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Bowel screening project improves learning disability patient referrals

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Low bowel cancer screening rates among people with learning disabilities are being tackled by a new programme in Wigan, which aims to improve awareness about the condition.

The scheme, which launched eight months ago, has seen an increase in referrals to Bridgewater Community Healthcare Foundation Trust’s adult learning disability team for support in understanding the condition.

Pictorial booklets and one-to-one education sessions were developed by the team alongside the Greater Manchester Bowel Movement campaign and charity Bowel Cancer UK.

“When invites or screening kits are sent out patients either do not understand the instructions or are anxious about the process or even too embarrassed to participate”

Ian Spurr

They have been designed to promote healthy eating and provide information on the symptoms of bowel cancer. Two types of session are offered - one aimed at patients and the other for carers, who receive more in depth information.

Andrew Hogg, an assistant practitioner at the trust who helped develop the materials, said: “The training can be tailored to support the person’s level of understanding and includes information on the digestive system, diet, fluid intake and bowel movements.

“Since we started promoting this additional support we have seen an encouraging rise in referrals for this type of support to our team.”

Rates of bowel screening for people with learning disabilities in Wigan is around 11% for those aged 60 to 74, much lower than the 50% national average across the whole population.

“Since we started promoting this additional support we have seen an encouraging rise in referrals for this type of support to our team”

Andrew Hogg

Ian Spurr, a senior nurse within the adult learning disability service who manages the teams delivering the scheme, said the low uptake was often down to the fact patients don’t understand the information sent to them.

learning disability bowel screening

Betty Charlesworth, who took part in Wigan’s bowel screening project

“When invites or screening kits are sent out patients either do not understand the instructions or are anxious about the process or even too embarrassed to participate or seek support.  These patients are then not routinely followed up and consequently it is never identified that the person may require extra support,” he said.

He added: “Consent has also always been a big issue with learning disabled patients as many patients are presumed to not be able to consent for themselves, so either they are bypassed completely or carers are asked to consent/dissent on their behalf.

“This is in contradiction to the Mental Capacity Act that states that a person must be assumed to have capacity unless it is established that he lacks capacity.”

Mr Spurr said he expected the success of the project so far to result in improved screening rates and noted another trust in the region had already approached the team for advice on how to introduce it in their area.

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