The Voluntary Organisations Disability Group (VODG), National Development Team for Inclusion (NDTi) and National Care Forum (NCF) has launched a new report describing how providers use the health charter in practice. The report is accompanied by refreshed guidance.
With well over 100 organisations now signed up to the health charter, this practical guide is based on the learning of 20 organisations who have been actively using the charter to improve support provided to people with learning disabilities and directly address health inequalities.
People with learning disabilities not only have worse health than the general population; they die younger than their non-learning disabled peers. Many of these health issues are preventable. These issues led to the launch of a health charter for social care providers in 2014, designed to improve the well-being of people using their services.
Speaking at the launch of the report, Dr Rhidian Hughes, VODG chief executive, said:
“We are encouraging learning disability providers to sign up to the health charter and to play their part in tackling health inequalities. Organisations and their staff have a vital role to play in promoting health and wellbeing and making it easier for individuals to access services. As more providers and staff adopt the principles and checks contained in the charter there is a better chance of closing the health inequality gap experienced by people with learning disabilities”.
Sue Turner, learning disability lead at NDTI commented:
“It is really important that health and social care commissioners and providers work in partnership with people with learning disabilities and families to address health inequalities. A partnership approach underpins the charter, and the report contains some excellent examples from practice, that could be replicated everywhere. We need to stop people dying as a result of basic errors in physical health care monitoring, and failures to implement the Mental Capacity Act when making decisions about issues like healthcare, diet and behaviour”.
Des Kelly OBE, executive director of the National Care Forum added:
“Care providers and their staff have an important role in supporting people with learning disabilities to lead healthy lives and access healthcare services in timely ways. The charter, and the resources that underpin it, have been developed and informed through co-production and partnership. We will be encouraging providers to make full use of them to improve individual well-being and health”.
Copies of the report and updated health charter are available to download: http://www.vodg.org.uk/health-charter/health-charter-home.html
Contrasting case studies
The importance of the health charter is demonstrated in these case studies.
Names have been changed to preserve anonymity.
When Brenda was admitted to hospital her notes on admission described her as“mute, aphasic and having learning difficulties.” A plan was made to stop treatment and return her to the nursing home for ‘TLC’ (tender, loving care).
The home manager disagreed, as did Brenda’s GP. The manager reported to the CIPOLD review that she had to insist on the Mental Capacity Act being followed and a best interest meeting being held, explaining to doctors that ‘just asking the relatives would have been illegal’.
A meeting was held that afternoon, attended by hospital doctors involved, the home manager, hospital learning disability liaison nurse, and four members of Brenda’s family. Treatment was resumed as a result of the decisions, Brenda improved within 48 hours, was discharged a couple of weeks later and lived for more than another year before dying peacefully at home.
Contrast this with Frances’ case.
The agencies attending Frances when she became acutely unwell did not think “capacity” should be reassessed under new circumstances. Frances refused to go to hospital; paramedics established she had been assessed as having the capacity to make this decision and decided they were powerless to act.
The following morning it was apparent that Frances needed urgent life-saving medical attention, but she was still refusing to go to hospital. The attending GP did not reassess her capacity, but relied on her previous mental capacity assessment when she was less critically ill. It was not until she collapsed several hours later that she was taken to hospital and received surgical treatment, but she did not recover.
Frances died two weeks later.