Learning disabilities: help to build the right support

Physiotherapists working with people who have a learning disability always advocated access to mainstream physiotherapy for our service users. However, patients are still being marginalised when it comes to accessing good mainstream NHS healthcare. 

 

In 2011, shocking undercover reports of abuse at Winterbourne View hospital, Gloucestershire, prompted widespread calls to transform care for people with a learning disability and/or autism who display challenging behaviours. 

 

Last month, NHS England published its national plan, Building the right support. This lays out plans to develop community services for people with a learning disability and to close inpatient hospital beds. (A reminder of the 1980s and 1990s, when large institutions were closed).

 

The national service model that will put the new NHS England plan into practice has nine principles. The key one for physiotherapists is Principle 6.

 

Enshrined in this principle is the expectation that people with a learning disability will access mainstream health services. Where necessary, they will be supported in doing so by specialist learning disability teams. 

 

Mainstream health services are required, under the Equality Act, to make ‘reasonable adjustments’ to facilitate access for people with a learning disability. Mainstream physiotherapists will no longer be able to hand over a referral to the learning disability team, just because the person has a learning disability.

 

Each acute hospital should have access to a learning disability acute liaison nurse, so find out who this person is in your hospital. These people have specialist knowledge enabling them to advise you on making reasonable adjustments. 

 

Also, the community learning disability team (CLDT) will be able to help you and in some cases support the service user with any ongoing physiotherapy programme. Where is your team based?

 

Within the next few months the Association of Chartered Physiotherapists for People with Learning Disabilities (ACPPLD), with support from the CSP, will launch an information leaflet called 'So your next patient has a learning disability'. 

 

This provides some helpful hints on how to plan and deliver your treatment session. It underlines the need to assess the patient’s capacity and gain consent, and shows how to get the best out of each session.