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The time has not yet come to stop talking about hospital passports

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Hospital passports are written about a lot in the learning disability field, so this is a blog that I wasn’t going to write.

However, three potentially serious incidents in the last three months has made me realise that we still have a lot of work to do in raising awareness of what they are and how they can benefit people with learning disabilities and/or autism as well as the individuals providing their care. 

Hospitals can be scary places, but for somebody with a learning disability they can be absolutely terrifying. Imagine being placed in an alien environment where no one can understand you, you can’t understand anybody, and people keep turning up at your bedside wanting to poke, prod or insert needles in to your body without you being able to fully understand why. This is the reality for some people with learning disabilities.

To overcome some of these barriers some hospitals employ acute liaison nurses who specialise in ensuring that people with learning disabilities have their needs met while they are in hospital. Unfortunately, there are nowhere near enough liaison nurses in practice and they generally aren’t available 24 hours a day.

If used correctly, a hospital passport can be a vital tool in delivering safe, person-centred care and ensuring that people with learning disabilities have the best possible experience while in hospital.

”While they do not cover everything, they provide a good overview of the important information that will need considering during a stay in hospital”

We are all complex individuals with specific likes, dislikes, needs and interests; this is no different for people with learning disabilities, except of course for the barriers that people may have in communicating their needs.

Hospital passports are the closest thing we can get to an ‘instruction manual’ as they are written in conjunction with an individual, their families, carers and friends, and contain essential information about a person’s preferences, health, social and communication needs.

While they do not cover everything, they provide a good overview of the important information that will need considering during a stay in hospital.

Unfortunately, hospital passports are still a mystery to some people and they are not always used correctly.

Over the last three months I have experienced the difficulties that can arise, and I have witnessed: passports being lost as a person moves to a different ward; passports being filed without being read; passports not being accessible (ideally, they should be placed at the end of a patient’s bed); as well as staff not having the time (or inclination) to read them.

This is a safety issue, and if an individual enters hospital with a hospital passport then it should not be seen as an ‘optional extra’ and more accountability is needed with regards to reading and sharing the information they contain.

The information contained in a hospital passport is not just for nurses but for everybody involved in care delivery; the information contained is as relevant to healthcare assistants as it is to senior consultants.

People with learning disabilities are entitled by law to ‘reasonable adjustments’ to their care based on their individual needs – how can any adjustments be made if an individual’s needs are not known?

It would also be true to say that people with learning disabilities sometimes need to have decisions made in their ‘best interests’ under the Mental Capacity Act – how can this be truly possible without a knowledge of their methods of communication and their likes, dislikes and preferences? 

We all have a responsibility to provide safe, high-quality, person-centred care, and just by having an understanding of hospital passports and raising awareness of them to others can go a long way to improving care for people with learning disabilities.

If you are interested in learning more, or even thinking of becoming an advocate for people with learning disabilities, why not consider becoming a ‘learning disability champion’?

Many universities are now offering students the opportunity to sign up for extra training to raise awareness of the needs of people with learning disabilities in healthcare settings.

If your university doesn’t offer this, why not ask them why? Or even better, offer to help develop a programme within your cohort or your university.

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