Following 2gether (2G) NHS Foundation Trust's new Learning Disability pathways we have worked together to create this pathway on referral into the Learning Disabilities (LD) Service.
Community LD Services include:
All Teams seek to work closely with mainstream health services as well as the wider support networks for people with Learning Disabilities.
Reviewers are always needed for the Learning Disabilities Mortality Review Programme (LeDeR). Please email firstname.lastname@example.org or telephone 0117 3310686 for further information.
Please click the relevant flowchart box to to be taken directly to textual information
Definition of learning disability
A person is identified as having a learning disbaility and being eligible to receive a service if all three of the following are present:
(The British Psychological Society, 2016)
Learning difficulty as opposed to Learning Disability?
Some people have specific learning difficulties which do not result in the depth and breadth of intellectual and other difficulties required for the diagnosis of a Learning Disability. Common example of specific learning difficulties include dyslexia and ADHD. Similarly someone with Autism can have normal high intellectual function combined with problems with social skills- These profiles would not meet the criteria for a Learning Disability.
Health Issues vs Learning Disability
People with a Learning Disability are prone to greater health issues than the general population but there is a history of people with a Learning Disability receiving sub-optimal health care- in part as a result of access issues but also as a result of diagnostic overshadowing. It is important to understand how the individual with a Learning Disability normally presents. Changes from 'their normal' may be indicative of an underlying health concern.
Communication difficulties and the potential for diagnostic overshadowing when people do use services mean preventative care and health screenings become particularly important in this population.
People who know the individual well can help understand what is usual for the person. They may also help with communication in the assessment phase.
The LD Service will work with potential referrers to facilitate appropriate referrals. This could for example take the form of discussion by telephone prior to any referral being made. The service is commissioned to access within 4 weeks and intervene within 18 weeks per the NHS Constitution. It is not an emergency service although efforts are made to be responsive within 2 or 3 days when necessary. If you feel someone needs to be seen urgently please telephone the CLDT in your area to discuss. (See below for contact details)
The Service is open to any adult with a diagnosis of learning disability who:
Also the Service monitors people with Downs syndrome because Downs is associated with early onset dementia. If someone has Downs syndrome, is not known the the CLDT, and they are aged 30 or over, please alert the Service.
Referrals will be made by GPs or by the Joint Commissioner for Learning Disabilities for patients who have never accessed the service.
Patients who have previously been on the CLDT caseloads can self-refer back into the service/ be referred back by their carer or care provider.
If uncertain please contact the CLDT covering your locality to discuss the potential referral:
The flowchart refers to specialist LD care-pathways. We have developed a number of these for internal use. Current Pathways are named below. Service-users will be allocated to one or more Pathways according to their individual need.
Annual Health Checks remain a Direct Enhanced Service (DES) that is designed to improve Healthcare for people with LD. The new DES is due to be associated with software that enable the printing off of a Health Action Plan following a health check.
My Health Book- produced by the Health Facilitation Team. This A5 book is a tool and foundation for producing person centred Health Action Plans making sure all the facts about health are in one place where they are safe and can be easily found.
Hospital and Community Traffic Light Assessment Form- produced by the Health Facilitation Team. It is a grab sheet that can accompany a person with a learning disability into a community or acute hospital, whether planned or emergency admission. It can be kept with a patient's Health Action Plan.
|Jonathon Cash||Head of Trust Psychological Services and Psychological Services LD||2gether NHS Foundation Trustemail@example.com|
|Simon Shorrick||Strategic Health Facilitator, Learning Disabilities||2gether NHS Foundation Trustfirstname.lastname@example.org|
|Crispin Hebron||Non-Medical LD Consultant||2gether NHS Foundation Trustemail@example.com|
|Jan Hoskins||Learning Disabilities Clinical Case Manager||Gloucestershire Clinical Commissioning Groupfirstname.lastname@example.org|
|Iain Jarvis||GP||Gloucestershire Clinical Commissioning Groupemail@example.com|
|Zain Patel||Commissioning Manager, Planned Care, Care Pathways||Gloucester Clinical Commissioning Groupfirstname.lastname@example.org|
|Cheryl Hampson||Outcome Manager-Learning Disabilities Health||Gloucestershire County Council||Cheryl.Hampson@gloucestershire.gov.uk|
Following 2gether NHS Foundation Trust's new Learning Disability pathways we have worked together to create this pathway on referral into the LD service. All teams seek to work closely with mainstream services as well as the wider support networks for people with Learning Disabilities.