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A new flagging system on patient records has been shown to improve health and care services for people with a learning disability and to also “promote confidence” among nursing staff, according to findings from a pilot scheme.
The system, called Reasonable Adjustment Flag and introduced by NHS Digital, is designed to inform nurses and other staff when a patient has a disability or other impairment and has specific needs that require adjustments.
“The flag also promotes confidence in our healthcare team”
These adjustments could include communication requirements, such as how to be contacted for appointments, or changes to the environment, for example, the use of particular music to help reduce anxiety.
Initial results from the pilot, which took place in Gloucestershire and Devon between June 2019 and March this year, have now been published to coincide with Learning Disability Week.
The findings suggested positive benefits for both patients and staff, according to nursing staff taking part in the pilots.
Bev Farrar, learning disability liaison nurse at Gloucestershire Hospitals NHS Foundation Trust, said: “Being able to access the Reasonable Adjustment Flag means that we can get it right for our patients and we have had really positive feedback on it so far.
“The flag also promotes confidence in our healthcare team as it provides useful information about how to best to interact with our patients as individuals.”
She recalled one particular example where the scheme had allowed the team to make a reasonable adjustment and improve the care the patient received.
“Recently we were able to make a reasonable adjustment for a patient to have his appointment details texted to him and this helped him to attend,” explained Ms Farrar.
“The initiative also promoted collaboration between colleagues and across organisations”
As part of the trial, staff securely created, accessed and updated patient information on the NHS Spine using the Summary Care Record application (SCRa) – a program designed to share key information about patients to staff with appropriate access rights.
Moving forwards, the plan is for staff to be able to access the information on their own screens and on their own systems when they search for a patient, according to NHS Digital.
During the pilot, which took place in in various care settings including GP surgeries, hospitals and community services for learning disability, more than 70 flags were created by clinicians in conjunction with patients and carers.
The scheme identified a wide range of adjustments that were found to positively affect the experience and outcomes for patients and carers and staff.
Those behind the initiative said the flagging system could even lead to financial benefits through saving costs by reducing the number of missed appointments.
Further development and testing of the scheme is now underway and it is expected that it will become more widely available from the end of the year.
“The key information shared through the flag would be valuable beyond learning disability and autism patients”
Dr Rob Jeeves, GP clinical lead for the project at NHS Digital, said: “The feedback from this pilot shows that the process to create and share reasonable adjustment information through the flag is well structured, simple and quick to follow.”
He stressed that patients, families and carers were all involved in discussions about adjustments to care that were made.
The flagging system was “warmly received, with enthusiasm for the benefits arising from the wider sharing of this key information”, added Dr Jeeves.
“The initiative also promoted collaboration between colleagues and across organisations as to how best to record well-formed reasonable adjustments on the flag and in local records,” he said.
“With further evaluation and wider use, we will be able to explore the benefits when a patient with learning disabilities accesses healthcare and sees a particular clinician for the first time.”
On the whole, he said the team hoped having a Reasonable Adjustment Flag would mean patients had a “better experience of care, with their needs being addressed earlier and more consistently”.
Dr Iain Jarvis, a GP with a special interest in learning disabilities who works at Aspen Medical Practice in Gloucester, said the project could help a range of patients.
“The key impairment and adjustment information shared through the flag would be valuable beyond learning disability and autism patients,” he said.
“Patients with dementia, sensory disabilities, physical disabilities, non-visible impairments such as mental health conditions and those receiving palliative care at the end of their lives could all definitely benefit.”