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'In a bad week for the learning disability sector let’s not ignore all the good work'

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I had intended to write a purely positive piece this week on about innovative work being done for patients with learning disabilities by nurses in Liverpool hospitals. 

But I have subsequently found that it’s likely to be a tough few days for all concerned in the world of learning disability nursing, so I’m afraid it’s not all good news.

On Tuesday, the Care Quality Commission called for action to fix the “broken system” that leads to people with learning disabilities or autism being segregated in hospital.

In an interim report the regulator said there should be an independent review of all patients held in segregation in mental health wards for children and young people and wards for those with learning disabilities or autism.

The health secretary, Matt Hancock, responded by agreeing to the move, admitting that he had been “deeply moved and appalled by the distressing stories”.

Much of the report dealt with the fault of the system, the inevitable lack of funding and insufficient training and skills among hard-pressed staff left in potentially dangerous situations.

Of course these are problems that need to be both uncovered and addressed through concerted action, backed by appropriate financial support. Patients and staff deserve nothing less.

Unfortunately, something less palatable is on the horizon. The next episode of the BBC documentary series Panorama, titled Undercover Hospital Abuse Scandal, is set to air tonight at 9pm.

The blurb on the BBC website promises that the programme will reveal “shocking footage” of patients with autism and learning disabilities being “mocked, taunted and intimidated by abusive staff”.

It also notes that the Panorama investigation comes eight years after the programme exposed the scandal of abuse at Winterbourne View, which was followed by government promises of reform.

If the new programme turns out to have anything like the same impact as the one on Winterbourne View, then everyone working in the learning disability sector needs to prepare to feel the uncomfortable spotlight of the media and those concerned with health policy.

However, this is in complete contrast to the examples of care innovation presented at a breakfast fringe event I co-hosted with NHS England yesterday at the Royal College of Nursing’s annual congress in Liverpool.

“Poor care, like that expected to feature in Panorama, should be exposed and addressed quickly”

The 80-plus delegates packed into the room heard about the work being done by learning disability nursing teams to help patients being cared for in acute settings at Royal Liverpool and Broadgreen University Hospitals Trust and Alder Hey Children’s Foundation Trust.

For example, the efforts of liaison nurses to improve care through the use of health passports have reduced the median length of stay for patients with learning disabilities or autism from 6.5 days in 2016-17 to four in 2018-19. Not only has this saved 1,375 bed days, but it has reduced the time patients spend in what is often for them a particularly distressing environment.

Poor care, like that expected to feature in Panorama, should be exposed and addressed quickly – any staff found to be negligent or abusive dealt with by the appropriate bodies. But I suspect such examples are often partly the result of the systemic failings highlighted by the CQC.

I can only hope is that such examples are the exception rather than the rule, and that the positivity, innovation and desire to improve care on show in my fringe event provides a more representative picture of the care provided to this vulnerable group of patients.

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