Released 23 May 2024
Request:
Since the beginning of 2019/20 until the end of 2023/24,
Total quarterly counts for each trust of patients attending type 1 A&E departments.
Please break this down by:
- Number of patients from their time of arrival until transfer, admission, or discharge (length of stay), broken up by how long they waited in one-hour intervals (so xx patients between 0-1 hours, xx between 1-2 hours and so on).
- Admitted or non-admitted patients.
- Whether or not classified as a patient with learning disabilities.
Please split this data by quarter.
Please could you also outline: - How many FTE learning disability liaison nurses are employed by the trust, and are there plans to hire more? During which hours are the learning disability nurses available?
- Do you have a policy or process on how to support people with a learning disability in A&E? If so, please share.
- What reasonable adjustments do you commonly make to accommodate patients with learning disabilities in A&E?
7. Do you participate in the Learning Disability Improvement Standards Benchmarking Survey? If so, please provide a copy of your response.
Information disclosed:
1-3. Please see attached pdf “FOI240078 Response data” for information relevant to these questions.
4. There are currently 4 Learning Disability Nurses employed in hospitals across the Trust, with cover provided by nurses from Sussex Community NHS Foundation Trust when necessary. We can confirm there are plans in place to hire additional staff into this role. Learning disability nurses are available between 9-5.
5-6. When a patient presents in A and E and staff are aware they have learning impairments, where possible staff will look to identify an area in the department that is quieter and where possible will make a side room available depending on the risk assessment made on arrival and the acuity of the patient’s medical needs.
For patients with learning disabilities or those with heightened anxiety due to mental health presentations, staff will contact the relevant teams (e.g. Learning Disabilities Liaison team) to see the patient and to also support A and E staff to ensure they are providing the right level of care. Also, where possible staff will allocate a healthcare support worker to support the patient.
If staff know they can get the patient seen and treated quickly and it is in the patient’s best interest, they will prioritise the patient in order to reduce the amount of time they need to spend in the Department to help reduce their anxieties.
The Trust’s Learning Disabilities Liaison team are often alerted by practitioners in A and E about the presence of someone with a learning disability. They advise on issues around communication, reasonable adjustments, capacity, etc. depending on the individual needs of the patient. Reasonable adjustments are individual to each person, but may include being seen more quickly (if possible), having someone they trust to provide support, a quieter environment or use of specific communication methods.
The Learning Disabilities Liaison team advise/liaise with the patient and those who know them well to find out how they can manage the attendance to make it as stress free as possible. If there is capacity, this team will visit the patient to support them directly. This team also promotes the use of hospital passports and the importance of these. They also have care bags available, which have items for distraction, engagement and managing within the environment (such as ear protectors and mask). These are provided when appropriate and are for individuals own personal use and to take home.
The Trust’s Learning Disability clinical team advise and liaise with appropriate support/family/professionals in the community. Where there is no one who can provide support, they advise on whether the use of an independent advocate is appropriate.
Additional information about the Trust’s Learning Disabilities Liaison team and the support they provide can be found on our website.
Further information about My Care Passports can also be found on our website.
The Health and Care Act 2022 introduced a requirement that regulated service providers must ensure their staff receive learning disability and autism training appropriate to their role. The Oliver McGowan Mandatory Training on Learning Disability and Autism is the standardised training that was developed for this purpose and is the government’s preferred and recommended training for health and social care staff.
The Oliver McGowan Mandatory Training on Learning Disability and Autism is named after Oliver McGowan, whose death shone a light on the need for health and social care staff to have better training. This training is currently available via the Trust’s IRIS training system and is mandatory for all those who are employed and volunteer at University Hospitals Sussex NHS Foundation Trust.
There are two tiers of training in the Oliver McGowan training:
Tier 1 is for people who require general awareness of the support autistic people or people with a learning disability may need. This is mandatory for all non-clinical staff.
Tier 2 provides more detailed learning for those who may need to provide care and support for autistic people or people with a learning disability. This is mandatory for all clinical staff.
Both tiers have two parts to the training:
The first part for both tiers 1 and 2 is the e-learning module which has been available for all staff on IRIS since 1st July 2023
The second part is interactive and includes:
A 1 hour online interactive session co-delivered by experts with lived experience and a facilitating co-trainer.
A 1 day face to face training co-delivered by experts with lived experience and a facilitating co-trainer.
This training is currently commissioned by NHS Sussex Integrated Care Board and the second part of the training will be made available in due course, but we do not have any further information about the timescale or content at this time.
Additionally, the Trust publishes specific information on our website relating to how we apply the Accessible Information Standard, including guidance for patients and visitors with learning difficulties and disabilities. The Trust also involves representatives of patients and visitors with learning disabilities and autism in the development of service changes, including through engagement events and by using patient feedback through the national surveys and the local ‘friends and family test’ survey. This is included in reports to the Trust committees to ensure the voice of patients is available at strategic decision making level.
7. University Hospitals Sussex NHS Foundation Trust has been in operation since 1 April 2021, following the merger of Brighton and Sussex University Hospitals NHS Trust and Western Sussex Hospitals NHS Foundation Trust. We can confirm the new Trust has not taken part in this survey since its formation, however, we intend to participate this year.