NHS England: How one Yorkshire Trust eliminated the elective care backlog for people with a learning disability

Summary

An NHS Trust in Yorkshire is leading the way on work to narrow inequalities in waiting lists, including clearing the backlog of people with a learning disability waiting for elective care.

Content

Evidence shows that people with a learning disability have poorer health and experience greater and persistent healthcare inequalities including premature mortality. The 2021 review, Learning from lives and deaths – people with a learning disability and autistic people (LeDeR), reported disparities in avoidable medical causes of deaths between those with a learning disability and the general population. LeDeR reports have also highlighted that a third of deaths of people with a learning disability were from treatable medical causes.

To help address this gap, senior leadership at CHFT made a commitment to improving the lives of people with a learning disability and have embedded a range of initiatives to ensure equitable access, experience and outcomes for this under-served group.

Dedicated sessions on all aspects of living with a learning disability were delivered to the board and an enhanced task and finish group was established to take forward learning disability priorities within the Trust with support from those with lived experience.

Adopting a data driven approach, the trust developed and implemented a range of tools to identify those with a learning disability, understand their experiences and monitor the difference being made. This included a flagging system within patient records, a learning disabilities data dashboard and a data model offering comparisons against the general population. A deep dive into patient journeys, from point of referral to treatment, was also undertaken as were audits on the reasonable adjustments made by the trust, cancer data and missed appointments. The trust also looked at information on readmissions, length of stay and mortality for people with a learning disability. This enabled them to identify areas for targeted action which included prioritising people with a learning disability who were waiting for surgery. Part of this involved partnership work with a private special needs dental service to restart theatre sessions and increase capacity to reduce the backlog on waiting lists.