Using a person-centred approach to undertake basic healthcare screening – including blood testing – for people with a learning disability has helped identify and treat previously undiagnosed underlying health issues. Warren Cocker, Charge Nurse at Wast Hills, part of the Danshell Group, explains how this individually-focused programme, which has been shortlisted for two national awards, has had a positive impact on people’s health and wellbeing.
It is well-known that people with a learning disability can struggle to access primary healthcare facilities, which can mean they are at higher risk of unidentified health concerns that affect their physical and mental wellbeing. Recently CIPOLD (Confidential Inquiry into Premature Deaths of People with Learning Disabilities) highlighted issues with the timely diagnosis and treatment of people with a learning disability which, in some cases, has resulted in premature death.
It was these health inequalities that we wanted to focus on, with the aim of increasing the number of people taking part in physical health screening, including blood tests. Our aim was to reduce the number of individuals living with unidentified health issues.
To help improve prompt and accurate diagnosis, it is vital that blood tests are carried out and their results used to implement treatment plans. Blood tests are also an important tool in monitoring medication side effects.
We recognise however, that it can be difficult for these tests to be carried out due to a person’s increased anxiety, difficulties around communication and the fact that tests may have to be carried out in unfamiliar surroundings and by unfamiliar people.
We wanted to create a person-centred environment for the people we support where these tests were done in a place they were familiar with, and by a person they knew and trusted, at a time which was best suited to them. It had to be flexible around each individual and their day-to-day mood and health fluctuations too.
I undertook a phlebotomy course and worked in a person-centred way to support people and assess their needs. Over a six-month period the team and I were able to ensure everyone at Wast Hills had a blood screening by conducting these in-house.
The Public Health England paper “Blood tests for people with learning disabilities: making reasonable adjustments” indicates in its conclusion that sedation, although as a last resort, can be used.
However, with the correct person-centred support in place, we were pleased that in our experience this was not necessary. Individuals were supported in a variety of ways during the process, depending on individual need, working from no intervention at all through to providing simple verbal reassurance or to physically supporting people in the least restrictive way possible.
The results have found that some people’s iron levels were low, with 25% suffering with anaemia, which we were able to treat immediately. This is significant as someone who may have been lethargic because of anaemia but wasn’t able to communicate that has seen an improvement in wellbeing and overall quality of life. As a result of the blood tests, one person was admitted to hospital following concerns over his renal function.
Overall, 30% were found to require medical treatment of some form on receiving the blood test results. These conditions may otherwise have gone undetected and may have led to further health complications for those people. Our initiative shows that a person-centred approach and a willingness to break down barriers to health equality can lead to a greater quality of life for the people we support.
