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Why we must learn to listen – Dr Dominic Slowie

The theme of this year’s Learning Disability Week, ‘Hear My Voice’, both reminds and challenges us how necessary it is to hear the voices of people with learning disability.

We must also listen to the voices of their families and carers because they know better than anybody if care is working for them and meeting their needs.

So when we are working to improve quality of care for this vulnerable group the most efficient place to start is to ask the people using the services what is working and what isn’t.

There are several individuals and groups representing people with learning disability and we have been engaged with many of them who have provided valuable perspectives and challenge. This has enabled the right focus and prioritisation of our work.

This week sees the launch of NHS England’s Learning Disability Forum which will bring together in one place all of the voices that we need to hear as our work gains further momentum.

As Jane Cummings will outline tomorrow, our work on Transforming Care for individuals, who have behaviour described as challenging or mental health problems, is ambitious, deliverable and will be catalysed by the five fast-track areas that were announced by Simon Stevens at the NHS Confederation conference.

This work will build on the momentum already established over the last 18 months to improve the lives of all those with learning disabilities, which is an estimated at around 1.2 million people.

As far back as 2007 we had evidence that people with Learning Disability do not always receive reasonably adjusted care in Acute and Primary Care settings. Recommendations by Sir Jonathan Michaels in 2008 to minimise ‘diagnostic overshadowing’ are only partially implemented and there is incomplete confidence that the six clinical quality criteria on learning disability outlined in Monitor’s Risk Assessment Framework are met as intended.

In response to this I have been working with senior colleagues at the Care Quality Commission and we have agreed to include consideration of the care received by people with learning disabilities in all Acute Trusts and Primary Care settings. This has been happening for a year and is already having a positive impact.

To further support hospital staff to consider the needs of people with learning disability we are, this week, distributing pens to frontline NHS staff with a pull out strip of ’10 top tips’ for caring for people with learning disability of all ages. These will arrive in every Acute Trust in the country and will give people useful reminders of simple things they can do that will make a difference.

Finally, we recognise that there are many determinants of poor health outcomes and in the Five Year Forward View we are committing to be as concerned about preventing poor health as we are about treating it. Only seven per cent of people with Learning Disability have paid employment despite Project Choice and other schemes demonstrating the benefits to individuals and organisations of employing people.

Sir Michael Marmot has led research pointing out the impact of the lack of paid employment and other factors have on health. It is for this reason, and in response to challenge from people with learning disability, that the Equality and Diversity Council in NHS England has produced a strategy to make NHS England a model employer of people with Learning Disability by 2017.

We are in an exciting time of transformation in the NHS for a vulnerable population who have felt undervalued and not listened to for far too long.

We are investing so much effort in this because we believe that the health and strength of our NHS can be measured by how we treat out most vulnerable patients. If we know we are delivering good outcomes for people with Learning Disability then it is probable that we are delivering good outcomes for all.

  • For updates on Learning Disability Week follow #LDWeek15

Dominic Slowie, National Clinical Director for Learning Disability

Dominic Slowie is the National Clinical Director for Learning Disability for NHS England.

He established and has chaired the North East and Cumbria Learning Disability Network which was established in 2010 and continues as part of the networks and senate hosted by Cumbria, Northumberland, Tyne and Wear Area Team. The network has been responsible for a number of improvements in the care that people with learning disability receive in a number of healthcare settings.

He is passionate about improving the experiences of health for people with learning disability and is convinced this can only be done effectively through health and social care working seamlessly for the people who need their help.

Dominic is a GP by clinical background, qualifying from Newcastle University in 1991, and continues his clinical work three sessions a week.

He was a senior medical tutor at Newcastle University Medical School and continues to provide a small number of lectures annually using the innovative approach of ‘Operating Theatre’ a professional theatre company that uses stories to challenge and change perspectives on health.

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