3010
30 November 2021 21:06
@salsa442 @drliberty @WeLDnurses was just discussing this this morning. Apparently possibly maybe one in development but doesn't work with IT and IG stuff I don't think #WeLDNs
@ross_6479_RNLD
30 November 2021 21:07
@salsa442 @CharleeB3010 @drliberty @WeLDnurses Didn’t we see a really good one of these presented at a PC we went to ?? #weldns
@WeLDnurses
30 November 2021 21:07
RT @salsa442: @ross_6479_RNLD @drliberty @WeLDnurses How can we make it so? Should community LDNs be supporting this? GPS? #WeLDNs
@EmLD90
30 November 2021 21:07
@WeLDnurses @WeNurses @WeStudentNurse As a student LD nurse I've heard about them. In my last job (special needs school). We had 1 page profiles for each child. Which said likes, dislikes, strengths and what they need support with. Very useful for new staff to read. #WeLDNs
@HannahScrivene2
30 November 2021 21:07
@WeLDnurses Depends if nurses take the time to read them #WeLDNs
@samabdulla
30 November 2021 21:07
@salsa442 @CharleeB3010 @drliberty @WeLDnurses Have you spoken to @jamieson_cat #weldns
@CharleeB3010
30 November 2021 21:08
@ross_6479_RNLD @salsa442 @drliberty @WeLDnurses When we could all be in a room together? Maybes #WeLDNs
@ross_6479_RNLD
30 November 2021 21:08
@salsa442 @drliberty @WeLDnurses This is the issue I guess, maybe it should be built into the annual health check and a national template developed and an annual review and update alongside #weldns
@WeLDnurses
30 November 2021 21:08
@HannahScrivene2 How can we encourage appropriate use? #WeLDNs
@salsa442
30 November 2021 21:08
@CharleeB3010 @drliberty @WeLDnurses If imagine the IT and IG issues are huge! But can we overcome them? #WeLDNs
@drliberty
30 November 2021 21:09
@salsa442 @CharleeB3010 @WeLDnurses Could be linked to the nhs app (like covid travel) and also link into last annual health check #weldns
@ross_6479_RNLD
30 November 2021 21:09
@CharleeB3010 @salsa442 @drliberty @WeLDnurses Im almost sure it was developed by a parent for their adult son and he came along to the presentation…or I dreamt something similar (which could also be the case!) #weldns
@salsa442
30 November 2021 21:10
@ross_6479_RNLD @drliberty @WeLDnurses I like that idea a lot #WeLDNs
@Craig_268
30 November 2021 21:10
@WeLDnurses Never met an acute liaison nurse who doesn’t have a vision or a desire to expand their remit. They are an undervalued asset. The complexities of covering multiple hospitals and supporting the diversity in such should not be undervalued #weLDNs @NisbetJemma
@samabdulla
30 November 2021 21:10
@ross_6479_RNLD @CharleeB3010 @salsa442 @drliberty @WeLDnurses This is one used here https://pamis.org.uk/services/digital-passports/ #weldns
@WeLDnurses
30 November 2021 21:10
@ross_6479_RNLD coming in with all the solutions!! Great ideas ????#WeLDNs https://twitter.com/ross_6479_rnld/status/1465789856685113348
@HannahScrivene2
30 November 2021 21:10
@WeLDnurses Make sure it is in the training that nurses get on LD and Autism, having posters up around the ward as a reminder, as RNLDs we can encourage and remind other nurses of their importance #WeLDNs
@salsa442
30 November 2021 21:10
@drliberty @CharleeB3010 @WeLDnurses That would be immense wouldn’t it? #WeLDNs
@WeLDnurses
30 November 2021 21:10
RT @salsa442: @CharleeB3010 @drliberty @WeLDnurses If imagine the IT and IG issues are huge! But can we overcome them? #WeLDNs
@salsa442
30 November 2021 21:11
@ross_6479_RNLD @CharleeB3010 @drliberty @WeLDnurses It was on an iPad - if you were dreaming I was there too! #WeLDNs
@WeLDnurses
30 November 2021 21:11
More great solutions! Wouldn’t this be awesome, how could we make this a reality? #WeLDNs https://twitter.com/drliberty/status/1465790104211972108
@WeLDnurses
30 November 2021 21:11
RT @samabdulla: @ross_6479_RNLD @CharleeB3010 @salsa442 @drliberty @WeLDnurses This is one used here https://pamis.org.uk/services/digital-passports/ #weldns
@salsa442
30 November 2021 21:12
Love bit of #EBP here ?? #WeLDNs https://twitter.com/samabdulla/status/1465790332306604034
@getmebetter
30 November 2021 21:13
@WeLDnurses We embed our passports on to the electronic patient record in addition to a hand held version. Needs to be seen more broadly than just at bedside/in person. (e.g. Bed managers and schedulers won't see the patient directly, so wouldn't see a paper or mobile-only profile) #WeLDNs
@CharleeB3010
30 November 2021 21:13
@salsa442 @drliberty @WeLDnurses There is maybe an argument for SLAs where information can be shared but into a single point - so pulled into a passport app and only specifics are shared - bit like retracting notes but not sure how that would work really #WeLDNs
@salsa442
30 November 2021 21:13
I think a national passport would be useful for staff, wherever they work the passport is the same, it’s another way of increasing the awareness of it and therefore increasing use #WeLDNs https://twitter.com/weldnurses/status/1465789142688800770
@bethaniik
30 November 2021 21:14
I would like to see a one for all profile for consistency and familiarity everywhere. I am forever having to explain our profile is not the 'All about me' dementia profile and have heard comments saying there's "so many out there" and "what's the difference anyway ?????". #WeLDNs https://twitter.com/WeLDnurses/status/1465789142688800770
@CharleeB3010
30 November 2021 21:14
@salsa442 @ross_6479_RNLD @drliberty @WeLDnurses My memory might be a bit hazy #weLDNs
@WeLDnurses
30 November 2021 21:14
???????????? #WeLDNs https://twitter.com/getmebetter/status/1465791150221058061
@ross_6479_RNLD
30 November 2021 21:14
@salsa442 Also with a national passport, guidance for completion, audit and ongoing review would be more streamlined #weldns
@WeLDnurses
30 November 2021 21:15
Excellent point @bethaniik! Has anyone else experienced similar? #WeLDNs https://twitter.com/bethaniik/status/1465791254533484549
@WeLDnurses
30 November 2021 21:15
So, moving on! Do you feel there is enough access within acute settings to tools such as easy read documents/ appointment letters or communication aids? #WeLDNs
@samabdulla
30 November 2021 21:15
@ross_6479_RNLD @salsa442 You would think we were small and connected enough to make it happen #weldns
@salsa442
30 November 2021 21:18
I think this is a real area for improvement, I find it really tricky to get easy read documents right and frequently had to amend or make bespoke to be meaningful #WeLDNs https://twitter.com/WeLDnurses/status/1465791683594002437
@bethaniik
30 November 2021 21:18
We have developed an intranet page with access to easy read resources we have and will continue to add to it. It has links to other websites they can try if not found on ours. We ask staff to let us know if there's something they could not find so we can get it added #WeLDNs https://twitter.com/WeLDnurses/status/1465791683594002437
@EmLD90
30 November 2021 21:18
@WeLDnurses From a student nurse point of view no. Usually have to have permission for certain folders if on placement etc. However his interest searches it's good to see many guidelines and polices now have an easy read version. #WeLDNs
@DrAnthea
30 November 2021 21:19
@WeLDnurses No, there is an increase in easy read information but just had to create one on cirrhosis for a person I support because I couldn’t find one that was suitable for her. Easy reads are still a growing resource #weldns
@ross_6479_RNLD
30 November 2021 21:19
@samabdulla @salsa442 The trouble is, much like with our research chat, we are so busy doing our direct clinical work we aren’t getting time to do additional project/service development work as much as we’d like #weldns
@CharleeB3010
30 November 2021 21:19
@samabdulla @ross_6479_RNLD @salsa442 It would be able to demonstrate role need not just ALDN/AHP but also wider in community. Which in turn would drive recruitment for students and then maybe more academics #WeLDNs
@EmLD90
30 November 2021 21:20
@WeLDnurses Meant to say with the internet oops #WeLDNs
@zoeeuk
30 November 2021 21:20
@WeLDnurses Just popping in! From my experience, No! Which is frustrating, usually my team or other CTLDs will try and do them for other services. Though getting the info in a timely way to do this for acute settings doesn't always happen. #WeLDNs
@WeLDnurses
30 November 2021 21:20
Excellent point Ross! We need more time!! #WeLDNs https://twitter.com/ross_6479_RNLD/status/1465792600703647748
@HannahScrivene2
30 November 2021 21:20
@WeLDnurses No i dont think there is. I know that there are systems that some trusts have to create easy read appointment letters but not all trusts do. There is some great guidance on creating easy read documentation out there though and some trusts do training for it too! #WeLDNs
@WeLDnurses
30 November 2021 21:21
@zoeeuk Hi @zoeeuk ! #WeLDNs
@WeLDnurses
30 November 2021 21:21
Other than what we’ve touched on already, what else should be available to support access to acute services for someone with learning disabilities? #WeLDNs
@bethaniik
30 November 2021 21:22
Our page. Still under construction but accessible to staff to use whilst we continue to add to it #WeLDNs https://t.co/HOMvM4fsXJ
@salsa442
30 November 2021 21:23
Specialist screening support, for example bowel or breast cancer screening #WeLDNs https://twitter.com/WeLDnurses/status/1465793174148980749
@CharleeB3010
30 November 2021 21:23
@WeLDnurses @ChangingPlaceUK or @MobilooUK because if you're coming for an OPA then finding somewhere to change can be tricky #WeLDNs
@Craig_268
30 November 2021 21:23
@WeLDnurses It is scattered out there, but it must be collated and accessible. Fundamentally we need to look at the skills and capacity of those delivering such interventions to ensure these are equitable and person centred #weLDNs
@salsa442
30 November 2021 21:23
@bethaniik That looks amazing ?? #WeLDNs
@zoeeuk
30 November 2021 21:23
@WeLDnurses Hi!! Sorry I was so late ?? #WeLDNs
@HannahScrivene2
30 November 2021 21:23
@WeLDnurses Theres a great Easy Read Facebook Group that shares easy read guides for things #WeLDNs
@CharleeB3010
30 November 2021 21:24
@salsa442 Primary Care liaison to make those screening programmes accessible would be ace #WeLDNs
@WeLDnurses
30 November 2021 21:24
This looks great!!! #EBP #WeLDNs https://twitter.com/bethaniik/status/1465793486825959432
@WeLDnurses
30 November 2021 21:24
RT @salsa442: Specialist screening support, for example bowel or breast cancer screening #WeLDNs
@salsa442
30 November 2021 21:25
@CharleeB3010 Exactly that #WeLDNs
@WeLDnurses
30 November 2021 21:25
Has anyone got any other examples of places to find easy read resources? #WeLDNs https://twitter.com/HannahScrivene2/status/1465793754909061129
@getmebetter
30 November 2021 21:25
@WeLDnurses A lifespan Acute Liaison service reduces difficulties associated with the transition from paediatrics to adult services #WeLDNs
@WeLDnurses
30 November 2021 21:26
Wow that hour has flown by!! We’ve covered a lot in this chat! What is the one thing that you’re going to take away from tonight? #WeLDNs
@zoeeuk
30 November 2021 21:26
@Craig_268 @WeLDnurses A good point. Some easy reads I have seen aren't always person centred, and then creating individual ones can take alot of time #WeLDNs
@EmLD90
30 November 2021 21:26
@HannahScrivene2 @WeLDnurses Is there a link or key word to find it? #WeLDNs
@ross_6479_RNLD
30 November 2021 21:26
@Craig_268 @WeLDnurses Person centred is key here, as often the easy read is seen as being about changing the words used but if the person doesn’t get the concept/context then the words are just words still #weldns
@samabdulla
30 November 2021 21:26
@salsa442 There’s been a lot of chat on the the timeline about this this week #weldns
@WeLDnurses
30 November 2021 21:26
Transition is another really important point to consider, thanks for sharing! #WeLDNs https://twitter.com/getmebetter/status/1465794253838245902
@WeLDnurses
30 November 2021 21:27
We’d love to see! #WeLDNs https://twitter.com/NisbetJemma/status/1465792368540540931
@salsa442
30 November 2021 21:28
That we need to keep working on improving access to and experience of acute services for people with learning disabilities #WeLDNs https://twitter.com/WeLDnurses/status/1465794292279132164
@WeLDnurses
30 November 2021 21:28
#WeLDNs https://twitter.com/lizjonwilltom/status/1465792410106187778
@chrishattoncedr
30 November 2021 21:28
@WeLDnurses The Easy Health web resource has recently gone through a major revamp https://www.easyhealth.org.uk/ #weldns (sorry, will go back to watching the football now)
@EmLD90
30 November 2021 21:29
@WeLDnurses The #EBP that have been linked in to the threads- looking forward to exploring them. Also, at my next placement, ask about hospital passports and what other reasonable adjustments are in place for hospital admissions #WeLDNs
@salsa442
30 November 2021 21:29
@bethaniik But you all worked together and made it happen, which is massively cool@in my opinion #Respect #WeLDNs
@samabdulla
30 November 2021 21:29
@WeLDnurses Consistency, of services, Of systems, of documentation #weldns
@WeLDnurses
30 November 2021 21:29
Thanks for sharing Chris! #WeLDNs https://twitter.com/chrishattoncedr/status/1465794931813933057
@drliberty
30 November 2021 21:29
@WeLDnurses James Clears quote ‘you don’t rise to the level of your goals. You fall to the level of your systems’ comes to mind. To tackle health inequalities we need to change the systems we work in #weldns
@WeLDnurses
30 November 2021 21:29
@chrishattoncedr Thanks for popping by! #WeLDNs
@WeLDnurses
30 November 2021 21:29
@salsa442 @bethaniik Huge respect! #WeLDNs
@WeLDnurses
30 November 2021 21:29
RT @samabdulla: @WeLDnurses Consistency, of services, Of systems, of documentation #weldns




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