Covid-19 update

Tips for successful remote consultations with patients with additional needs

To make consultations with patients who have additional needs, such as learning disabilities, as successful as possible, it can be hellpful to:

• Allow more time for them
• Check regularly that the patient is finding the consultation helpful
• Consider whether other forms of communication would be more suitable
• Augment the consultation with written material and follow up via email
• Have family members or carers present
• Apply a lower threshold for a comfort follow-up call the next day than you would normally.

See the downloads section (click on show more) for easy read advice on coping with Covid-19, staying safe and staying at home, for both those with learning disabilites and their carers. Mencap has also produced easy-read advice explaining about Covid-19.

20 May 2020: Legal guidance for mental health, learning disability and autism has been issued by the government concerning the impact of the Covid-19 outbreak on the use of the Mental Health Act (MHA) and supporting systems to safeguard the legal rights of people receiving mental health, learning disability and autism services, including specialised commissioned services. It includes additional sections on the use of the Mental Health Act code of practice during the pandemic period, escorting patients detained under the Mental Health Act, and on the use of digital technology to support remote Mental Health Act assessments. It will be regularly updated to reflect the rapidly changing context and questions/concerns as well as feedback from the sector.

7 May 2020: Additional guidance covering monitoring aspects of ADHD and oral antipsychotic drugs during the Covid-19 outbreak has been released. The documents on antipsychotics and  ADHD can be accessed via the North Central London (NCL) Joint Formulary Committee (JFC) website.

The NCL document Guidance on the Management of Drugs Requiring Monitoring during Covid-19, hosted on the NCL Covid-19 website, has also been refreshed to include links to the above guidelines.

7 May 2020:  Covid-19 is affecting vulnerable people’s ability to access medical care and increasing their risk of exploitation and abuse. The Central North West London Integrated Sexual Health Service has said  it will prioritise access to advice, information, testing and treatment to vulnerable and hard to reach groups and the organisations that support them. The service continues to have lots of capacity for telephone consultations and is also able to offer limited face-to-face appointments and a walk-in service for those in need. 

The team of nurses, doctors and safeguarding advisers are available to offer support to patients and professionals.

t: 020 3317 5252 (Mon-Fri 9am-5pm)

Useful information

Easy-read patient information leaflets on a variety of conditions and medications can be accessed via the EasyHealth website. The Royal College of Psychiatrists also has resources and leaflets available for people with learning disabilities in easy-read format and for their carers and clinicians. This includes information about capacity and consent.

NHS England has produced a series of leaflets to help families and carers of people with a learning disability know the signs of constipation, which can have fatal consequences more often in this group than in the population as a whole, and what to do if you think someone is constipated.

Initiatives to stop over-medication

STOMP and STAMP are initiatives to stop over-medication and support appropriate treatment in children with learning disabilities. This leaflet provides information on STOMP and STAMP to help families become more involved in discussion regarding psychotropic medication.

How to prepare your patient for a hospital visit

• Ask the patient's carer to fill in a Hospital Passport for them to take into hospital
• Encourage the patient to watch UCLH's videos prior to their visit
• Notify the LD liaison nurse at the hospital that the person is coming in
• Royal Free London: Sarah Lally 020 7794 0500 ext 39517/07903 225 052 s.lally@nhs.net and Tamara McNamara 07931 290 623/020 8216 4474  tamara.mcnamara@nhs.net
• UCLH: Megan Green  07984 288 589/020 3447 8238 megan.green5@nhs.net
• Whittington Health: Ruth Wetherall 020 7288 5358 / 07876 145 298 ruth.wetherall@nhs.net
• Print off/encourage the patient to read the relevant easy-read leaflets below:

Going to hospital (PDF)

Going to A&E (PDF)

How to get the help you need in hospital (PDF)

Having an X-ray (PDF)

Having a scan (PDF)

Having a general anaesthetic (PDF)

Reporting the death of a person with a learning disability

The Learning Disabilities Mortality Review (LeDeR) is a national review of deaths of people with learning disabilities. Please use this website to report a death of patient with learning disability who was aged more than four years old.