1. Health, wellbeing and people with learning disabilities – Professor Jane Cummings
2. What the numbers are telling us – Professor Chris Hatton
3. What the numbers are telling us – Professor Chris Hatton (accessible)
4. The Learning Disability Mortality Review – and what it is telling us – Dr Richard Jeffrey
5. The Learning Disability Mortality Review – and what it is telling us – Dr Richard Jeffrey (accessible)
6. Health inequalities – Dr Angela Donkin
7. Health Checks – Dr Kirsten Lamb
The document discusses tips for being a successful medical student. It emphasizes the importance of interaction between students and teachers for learning medicine effectively. While lectures are important, spaced repetition and finding what learning style works best for each student is key to success. The medical field requires lifelong learning through conferences, journals, and case discussions with colleagues. Taking breaks and nurturing relationships is also important to avoid burnout from the demanding workload of medical education.
This document discusses diabetes management in the elderly population. It highlights that life expectancy is lower for those with type 1 diabetes compared to those without. A study on elderly patients who received awards for long-term diabetes found identifiers of long survival included reasonable blood sugar control, normal weight, and being non-smokers. Guidelines recommend individualized care plans for elderly patients in care homes that are agreed upon by the patient, doctor, and home staff. An audit found that some care home staff lacked diabetes education and homes did not always have policies for treating low blood sugar. Management of diabetes in the elderly aims to avoid low blood sugar, control symptoms, and reduce risks of infection and hospitalization.
O documento fornece um resumo histórico do diabetes, descrevendo suas primeiras menções na Grécia, Egito e Índia. Também aborda os principais desenvolvimentos no entendimento da doença desde os séculos 17-19, incluindo a diferenciação entre diabetes mellitus e insipidus e a descoberta de sua origem pancreática.
Over 60% of men and over 50% of women in England are overweight or obese. Obesity rates have nearly doubled over the past 20 years from around 15% to over 25% today. Risk factors for obesity include increasing age, lower income and education levels, living in deprived areas, and belonging to certain ethnic minority groups. Maintaining a healthy weight and waist circumference is important for reducing health risks.
Palliative care beyond cancer. Julia Addington-Hall. I Technical Conference about the Strategy in Palliative Care in The Nacional Health System of Spain. (Madrid, Ministry of Health and Consumer Affairs, 2008)
O documento discute a diabetes, identificando seus tipos principais, sintomas, tratamentos e passos para prevenção. Aborda a diabetes tipo 1 e tipo 2, sintomas como sede intensa e fome frequente, complicações como hipertensão e retinopatia, e a importância de dieta, exercício, controle de glicemia e evitar hábitos como fumar.
This document discusses weight bias and obesity stigma. It begins by defining key concepts such as weight bias, obesity stigma, and weight-based discrimination. It then discusses stereotypes commonly associated with obese individuals and reviews evidence that weight bias exists among health professionals and is linked to poorer quality of care for obese patients. The document also notes that weight bias has negative health consequences and is a public health issue. It reviews interventions to address weight bias and recommendations to improve public health messaging and reduce stigma.
This document provides information about type 2 diabetes, including:
- Type 2 diabetes is characterized by high blood sugar levels due to the body not properly using insulin or the pancreas not producing enough insulin over time.
- Risk factors include obesity, poor diet, and lack of exercise, as these factors can lead to insulin resistance.
- Symptoms may include increased thirst, urination, appetite, and weight loss, though many people do not experience symptoms initially.
- Treatment involves lifestyle changes like healthy diet, exercise and weight loss as well as medication in some cases.
- Prevention is possible by maintaining a healthy lifestyle with balanced nutrition and regular physical activity from a young age.
The document discusses tips for being a successful medical student. It emphasizes the importance of interaction between students and teachers for learning medicine effectively. While lectures are important, spaced repetition and finding what learning style works best for each student is key to success. The medical field requires lifelong learning through conferences, journals, and case discussions with colleagues. Taking breaks and nurturing relationships is also important to avoid burnout from the demanding workload of medical education.
This document discusses diabetes management in the elderly population. It highlights that life expectancy is lower for those with type 1 diabetes compared to those without. A study on elderly patients who received awards for long-term diabetes found identifiers of long survival included reasonable blood sugar control, normal weight, and being non-smokers. Guidelines recommend individualized care plans for elderly patients in care homes that are agreed upon by the patient, doctor, and home staff. An audit found that some care home staff lacked diabetes education and homes did not always have policies for treating low blood sugar. Management of diabetes in the elderly aims to avoid low blood sugar, control symptoms, and reduce risks of infection and hospitalization.
O documento fornece um resumo histórico do diabetes, descrevendo suas primeiras menções na Grécia, Egito e Índia. Também aborda os principais desenvolvimentos no entendimento da doença desde os séculos 17-19, incluindo a diferenciação entre diabetes mellitus e insipidus e a descoberta de sua origem pancreática.
Over 60% of men and over 50% of women in England are overweight or obese. Obesity rates have nearly doubled over the past 20 years from around 15% to over 25% today. Risk factors for obesity include increasing age, lower income and education levels, living in deprived areas, and belonging to certain ethnic minority groups. Maintaining a healthy weight and waist circumference is important for reducing health risks.
Palliative care beyond cancer. Julia Addington-Hall. I Technical Conference about the Strategy in Palliative Care in The Nacional Health System of Spain. (Madrid, Ministry of Health and Consumer Affairs, 2008)
O documento discute a diabetes, identificando seus tipos principais, sintomas, tratamentos e passos para prevenção. Aborda a diabetes tipo 1 e tipo 2, sintomas como sede intensa e fome frequente, complicações como hipertensão e retinopatia, e a importância de dieta, exercício, controle de glicemia e evitar hábitos como fumar.
This document discusses weight bias and obesity stigma. It begins by defining key concepts such as weight bias, obesity stigma, and weight-based discrimination. It then discusses stereotypes commonly associated with obese individuals and reviews evidence that weight bias exists among health professionals and is linked to poorer quality of care for obese patients. The document also notes that weight bias has negative health consequences and is a public health issue. It reviews interventions to address weight bias and recommendations to improve public health messaging and reduce stigma.
This document provides information about type 2 diabetes, including:
- Type 2 diabetes is characterized by high blood sugar levels due to the body not properly using insulin or the pancreas not producing enough insulin over time.
- Risk factors include obesity, poor diet, and lack of exercise, as these factors can lead to insulin resistance.
- Symptoms may include increased thirst, urination, appetite, and weight loss, though many people do not experience symptoms initially.
- Treatment involves lifestyle changes like healthy diet, exercise and weight loss as well as medication in some cases.
- Prevention is possible by maintaining a healthy lifestyle with balanced nutrition and regular physical activity from a young age.
This document provides information on screening patients for domestic violence. It defines domestic violence and discusses its prevalence and health impacts. Screening all female patients is recommended to identify those experiencing intimate partner violence and refer them to support services. The document reviews screening tools like HARK and proper protocols for responding to positive screens while ensuring safety and confidentiality. Follow-up is important to provide ongoing support and review referral options. The overall goal is to integrate domestic violence screening into routine care to improve patient health and well-being.
So You’re a New Teacher??
How to Survive the First Years
“Every teacher must understand the importance of promoting a positive class atmosphere. Each school is a microcosm of our society with its positives and negatives, and the importance
of respect, kindness and
honesty among students
should NOT be minimized”
- Lindberg and Swick, 2005
A doença de Crohn é uma doença inflamatória intestinal crônica descoberta por Burrill Crohn em 1932. Apresenta sintomas como dores abdominais, diarreia e perda de peso. É diagnosticada por exames como colonoscopia e tomografia computadorizada. Ainda não tem cura, mas pode ser tratada com medicamentos para controlar os sintomas ou cirurgia nos casos mais graves. A doença afeta a qualidade de vida dos pacientes no trabalho, viagens e alimentação fora de casa.
A lecture given at a Primary Care Conference in Massachusetts - on the important role primary care physicians could play in ensuring good palliative care for patients, communication, hospice, myths & realities
In 21st Century, when medical information is freely available to everyone, soft skill-set combined with technical competence is the key to professional success as a clinical care provider. The various components of soft-skills viz, Professionalism Humanism, Communication skills are discussed. Research findings on how to enhance patient satisfaction 8-fold by improving communication skills is highlighted.
O documento discute a Hipercolesterolemia Familiar (HF), uma doença genética caracterizada por níveis muito elevados de colesterol LDL e risco aumentado de doenças cardíacas. A HF é causada por mutações genéticas e pode levar a complicações como infarto e derrame devido à formação de placas de gordura nas artérias. O diagnóstico é realizado por meio de exames clínicos, histórico familiar e dosagem de lípides no sangue. O tratamento envolve mudanças no estilo de vida
The document summarizes key information about functional gastrointestinal disorders (FGIDs):
- FGIDs affect 40% of patients seen in GI settings and are a leading cause of emergency referrals. They are defined by symptoms in the absence of structural abnormalities and involve motility, sensitivity, immune, and central nervous system abnormalities.
- Food can trigger FGID symptoms in many patients. Dietary triggers may involve immune activation, direct effects of food chemicals, or carbohydrate malabsorption. Low FODMAP and gluten-free diets can provide relief.
- A multidisciplinary approach including a gastroenterologist, psychologist, dietician, and others results in significantly reduced anxiety and depression in FGID patients
A doença de Crohn é uma patologia inflamatória do trato gastrointestinal que afeta principalmente o íleo e o cólon, ocorrendo principalmente em pessoas da raça branca entre 20-40 anos. Os sintomas variam, mas incluem febre, perda de apetite e peso. Ainda não se conhece a causa exata, mas sabe-se que é crônica e sem cura, tratando-se os sintomas com medicamentos imunossupressores e evitando fatores como fumar.
O documento discute as dislipidemias, o transporte de lipídios pelas lipoproteínas, o metabolismo das lipoproteínas e como a atividade física regular pode afetar positivamente o perfil lipídico, reduzindo os níveis de LDL e triglicéridos e aumentando os níveis de HDL. Exercícios aeróbicos parecem ter maiores benefícios no perfil lipídico do que exercícios de resistência. A prática regular de exercícios é recomendada como parte do tratamento e prevenção de
O documento discute diabetes mellitus, um grupo de distúrbios metabólicos caracterizados pela hiperglicemia. A diabetes afeta 246 milhões de pessoas no mundo e estima-se que esse número aumente para 380 milhões até 2025. Existem dois principais tipos de diabetes: tipo 1, causada por falta de produção de insulina, e tipo 2, causada por resistência à insulina. O diagnóstico é feito por meio de testes de glicemia e hemoglobina glicada, e o tratamento envolve dieta, exercício, e possivelmente medicamentos
Five reasons are provided for student misbehavior:
1. Students have previously been rewarded for misbehavior through attention, even if negative.
2. Different expectations between home and school cause students to feel uneasy and misbehave.
3. When basic needs like food, rest aren't met, students are more likely to misbehave.
4. Students sometimes misbehave to test boundaries and authority. This allows teachers to reinforce clear rules.
5. Students want to assert independence, which they do by controlling situations like refusing assignments.
This case study describes the palliative care team that cared for a patient named Phil over several years as his prostate cancer progressed. The team included specialists from Hospice Mid-Northland, local doctors and nurses, hospital staff, and support services. They worked collaboratively to manage Phil's multiple symptoms and provide care in both inpatient and home settings. The case highlights both the successes and challenges of coordinating care among different providers and adapting to Phil's changing needs over time. It also emphasizes the importance of effective teamwork, communication, and maintaining trust within the palliative care team.
A importância da avaliação nutricional e exames laboratoriaisUNIME
O documento discute a importância da avaliação nutricional e exames laboratoriais para o exame físico. A avaliação nutricional envolve anamnese, antropometria, exames laboratoriais e diagnóstico de enfermagem. Exames como hemograma, glicemia, lipídeos e albumina são importantes para avaliar o estado nutricional.
This document discusses chronic diseases, specifically obesity, coronary heart disease, hypertension, and diabetes mellitus. It defines each condition, discusses their prevalence, risk factors, measurement, prevention, and management. Obesity is defined by BMI measurements and poses health hazards like increased mortality and morbidity. Prevention focuses on diet, exercise, and lifestyle modifications. Hypertension is a major risk factor for other diseases and its management requires patient education and controlling risk factors through medication and lifestyle changes. Diabetes mellitus can be prevented through identifying at-risk groups and promoting healthy behaviors.
Integrating culture and social responsibility tesol 11Joe McVeigh
Joe McVeigh and Ann Wintergerst describe research and practical ideas for the integration of culture and social responsibility in the English language classroom. Download the accompanying handout at www.joemcveigh.org. Learn more about the accompanying book at http://amzn.to/hOO2bz
Changing trends in medical education :Role of MEU,CISP,RBCWanitasreekanth
Dr. Anita Ramesh is a professor in the OBGY department who discusses changes in medical education from pedagogy to andragogy. This includes shifts in teaching approaches, learning styles, medical principles, practice, and assessment methods due to advanced technology. She notes that India has over 500 medical colleges but curriculum goals do not always match health needs and there is a lack of faculty development. Her goal is to produce competent physicians through faculty development programs, curriculum reviews, and subcommittees to align teaching methods with the objective of health for all.
O documento discute o que é diabetes mellitus, definindo-a como uma doença caracterizada por níveis elevados de glicose no sangue. Ele descreve os dois principais tipos de diabetes, tipo 1 e tipo 2, explicando as diferenças entre eles, incluindo causas, sintomas e tratamentos.
Peter Scott, CEO of ENABLE Scotland, gave a presentation at the TCV Greenability Conference about issues facing those with learning disabilities in Scotland. He discussed that approximately 120,000 people in Scotland have a learning disability. People with learning disabilities often have poorer health than others and die around 20 years younger on average. They also experience high levels of social isolation, deprivation, and poverty. The Scottish government's 10-year strategy called "The Keys to Life" aims to improve health, social connections, and dignity for those with learning disabilities. Green Gyms provide a natural way to improve both physical and mental health for this group through outdoor activities and social interaction in nature.
The mismatch between information that people need and what we provide them withCILIP
The document discusses the mismatch between the health information people need and what is currently provided. It notes that 43% of working adults do not understand health information and 61% do not understand information with numeracy elements. This can negatively impact health outcomes. The document provides examples of information misunderstandings and suggests using simple language, chunking information, and tools like The Information Standard quality mark to help close this mismatch. It emphasizes the importance of understanding users and involving them in developing easily understood information.
This document provides information on screening patients for domestic violence. It defines domestic violence and discusses its prevalence and health impacts. Screening all female patients is recommended to identify those experiencing intimate partner violence and refer them to support services. The document reviews screening tools like HARK and proper protocols for responding to positive screens while ensuring safety and confidentiality. Follow-up is important to provide ongoing support and review referral options. The overall goal is to integrate domestic violence screening into routine care to improve patient health and well-being.
So You’re a New Teacher??
How to Survive the First Years
“Every teacher must understand the importance of promoting a positive class atmosphere. Each school is a microcosm of our society with its positives and negatives, and the importance
of respect, kindness and
honesty among students
should NOT be minimized”
- Lindberg and Swick, 2005
A doença de Crohn é uma doença inflamatória intestinal crônica descoberta por Burrill Crohn em 1932. Apresenta sintomas como dores abdominais, diarreia e perda de peso. É diagnosticada por exames como colonoscopia e tomografia computadorizada. Ainda não tem cura, mas pode ser tratada com medicamentos para controlar os sintomas ou cirurgia nos casos mais graves. A doença afeta a qualidade de vida dos pacientes no trabalho, viagens e alimentação fora de casa.
A lecture given at a Primary Care Conference in Massachusetts - on the important role primary care physicians could play in ensuring good palliative care for patients, communication, hospice, myths & realities
In 21st Century, when medical information is freely available to everyone, soft skill-set combined with technical competence is the key to professional success as a clinical care provider. The various components of soft-skills viz, Professionalism Humanism, Communication skills are discussed. Research findings on how to enhance patient satisfaction 8-fold by improving communication skills is highlighted.
O documento discute a Hipercolesterolemia Familiar (HF), uma doença genética caracterizada por níveis muito elevados de colesterol LDL e risco aumentado de doenças cardíacas. A HF é causada por mutações genéticas e pode levar a complicações como infarto e derrame devido à formação de placas de gordura nas artérias. O diagnóstico é realizado por meio de exames clínicos, histórico familiar e dosagem de lípides no sangue. O tratamento envolve mudanças no estilo de vida
The document summarizes key information about functional gastrointestinal disorders (FGIDs):
- FGIDs affect 40% of patients seen in GI settings and are a leading cause of emergency referrals. They are defined by symptoms in the absence of structural abnormalities and involve motility, sensitivity, immune, and central nervous system abnormalities.
- Food can trigger FGID symptoms in many patients. Dietary triggers may involve immune activation, direct effects of food chemicals, or carbohydrate malabsorption. Low FODMAP and gluten-free diets can provide relief.
- A multidisciplinary approach including a gastroenterologist, psychologist, dietician, and others results in significantly reduced anxiety and depression in FGID patients
A doença de Crohn é uma patologia inflamatória do trato gastrointestinal que afeta principalmente o íleo e o cólon, ocorrendo principalmente em pessoas da raça branca entre 20-40 anos. Os sintomas variam, mas incluem febre, perda de apetite e peso. Ainda não se conhece a causa exata, mas sabe-se que é crônica e sem cura, tratando-se os sintomas com medicamentos imunossupressores e evitando fatores como fumar.
O documento discute as dislipidemias, o transporte de lipídios pelas lipoproteínas, o metabolismo das lipoproteínas e como a atividade física regular pode afetar positivamente o perfil lipídico, reduzindo os níveis de LDL e triglicéridos e aumentando os níveis de HDL. Exercícios aeróbicos parecem ter maiores benefícios no perfil lipídico do que exercícios de resistência. A prática regular de exercícios é recomendada como parte do tratamento e prevenção de
O documento discute diabetes mellitus, um grupo de distúrbios metabólicos caracterizados pela hiperglicemia. A diabetes afeta 246 milhões de pessoas no mundo e estima-se que esse número aumente para 380 milhões até 2025. Existem dois principais tipos de diabetes: tipo 1, causada por falta de produção de insulina, e tipo 2, causada por resistência à insulina. O diagnóstico é feito por meio de testes de glicemia e hemoglobina glicada, e o tratamento envolve dieta, exercício, e possivelmente medicamentos
Five reasons are provided for student misbehavior:
1. Students have previously been rewarded for misbehavior through attention, even if negative.
2. Different expectations between home and school cause students to feel uneasy and misbehave.
3. When basic needs like food, rest aren't met, students are more likely to misbehave.
4. Students sometimes misbehave to test boundaries and authority. This allows teachers to reinforce clear rules.
5. Students want to assert independence, which they do by controlling situations like refusing assignments.
This case study describes the palliative care team that cared for a patient named Phil over several years as his prostate cancer progressed. The team included specialists from Hospice Mid-Northland, local doctors and nurses, hospital staff, and support services. They worked collaboratively to manage Phil's multiple symptoms and provide care in both inpatient and home settings. The case highlights both the successes and challenges of coordinating care among different providers and adapting to Phil's changing needs over time. It also emphasizes the importance of effective teamwork, communication, and maintaining trust within the palliative care team.
A importância da avaliação nutricional e exames laboratoriaisUNIME
O documento discute a importância da avaliação nutricional e exames laboratoriais para o exame físico. A avaliação nutricional envolve anamnese, antropometria, exames laboratoriais e diagnóstico de enfermagem. Exames como hemograma, glicemia, lipídeos e albumina são importantes para avaliar o estado nutricional.
This document discusses chronic diseases, specifically obesity, coronary heart disease, hypertension, and diabetes mellitus. It defines each condition, discusses their prevalence, risk factors, measurement, prevention, and management. Obesity is defined by BMI measurements and poses health hazards like increased mortality and morbidity. Prevention focuses on diet, exercise, and lifestyle modifications. Hypertension is a major risk factor for other diseases and its management requires patient education and controlling risk factors through medication and lifestyle changes. Diabetes mellitus can be prevented through identifying at-risk groups and promoting healthy behaviors.
Integrating culture and social responsibility tesol 11Joe McVeigh
Joe McVeigh and Ann Wintergerst describe research and practical ideas for the integration of culture and social responsibility in the English language classroom. Download the accompanying handout at www.joemcveigh.org. Learn more about the accompanying book at http://amzn.to/hOO2bz
Changing trends in medical education :Role of MEU,CISP,RBCWanitasreekanth
Dr. Anita Ramesh is a professor in the OBGY department who discusses changes in medical education from pedagogy to andragogy. This includes shifts in teaching approaches, learning styles, medical principles, practice, and assessment methods due to advanced technology. She notes that India has over 500 medical colleges but curriculum goals do not always match health needs and there is a lack of faculty development. Her goal is to produce competent physicians through faculty development programs, curriculum reviews, and subcommittees to align teaching methods with the objective of health for all.
O documento discute o que é diabetes mellitus, definindo-a como uma doença caracterizada por níveis elevados de glicose no sangue. Ele descreve os dois principais tipos de diabetes, tipo 1 e tipo 2, explicando as diferenças entre eles, incluindo causas, sintomas e tratamentos.
Peter Scott, CEO of ENABLE Scotland, gave a presentation at the TCV Greenability Conference about issues facing those with learning disabilities in Scotland. He discussed that approximately 120,000 people in Scotland have a learning disability. People with learning disabilities often have poorer health than others and die around 20 years younger on average. They also experience high levels of social isolation, deprivation, and poverty. The Scottish government's 10-year strategy called "The Keys to Life" aims to improve health, social connections, and dignity for those with learning disabilities. Green Gyms provide a natural way to improve both physical and mental health for this group through outdoor activities and social interaction in nature.
The mismatch between information that people need and what we provide them withCILIP
The document discusses the mismatch between the health information people need and what is currently provided. It notes that 43% of working adults do not understand health information and 61% do not understand information with numeracy elements. This can negatively impact health outcomes. The document provides examples of information misunderstandings and suggests using simple language, chunking information, and tools like The Information Standard quality mark to help close this mismatch. It emphasizes the importance of understanding users and involving them in developing easily understood information.
LTC Lunch and Learn: Prevention & Effective Interventions in Frailty, 6 May 2015NHS Improving Quality
LTC Lunch and Learn: Prevention & Effective Interventions in Frailty, 6 May 2015 with Helen Lyndon, Nurse Consultant Older People, Clinical Lead Frailty, NHS England
Prevention and Intervention for Frailty
Wednesday 6th May 2015
Hosted by Beverley Matthews, Long Term Conditions Programme Lead, NHS Improving Quality and Helen Lyndon, Nurse Consultant Older People, Clinical Lead Frailty NHS England. Learning outcomes will include:
Understanding the preventable components of frailty
Understanding how clinicians can support people to prevent and delay the adverse effects of frailty
Understanding what interventions are effective across the frailty trajectory.
- See more at: http://www.nhsiq.nhs.uk/improvement-programmes/long-term-conditions-and-integrated-care/long-term-conditions-improvement-programme/webinar-series/previous-webinars.aspx#sthash.0uO8KBsy.dpuf
Social care information packs
This is a series of short information sheets and matching slide sets about how social care staff can support people with learning disabilities to have better access to health services. They provide an introduction to each area and links to where further information and useful resources can be found.
Challenges for economic evaluation when doing research with people with learn...cheweb1
Challenges for economic evaluation when doing research with people with learning disabilities - Claire Hulme, Professor of Health Economics, University of Leeds
Better health, better lives conference tuesday 20 june 2017 - workshopsNHS England
1. Using reasonable adjustments to improve health care – Anna Marriott and Siraaj Nadat
2. Stop Overmedication of people with learning disabilities (STOMP) – David Branford, Carl Shaw, Jill
Parker and David Gill
3. The Right Care Diabetes Pathway – Jane Kachika
4. Lab in a bag – Stephamie Laconianni
5. Don’t miss out – having a health check and using the GP – Rachel Ashcroft & Harry Roche
6. SeeAbility – Scott Watkin & Stephen Kill
7. Summary care records
- Enlightened aging is a hopeful approach to aging based on science that empowers people to prepare well for late life and live well with the natural changes of aging.
- The Group Health Research Institute has been conducting research on aging for over 30 years through studies like the Adult Changes in Thought Project to better understand normal and abnormal aging and identify ways to prevent or delay age-related mental and physical declines.
- Findings from the ACT study have provided insights on how exercise, physical activity, diet, brain health, and other lifestyle factors can help people remain independent and functional for as long as possible.
This document provides information about dementia to general practice staff to help their understanding of the condition. Some key points:
- Dementia affects over 850,000 people in the UK, including around 20,000 in Hampshire. The risk increases significantly with age.
- Early diagnosis allows more time for planning and managing the condition. However, only 1/3 of people with dementia have a proper diagnosis.
- The document outlines ways practices can become more dementia-friendly, such as ensuring staff are aware of patients' diagnoses, allowing longer appointments, and including family in care decisions.
- It emphasizes the importance of support for carers, and provides resources for further information.
This presentation introduces the types of Diabetes and updates on the care, support and information available from Diabetes UK.
It also lets know how one can get involved and support in dealing with Diabetes.
Making a difference: benefits of providing high quality information - Ddan li...CILIP
Benefits and Value of Health Information Services
• What is health literacy?
• Why does health literacy matter?
• What is the impact of health literacy on a population?
• What can be done to improve health literacy?
• Some examples from a mental health NHS Trust perspective.
This document summarizes a presentation about end of life care for people with dementia. It discusses what people with dementia say about end of life care, including challenges around communication and acknowledging loss. It also examines the palliative care needs of people with dementia, noting issues around symptoms, care transitions and multidisciplinary support. Further, it outlines how incorporating a palliative approach into routine dementia care can help with advance care planning, loss and grief, and staff education. Finally, it analyzes how supporting people with dementia to die at home requires individualized care, future planning, symptom management and access to family and community support services.
23 September 2010 - National End of Life Care Programme
This guide is principally for professionals working in health and social care and allied professions. Its main aim is to provide links to information sources, resources and good practice in end of life care (EoLC) for people with dementia, particularly for those who work with people with dementia who are not EoLC experts and EoLC experts who are not particularly knowledgeable about dementia.
While the document is not principally written for patients and carers, some of the information will be relevant to them.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
#Caring4NHSPeople - virtual wellbeing session 10 June 2020NHS Horizons
This document summarizes a virtual community meeting to support the health and wellbeing of NHS people during the Covid-19 response. The meeting will include introductions from participants, an update on the national support offer, a discussion on supporting leaders, a presentation on compassion from Professor Michael West, and a conversation on experiences supporting staff wellbeing. Participants will also have the opportunity to complete a survey on their experiences for a chance to win a coaching session. The aim of the weekly sessions is to offer support, share wellbeing activities, and connect people supporting NHS staff health and wellbeing.
The document analyzes data from the UK Office of National Statistics to identify the most vulnerable populations in the UK. It defines the elderly as those over 65 and examines populations with both high proportions of elderly residents and lower healthy life expectancies. The analysis finds that the most vulnerable populations are located in the North of England, with some areas in the South and London also showing high levels of elderly residents with poor health conditions and limited ability to perform daily activities.
Geriatrics is the medical specialty dedicated to providing care for older adults. Geriatricians are trained to address health issues that may affect older patients differently than younger adults, such as multiple illnesses occurring at the same time or medications affecting older people differently. Common conditions seen in older adults include heart disease, arthritis, diabetes, falls, depression, Alzheimer's disease, and Parkinson's disease. As people age, assistive devices and home modifications may help extend independence by assisting with activities of daily living.
The document summarizes an upcoming summit on healthy aging and prevention. The summit will include sessions on developing a system-wide agenda for healthy aging across Cambridgeshire and Peterborough, and committing organizations to embed preventative principles. The program includes keynote presentations, panel discussions, and group work to discuss topics like physical activity, long-term conditions, older adults, and mental health. The overall aims are to promote well-being in later life through a lifecourse approach and new solutions to meet changing needs of an aging population.
Older adults and physical activity outdoors: National policy in contextUniversity of Bath
Presentation by Nuzhat Ali for the ESRC Seminar Series on Ageing and Physical Activity - "Outdoor natural environments: An active space for the older adult?"
Similar to Better health, better lives conference tuesday 20 june 2017 - presentations (20)
The document discusses improving care for people with learning disabilities and autism. It notes that care is not always safe or personalized for these groups. It also states that some trusts have failed to respect people's rights, and there are workforce skills deficits in knowledge of learning disabilities and autism. The Learning Disability Improvement Standards were created to address these issues and reflect principles of person-centered care. The standards aim to tackle health inequalities over the next 10 years and create an evidence base to develop targeted initiatives.
Swimming from the shallows to the deep endNHS England
The document discusses several topics related to flexible working in the NHS:
1) It summarizes that when the NHS was established in 1948, it faced immediate staff shortages, with over 53,000 hospital beds lying empty due to a lack of nursing staff. Despite efforts to increase staffing levels, shortages of around 48,000 nurses remained.
2) It notes that millennials prefer more flexible work arrangements than staying in the same job for 30 years.
3) It describes NHSP's process for evaluating the performance of flexible workers, which includes seeking feedback from Trusts across five quality criteria and identifying workers performing well or in need of skills development.
Co-production, person centredness and leading across organisational boundariesNHS England
This document discusses co-production and person-centered care across organizational boundaries in healthcare. It emphasizes that integrated care involving expertise from various sectors designed based on local needs is more likely to succeed. Successful transformation requires investment in staff, leadership, and co-production with stakeholders. Several case studies showcase co-production approaches used by different NHS trusts to develop innovative services.
Better Births/The Long Term Plan and Safer maternity careNHS England
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1. Better Health, Better Lives Conference
Tuesday 20 June 2017
Presentations – Contents
1. Health, wellbeing and people with learning disabilities – Professor Jane Cummings
2. What the numbers are telling us – Professor Chris Hatton
3. What the numbers are telling us – Professor Chris Hatton (accessible)
4. The Learning Disability Mortality Review – and what it is telling us – Dr Richard Jeffrey
5. The Learning Disability Mortality Review – and what it is telling us – Dr Richard Jeffrey (accessible)
6. Health inequalities – Dr Angela Donkin
7. Health Checks – Dr Kirsten Lamb
3. www.england.nhs.uk
‘Better Health Better Lives’
for people with a learning
disability:
everyone should have good
healthcare and a good life
Professor Jane Cummings,
Chief Nursing Officer for England
June 2017
4. www.england.nhs.uk
• People aren’t living long
enough or as well as they
could
• Not enough people are
known to their GP as having
a learning disability
• Not enough people are
getting routine screening,
missing out on diagnosis
and treatment
• People are given too much
medication
What we know
4
5. www.england.nhs.uk
• Delays in diagnosis
and treatment aren’t
inevitable!
• They can happen
because a person
finds it difficult to
communicate or make
decisions
• Providers can make
adjustments
What we know
5
6. www.england.nhs.uk
• STOMP
• Priority in the flu plan
• Learning disabilities in the
National Diabetes Audit
• ‘Lab in a bag’ project
• Children and young people
• End of life care
• Annual Health Checks
A priority to get right - what NHS England
is doing:
6
8. www.england.nhs.uk
• Prevention, support and
choice
• Housing options
• Employment
• Use of personal budgets
• What does better health
and better lives mean to
you?
• We are ambitious for people’s lives as
well as their care!
8
10. www.england.nhs.uk
• Help people to understand NHS
111
• Show people what to expect
when they phone 111
• Give tips on what to do to have a
good call
• Get more people with a learning
disability and/or autism to use
NHS 111
Inclusive NHS 111
15. The health of people with learning
disabilities:
What do the numbers tell us?
Professor Chris Hatton
Public Health England Learning Disabilities Observatory
16. What do the numbers tell us?
• About when people die?
• About how good people’s health is?
• About why people have worse health?
17. When do people with learning disabilities die?
• People with learning disabilities are
living longer than in the past
• BUT…
• People with learning disabilities die
15-20 years younger than other
people
• AND
• Many deaths of people with learning
disabilities are avoidable
18. Median age of death: men with learning disabilities in England
19. Median age of death: women with learning disabilities in England
20. Avoidable deaths
• Nearly half of deaths of people
with learning disabilities were
avoidable
• Common problems:
• Delays in diagnosis and
treatment
• A lack of reasonable
adjustments to healthcare
21. How good is people’s health?
• Not very good
• In many ways
• At every age
22. The health of 7-year old children
0
10
20
30
40
50
60
Parent rates
child health as
fair/poor
Child has 3+
health
problems
Child is very
overweight
Children with learning
disabilities
Other children
23. The health of people known to GPs
Much more likely for people with learning
disabilities:
• Epilepsy
• Severe mental health problems
• Dementia
• Underactive thyroid gland
24. The health of people known to GPs
More likely for people with learning disabilities:
• Heart failure
• Type 1 and 2 diabetes
• Kidney disease
• Stroke
• Asthma
25. The health of people known to GPs
Less likely for people with learning
disabilities:
• Diseases that make breathing difficult
• Cancer
• Diseases that stop the blood going
round your body
26. The health of the ‘hidden majority’
0
5
10
15
20
25
30
35
Poor health Poor mental health
Adults with learning
disabilities
Other adults
28. Being very overweight
• Being very overweight (obese)
twice as likely for young adults
with learning disabilities
• Increases with age
• Older people with learning
disabilities twice as likely to be
underweight
29. Why do people with learning
disabilities have poorer health?
• A learning disability is not in itself a health problem
• Bad things (all of which make people ill) are more likely
happen to people with learning disabilities
• Being poor as a child
• Bullied and abused
• Excluded and isolated
• Being poor and unemployed as an adult
• Poor health care
31. Being in a paid job
0
10
20
30
40
50
60
70
80
All adults Adults with
learning
disabilities
Percentageofpopulationinwork
Working more than
16 hours per week
Working up to 16
hours per week
33. Diabetes
• Compared to other people…
• People with learning disabilities with
Type 1 diabetes more likely to get
checks
• People with learning disabilities with
Type 2 diabetes less likely to get
checks
• People with learning disabilities are
treated well for their diabetes
34. What do the numbers tell us?
• Numbers can never tell us the whole story
• On average, the health of people with learning
disabilities is poorer than the health of other people
• But for some health conditions, people with learning
disabilities are doing well and are being treated well
• There are lots of things we can do to help people live
longer, healthier lives
36. Sources of information
People with Learning Disabilities in England 2015. Public Health England
www.gov.uk/government/publications/people-with-learning-disabilities-in-england-
2015
Confidential Inquiry into Premature Deaths of People with Learning Disabilities.
University of Bristol www.bristol.ac.uk/cipold/reports/
Health and Care of People with Learning Disabilities. NHS Digital and Public Health
England http://content.digital.nhs.uk/article/7543/Health-and-Care-of-People-with-
Learning-Disabilities
Joint Health and Social Care Self-Assessment Framework 2014. Public Health England
http://content.digital.nhs.uk/article/7543/Health-and-Care-of-People-with-Learning-
Disabilities
National Diabetes Audit 2015-16. Report 1: Care Processes and Treatment Targets.
Learning Disability Supplementary Information. NHS Digital
http://content.digital.nhs.uk/catalogue/PUB23241/nati-diab-rep1-audi-ld-suppl-2015-
16.pdf
Emerson E & Hatton C (2014). Health inequalities and people with intellectual
disabilities. Cambridge: Cambridge University Press.
36 LDT@phe.gov.uk
37. What the numbers are telling us
(accessible)
Professor Chris Hatton
38. The health of
people with learning disabilities:
What do the numbers tell us?
This presentation is based on the presentation by
Professor Chris Hatton
Public Health England Learning Disabilities Observatory
39. What do the numbers tell us?
About when people die
About why people have worse health
About how good people’s health is
40. What do the numbers tell us?
Numbers can never tell us the whole story
The health of people with learning disabilities
is worse than the health of other people
But for some health conditions,
people with learning disabilities
are doing well and will be treated well
There are lots of things we can do
to help people live longer, healthier lives
43. Content
• What is the LeDeR programme?
• What are the main parts of the Programme?
• What is LeDeR telling us, as of today?
43
44. Background
• Several reports and inquiries have said that people with
learning disabilities are not getting good health and social
care
• Some people are dying too soon
These reports include:
Mencap – Death by Indifference (2007)
The Confidential Inquiry into deaths of
people with learning disabilities (2013)
44
45. What do we know?
Some people with learning disabilities:
• Are more likely to die at a young age
than other people
• Some deaths should not happen when
they do
45
46. Age at death
Men and women with learning
disabilities die about 20 years
sooner than people without
learning disabilities
46
47. People with learning disabilities are:
47
Three times more likely to
die from a cause of death
that could be prevented
by good quality care …..
than people in the general
population.
48. LeDeR programme aims
• Improve health and social care
services
• Stop so many people dying early
48
50. • Someone lets us know when a person
dies
• A local reviewer speaks to those who
knew the person best, including their
family
• And then they look at their notes
• Find out what happened…
Initial review
50
51. • If it is felt that further learning could
come from a full review, they organise
a multi-agency meeting
• A multi-agency meeting
looks more closely at why
someone died
51
52. • Deaths of people from black and
minority ethnic communities
• Deaths of young people aged 18-24
Things we will look at more closely:
52
53. • All the information from a review is
discussed in the local area to decide
whether changes need to be made to
improve services
• These are called action plans listing
actions & recommendations
Action planning and improvements
53
54. • We collect all of the information from
across England and look at it in more
detail
• We send reports to national LeDeR
steering groups to say what the
information tells us and what patterns
we can see
• We help make sure action plans are
carried out
Action planning and improvements
54
56. As of today…
• 15 of the 38 national LeDeR steering
groups are setup. Complete by
December 2017
• LeDeR has trained 750 staff
• LeDeR has been notified of over 500
deaths of people with a learning
disability. Those eligible for review is
over 470.
56
57. Of eligible deaths notified to LeDeR so far…
• 52% are male & 48% female
• Most of the deaths we have been told about
are people aged 55-64 years of age. A small
number (3%) were between ages 18-24
• Most individuals were single (80%) and lived
with someone else (79%)
• Most common place of death so far has
been the hospital (61%)
n=471
57
58. Cause of Death
Of those reviews currently coded into ICD10 , the first
recorded reason for cause of death was:
1. Pneumonia (18%)
2. Aspiration pneumonia (14%)
3. Sepsis (13%)
n=173
58
59. Associated health conditions
We know from the reviews, some of the common health
conditions of the deceased are:
1. Epilepsy(13%)
2. Dementia (7%)
3. Cerebral Palsy (6%)
4. Diabetes (4%)
5. Cancer (3%)
n=471
59
60. Actions & Recommendations so far…
• We have finished 19 reviews
so far
• These have given 27 actions
and recommendations
• Some completed reviews
generated no actions, because
there were no issues with the
care provided
60
61. Secondary Care recommendations
Examples
• Accident & Emergency learning disability training
• Better communication at patient discharge
• Better communications with regard Mental Health referrals
• Ensure reasonable adjustments are made in Accident &
Emergency
• Improve end of life care through better end of life training
• Reducing infections whilst in hospital
• Improving communication with regard medication changes
• Improving processes on the best action to take should the
person suffer cardiac arrest or die suddenly
61
62. Primary Care recommendations
Examples
• Audit annual health checks & raise awareness of
importance of the health check
• Better understanding in primary care with regard
completing Cause of Death certificates
• Ensuring patients with a learning disability or a
mental health condition are on the correct registers
• Improving communication between case
coordinators & case managers
• Improving communication with regard medication
changes
62
63. Other recommendations include
• Multi-disciplinary meetings must be fully inclusive of
all agencies
• Ensuring social care staff are aware of the importance
of recording & documenting contact with families
• Implement end of life training in residential &
supported living accommodation
• More timely Mental Capacity Assessments
• Improving learning disability awareness training with
District Nurses
• Ambulance Trust - Ensure reasonable adjustments
are made
63
64. Five key factors contributing to early deaths
(from CIPOLD 2013)
1. Not listening to people with learning disabilities
and their family and carers
2. Not knowing who has a learning disability and
making reasonable adjustments
3. Not finding out what is wrong and treating illness
quickly
4. Not coordinating a persons care and sharing
information
5. Not following the Mental Capacity Act 2005
64
65. What else is LeDeR telling us?
• The programme is already improving
services for people with a learning
disability
• Actions from completed reviews show
lots of different improvements in care, in
different organisations
• We will bring the learning together from
all the local reviews to help improve
services across the country
65
66. What else is LeDeR telling us?
• We have trained reviewers from all professions
across the country. But we need to work more with
GPs and social care
• We also know what works well and need to share
this across the country
• LeDeR steering groups need help to turn actions
from reviews into better services & commissioning.
We have workshops in June and July to do this
66
68. Contact details
Richard Jeffery, Programme Manager
Norah Fry Centre for Disability Studies,
University of Bristol, 8 Priory Road, Bristol BS8 1TN
LeDeR-team@bristol.ac.uk
Tel: 0117 3310686
http://www.bristol.ac.uk/sps/leder/
@leder_team
https://www.facebook.com/lederteam/
68
69. The Learning Disability Mortality
Review and what it is telling us
(accessible)
Dr Richard Jeffrey
70. Learning Disabilities Mortality Review
(LeDeR) Programme
This presentation is an
accessible version of a
presentation by
LeDeR Programme Manager
Richard Jeffery
70
71. 71
The LeDeR programme is about
finding out about the deaths of
people with a learning disability.
The LeDeR programme is about
anyone aged 4 or more who dies
that has a learning disability.
72. 72
Finding out if anything could have
been done better for the person
that died is important.
It will help health services make
improvements to the way they work
for people with a learning disability.
73. 73
Families, carers and staff who
support people can take part in
reviews if they want to.
This helps make sure the review
knows about who the person that
died was – not just about their
medical condition.
75. Improving the health of
people with a learning
disabilities-
improving the social
determinants of health
Dr Angela
Donkin,
Dr Wendy Rickard
UCL Institute of
Health Equity
76. Marmot
Review Policy
Objectives:
The Social
Determinant
s of Health
• Give every child the best start in life
• Help all people have control over their
lives.
• Create good jobs for all
• Help people have enough money to live
well
• Make places and communities more
accessible
• Stop people from getting ill
77. Nearly half of the increased risk of mental health difficulties
among children with learning disability may be attributable to
their increased rate of exposure to common ‘social
determinants’ of poorer mental health rather than to their
intellectual disability per se’
(Emerson & Hatton 2007, 2015)
78. British adults with
intellectual impairments
living in general households
are at significantly increased
risk of potential mental
health problems than their
non-disabled peers.
Adjusting for differences in
age, gender and socio-
economic position (e.g. if
poor, in a good job)
eliminated this increased
risk
79. People with learning disabilities often have worse health.
Health can be improved by improving daily life:
Enough money
Having work/a purpose
Better housing
More support and less bullying
80. A. Give
every child
the best
start in life
Children with learning disabilities:
• More likely to have poor bonding with
parent and harsh, inconsistent parenting.
• More likely to be poor
• Being poor associated with worse child
mental health and more risky health
behaviours, such as not exercising
enough, not eating healthily, and smoking
and drinking alcohol too much.
• British children second highest rate of
untreated tooth decay
• highest rate of never having had an eye
exam
81. What
works
• Three domains – action with children, action with parents
and action to improve the context in which children live. (An
Equal Start IHE 2012)
• Improve mothers mental health
• Reduce stress -
• improve income/reduce prices
• support social networks
• Better information and support for positive parenting.
• Building communication skills and ability to control
behaviour
• Specialised parenting programmes
PLUS…
Focus on basics – teeth brushing, diet, eye tests, exercise – all
still important.
82. Outcomes can improve
• Incredible Years programme with parents of 2-5 year olds with LD.
in negative parent behaviour (63% to 24% parents after 12 week sessions)
poor child behaviour (10% to 6% after programme).
• Triple P “Stepping Stones” parents and children aged 2-8 with LD.
significant positive impact on: parenting style, how parents feel about how well
they are doing and on relationship between parents and children
83. B. Enable all
children,
young people
and adults to
maximise their
capabilities
and have
control over
their lives: key
points
• Foundation level learning focusing on social and
emotional skills has been positive.
• Children and young people twice as likely to be on free
school meals
• Better outcomes for those with mild LD is possible
• E.g. Numbers achieving the expected level of
attainment in both English and Maths rose from
9% to 15%
• Bullying is a big issue.
• 83% of young people with learning disabilities
experience bullying.
• Bullying at school leads to poorer health in adults.
• Awful conditions in secure settings (a quarter of those
in secure settings have LD)
• High use of restraint
• High level of isolation
84. Regional differences provide an opportunity to learn from others……
Good level of Development (Age 5) and eligible for Free School Meals
Nearly seven out of ten children in Haringey, Lewisham, Bexley, Greenwich on free
school meals reach a good level of development by age 5
Just four in ten children in Stockton onTees, Blackburn and Darwen, and
Leicestershire reach a good level of development by age 5.
In London the gap in GCSE attainment between those on free school meals
and all children is half the size of the
gap in the South East..
85. What to
do?
• Maintain/build on strength of foundation level
learning
• Maintain improvements in subjects for those
with mild learning disabilities
• Reduce inequalities in outcomes by level of
poverty/types of jobs
• Eye exams and dentists – appropriate access
needed
• Effective anti-bullying interventions
• Reduce poverty
• Reduce restraint/isolation in secure
settings/move children closer to homes/more
early intervention to reduce numbers needing
to be in secure settings
• Improve clarity on best educational system –
best for results? Best for well-
being/happiness? What is the goal?
86. Work and
income
• Most of those with learning
disabilities want to work
• However only 6% do.
• Disincentives to look for non
existent work as would lose more
generous benefits.
• More likely to live in poverty
87. Good work may be different and this
could benefit employers – need a ‘sell’ to
push up demand
Capabilities will vary but
more than 6% can work.
More routine, repetitive
work may be appropriate
with little autonomy over
how tasks are completed.
A third of family carers of
adults with learning
disabilities are also not in
paid employment due to
their caring responsibilities
(PHE, 2014).
Need to recognise real
difficulties regarding
gaining work/income
generation for this group
and pay/ and support
appropriately.
88. A minimum income for
healthy living
JRF acceptable minimum income
standard 2016
In 2016, single people need to earn
at least £17,100 a year before tax
to achieve the MIS, and couples
with two children at least £18,900
each.
Incomes of working-age
households receiving out-of-work
benefits were far below MIS. Single
people could afford 39 per cent of
the budget and couples with two
children 61 per cent.
89. Outcomes can be better
In the state of Vermont, USA, a programme begun in 1983
had achieved a 48% employment rate in regular jobs for
people classified with ‘developmental disabilities’ by 2015
compared to a USA average of 19%
All paid at Vermont minimum wage or higher.
A 2015 survey showed 90 per cent of these workers enjoyed
their current job although just 52 per cent felt they were
able to work enough hours.
90. Discrimination
• Tackling discrimination is not explicitly in UK Marmot review
as key recommendation but picked up subsequently in
Euro/other country reports as important SD health.
• People with learning disabilities are more likely to suffer
discrimination, poor access to some health services and
worse employment prospects as a result of their disabilities,
all of which impact negatively on their health.
91. Improve data on effective interventions
A good (systematic) review of interventions to prevent violence against people with disabilities
concluded that the current evidence base offers little guidance to policy makers, program
commissioners, and persons with disabilities for selecting hate-crime prevention
interventions.
Consider developing new interventions and testing them
• Rounded whole package/household centred support
Given the importance of the few relationships those with learning disabilities have, it is
important that carers and family are supported in their role as care providers for those with
learning disabilities.
• Improve living conditions
Poor social determinants of health will exacerbate stress and so efforts to tackle
unemployment, low income and poor housing, alongside measures to reduce reliance on one
person should be considered.
• Widen and strengthen adherence to diversity legislation in non work/school
settings.
There is a clear need to design and test new interventions to minimise discrimination on
high streets and in public places, alongside tighter monitoring by the police and
publicity of cases that have successfully resulted in criminal charges appear to be
indicated.
What to do - discrimination
92. Isolation
and social
participati
on
• 50% of people with a learning disability
experience chronic loneliness, compared
to around 15-30% of people in the general
population
• As in the general population, loneliness
has been associated with health risks such
as depression and stress amongst people
with a learning disability, high blood
pressure and higher risk of death.
93. Ways forward
• Reduce bullying/more visability
• Teach people how to communicate with those with
learning disabilities/courses
• Recognise the chronic loneliness and centre care
around people not provision of services
• Signposting to groups/support by schools/GPs etc
94. The ‘Stay Up Late’ Campaign - active social lives for people with
learning disabilities.
On-line tweet campaign, with 16, 600 followers
Based on workshops about the freedoms that people with learning
disabilities want, conducted over a three year period, Stay Up Late have
drawn up a ‘Magna Carta’.
This sets out a range of freedoms –
- to choose support staff,
- to have happy support staff,
- to choose friends and have a social life,
- to choose where to live
- to have the right to have a relationship and a sex life.
Stay Up Late have helped set up a number of GigBuddies projects in the
UK, aiming to match people with learning disabilities who like going out
to mainstream gigs and events with volunteers who like the same types
of music
95. Next steps
• In scope
• Stakeholder group, editing and
finalising recommendations in context
of Marmot review
• Including setting out priority evidence
gaps
• Future possibilities
• Consider could be a work in progress,
possibility to have a hub/portal for
effective interventions
• Consider monitoring on annual basis
alongside Marmot indicators
• Clarify priorities for action and
funding streams
99. Why is it important?
2010 – IHAL review of the evidence shows that
health checks improve:
• the detection of unmet, unrecognised and
potentially treatable health needs (including
serious and life threatening conditions such as
cancer, heart disease and dementia)
• targeted actions to address these health needs
Recent study in The Lancet showed GP practices
in the ES had:
• increased rates of general and specific health
assessments
• increased identification of co-morbidities
• more health action plans and secondary care
referrals
100. What we know
• People with learning disabilities have poorer physical and
mental health than other people. This is not inevitable.
• The average age of death for people with a learning
disability is 65 for men and 63 for women. (Average age of
death of 78 for men and 83 for women in the general
population)
• 37% of people with a learning disability die from avoidable
causes, compared with 8.8% of the general population
• Only 49% of adults with a learning disability on the GP or
health register in England received an annual health check
in 2014-15
• Annual health checks can reduce health inequalities, but
not enough people with a learning disability get them
101. Evidence from ‘Being Disabled in
Britain’
• Increased hospital admission for
problems that should be
managed in community –
76/1000 for people with LD and
15/1000 for those without LD
• Low uptake of health promotion
and screening in people with LD
• Prolonged psychiatric hospital
stays for assessment and
treatment
• Over-use of psychotropic
medication as chemical restraint
102. Health problems for people with a
learning disability
• NHS Digital and Public Health England data (Gyles
Glover) – General Practice Extraction Service
• Covered 51% of all patients registered with a GP in
England = 127,350 people with a learning disability
103. Significant health problems for
people with a learning disability
• Obesity
• Epilepsy
• Severe mental illness
• Dementia
• Diabetes
• Gastrointestinal problems eg constipation, gastro-
oesophageal reflux disorder, dysphagia
• And many others
104. The Learning Disability Direct
Enhanced Service
Health checks
• Practices should invite all patients on the health check register for a
review of physical and mental health annually. As a minimum the health
check should include:
• A collaborative review with the patient and carer (where applicable) of
physical and mental health including: health promotion, chronic illness
and symptoms enquiry; physical examination; epilepsy, dysphagia,
behaviour and mental health and specific syndrome check
• Accuracy and appropriateness of prescribed medication checked
• A review of co-ordination arrangements with secondary care
• A review of transition arrangements (where appropriate).
• A review of communication needs
• A review of family and carer needs
• Support for the patient to manage their own health and make decisions
about the health and healthcare
105. What do we need to do?
• Ensure that everyone who has a learning disability of
any age, is on the GP learning disability register – see
Mencap ‘Don’t Miss Out campaign’
https://www.mencap.org.uk/advice-and-
support/health/dont-miss-out/dont-miss-out-annual-
health-checks
• Ensure that as many people aged 14 and over have a
health check each year.
• Ensure the health check is meaningful and of good
quality
• Ensure that everyone has a health-check action plan
106. Improving the quality of the GP
health check
The plan:
• Discuss the content of the health check at national level
with the General Practitioner Committee of the BMA
• Develop a National computer template for the health
check
• Develop guidance to go alongside the template – RCGP
step-by-step toolkit
• Develop guidance for carers about the importance and
specific aspects of the health check
107. The National Template
There is a summary and overview on NHS England
website -
https://www.england.nhs.uk/wp-
content/uploads/2017/05/nat-elec-health-check-ld-
clinical-template.pdf
108. The template
• Has a practice nurse
section
• Has a GP section
• Can automatically
produce an
easy read health-check
action plan
110. The practice nurse section of the
template
• Support and patient
information
• Immunisation
• Allergies
• Reasonable adjustments
and communication needs
• Functional life skills
• Lifestyle and health
promotion
• Screening
• Vision, hearing, dental
114. Summary Care Record with
Additional Information
• Specifically included on
template
• This means that the GP can
make information available
to others such as doctors in
hospital.
• https://digital.nhs.uk/media/
1175/Easy-read-SCR-
additional-information-
leaflet/pdf/scr_easy_read_pa
tient_leaflet_additional_infor
mation
116. The final message!
• We all have to work together
• People with a learning
disability and their carers
understand the benefit of the
health check
• People are proactive in asking
for a check
• GP practices are well organised
to make it work for people
• The health check action plan is
meaningful
• Community learning disability
teams support the process
117. Thank you for listening!
Resources:
• https://www.england.nhs.uk/learning-disabilities/
• RCGP Step by Step guide - http://www.rcgp.org.uk/clinical-and-
research/toolkits/health-check-toolkit.aspx
• National Learning Disability Health Check -
https://www.england.nhs.uk/gp/gpfv/investment/gp-contract/
• Summary Care Records -
http://webarchive.nationalarchives.gov.uk/20160921135209/http://s
ystems.digital.nhs.uk/scr/additional
• Mencap ‘Don’t miss out” - https://www.mencap.org.uk/advice-and-
support/health/dont-miss-out/dont-miss-out-guides