At the practice, find the best way to communicate, picking up on non-verbal communication. For example, look at facial expressions, gestures and body language. Keep information simple and brief.
Avoid using jargon. Consider working with national or local groups to establish a procedure that establishes the best way to work with people with a learning disability. Ask if a health action plan exists.
Check how many people with learning disabilities are registered with the practice. If your practice has a high number of people with learning disabilities, then you may want to join a scheme to work with a primary care learning disabilities facilitator. Listen to family carers and support workers to highlight particular access needs.
Train staff to offer the maximum, appropriate help. A person with a learning disability may have difficulty with crowds, lack of space and long waiting times. Not understanding the social conventions of reception and waiting rooms may cause distress.
Consider offering them one of the first appointments of the day or one at a quieter time. Think about offering double consultation times or booking an appointment on the hour (which might be easier for the patient to remember). Some patients may need encouragement to speak up and explain why they need a consultation.
This will help the GP or other clinical professional ensure that they have a full picture. If there is a requirement for more than one type of consultation (eg with a doctor and a nurse), you should co-ordinate the appointments so that the patient only needs to make one visit.
Speak to the person first and only then check with the carer if something is unclear. Be sensitive to the person’s feelings and be encouraging. Ask open questions or change the question round to check if you get the same response.
Don’t assume that the person has understood a particular fact or piece of information. Check whether someone needs help to find their way around the surgery. Ask what help is required and try to provide it. If necessary, guide the patient from the waiting area to the consultation room.
Don’t just leave them at the door, but introduce them to the doctor so that they feel secure and welcomed. If a consultation is delayed, offer an explanation; otherwise the patient may get anxious and agitated.
Provide information in an appropriate, agreed format. Consider the patient’s needs first. Check how they wish to receive information. Should it be sent to them or to a carer or family member?
Be aware of any additional medical conditions, such as poor sight, when providing or sending out information. Consider working with the local Community Learning Disability team or Patient Participation Group to develop formats for standard letters. Do not assume that a patient can or cannot use a particular format such as the phone. Check with the patient first.
Staff may not always know the best way to communicate with and support people with learning disabilities.
Link with local groups and societies to work out a plan for training and keeping staff knowledge up to date. Seek a champion from your team to lead on this aspect of the work.
Consider compiling a folder or checklist for staff, including pictures for patients to point to if they cannot explain in words. The website www.easyhealth.org.uk has a vast number of accessible leaflets for people with learning disabilities and healthcare staff. Stay calm and don’t rush the patient; they may get flustered or upset.
Link to other awareness training such as hearing or sight loss awareness training. Consider providing a general awareness training exercise for all your patient-facing staff. Explore opportunities for rewarding and publicising extended training through national vocational qualifications, certificates, local newspaper features and photographs in the surgery, etc. Remind patients to help staff by being clear about how they wish to receive information. Ask them to communicate what help and assistance they require.
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