Improving care for our service users
The LYPFT Learning Disability Service shares best practice on tackling health inequalities in Leeds
Specialist teams in our Learning Disability Service have worked closely with healthcare partners in Leeds to improve care for people who have a learning disability, helping them to access their Covid vaccinations and taking action on health inequalities in our local community.
Poor quality healthcare causes health inequalities and avoidable deaths
Research shows that on average, people with a learning disability and autistic people die earlier than the general public, and do not receive the same quality of care as people without a learning disability or who are not autistic.
According to the 2021 Learning Disabilities Mortality Review (LeDeR) Age at death – the median age of death for people with a learning disability was 62. The median age of death for the general population in 2018- 2020 was 82.7
LeDeR (Learning from Lives and Deaths of People with a Learning Disability and autistic people) is a service improvement programme for people with a learning disability and autistic people. It was established in 2017 and funded by NHS England.
LeDeR reviews deaths to see where we can find areas of learning, opportunities to improve, and examples of excellent practice. This information is then used to improve services for people living with a learning disability and autistic people.
Take a look at this Easy Read infographic.
The impact of Covid
Early research in England at the start of the pandemic showed that the death rate during the first wave of the pandemic was found to be up to 6 times higher from Covid for people with a learning disability than the general population, confirming that prompt access to Covid testing and healthcare was warranted for this group, and that people should also be prioritised for Covid vaccination and other targeted preventive measures.
You can read more on the impact of Covid on people with a learning disability on gov.uk from a Public Health England report.
The Trust’s Learning Disability Services have worked tirelessly with healthcare partners in Leeds to improve access to and the experience of healthcare services during the pandemic and beyond.
Covid vaccination for people in Leeds who have a learning disability
The below figures show how many people have been supported to access their Covid vaccinations during the pandemic, protecting them from serious illness.
The latest figures for Covid vaccination uptake for Leeds:
| Learning Disability population results | Male uptake % | Female uptake % |
| 1st Dose % | 80.3% | 85.5% |
| 2nd dose % | 76.2% | 81.8% |
| Booster % | 74.3% | 72.1% |
| Autumn Booster 2022 % | 51.8% | 52% |
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The Trust’s Health Facilitation Team have shared some best practice examples in relation to the
effective use of the Mental Capacity Act and best interest decision making for service users with a learning disability.
You can download those here and below we have included some key activities they have been involved with.
- a best practice document
COVID offer info LD Service.docx and - a positive case study showing how the Mental Capacity Act has been used in relation to Covid vaccinations CVID 19 case study Rapid Read WY ICB in Leeds.docx
Accessible resources
A lot of standard documentation can be difficult to decipher for people with a learning disability so the team ensure that easy read resources are available such as information leaflets, capacity assessment forms and consent forms. This ensures that service users and their carers are fully involved and understand what is happening.
The Health Facilitation Team ensure that the ‘Get Checked Out’ website is kept fully up-to-date. The style of the website means that their support always maintains the service user at the centre of that health offer, utilising their bespoke image resource to make information supportive and inclusive of the person, their carers and the professional engaging with them so that resources are easy to access by professionals and families.
Service user support
Our Community Learning Disability Team supported service users when there were issues around needle phobia to support a reduction in anxiety around the vaccine.
Our vaccination team also supported the nurses to create a vaccination environment and a support network around the vaccination appointment.
When there are service users identified the team support a review of contact so far and they implement a bespoke offer to each individual service user who has not yet taken up the vaccination offer. This includes offering easy read information, telephone discussion about the barriers to being vaccinated, offering advice and information about where to get more support
Guidance and support for GPs
The team shared lots of guidance with GPs across the patch, for example top tips for clinicians to help them make reasonable adjustments so the vaccination offer was right for each individual e.g. a phone call, an easy read letter. The team have built a joined up relationship between agencies in the city such as the LD Lead in the ICB and GP practices to encourage and support working together.
Case study: Arthur was in his 80’s. Although he was on the learning disability register at his GP practice after 3 letters inviting him for his vaccination he had still not turned up.
He was on a list of over 600 people who had not responded. The team prepared an easy read guide about Covid vaccination and sent these out to all people not yet vaccinated to try to engage them.
Once Arthur received his letter, he phoned the team office and asked how he could have his vaccination. He explained that he had been waiting to be vaccinated.
When we liaised with the practice, they informed us that they had wrote to Arthur 3 times, but he had not responded to the letters.
Arthur could not read. This was the only reason he had not already attended the appointments.
The team have asked the practice to update Arthur’s reasonable adjustment alert so that this does not happen again.
The team worked with Leeds Teaching Hospitals Trust Learning Disability and Autism Team to make sure that medics admitted people at the right time with the right information, especially as carers might not have been allowed in to the hospital. This made the treatment pathway clear with a record of the current symptoms being included in the Covid hospital summary.
The Health Facilitation Team have also worked with the Learning Disability Lead at Leeds Community Hospital Trust to ensure that community vaccination services are included in the supportive framework and resources are being promoted in the city to support vaccination uptake.
Our LD Service created the Covid Advisory Group who would come together to support all agencies in the city where there were issues relating to the vaccination uptake concerns.
Working within Leeds, the Health Facilitation Team have brought about agencies to sit and discuss how we can change and improve our approach across different NHS and Adult Social Care agencies. This means we are utilising our own unique skill set as a city. One example is that the team have been working alongside the Covid vaccination team in the city to sense check their vaccination facilities with other LD professionals. They have provided advice on environment and resources and provided the link with other agencies to support the growth of professional networks.
Our LD Services will continue to review the offers and ensure that they provide proactive information and resources so that people with a learning disability are not delayed in taking up any health offer going forward.
For more information visit www.learningdisabilityservice-leeds.nhs.uk/get-checked-out/