What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?

Patients with learning disability (LD) are a vulnerable patient cohort and face barriers when accessing care. At University Hospitals Plymouth NHS Trust (UHP), a recent project has identified that the LD population are experiencing differential access compared to the rest of the population. The data demonstrate that some are waiting longer for their required intervention with increased frequency of admissions to hospital while waiting for procedures.

This project aims to ensure the LD’s population access to surgical or medical procedure services at UHP is equitable.  In addition, that the support provided to people with LD is tailored to support a reduction is avoidable access to non-elective care.  This can be achieved by understanding the rationale behind differential access, and subsequently work with our relevant partners to develop a systems approach to reduce delays to elective care for the LD population as well as supporting them through a “waiting well” initiative.

What does your project aim to achieve?

The overarching aim of this project is to identify and reduce potential inequality in accessing medical or surgical intervention for the LD population.

Objectives include:

1. Identify the rationale behind differential access to care that LD population may face while waiting for their medical procedure or surgical intervention.
2. To improve their experience and reduce frequency of emergency admissions while on the waiting list as part of the “waiting well” initiative.
3. Develop and implement operational interventions to reduce delays in waiting list for LD population. (extra procedural/ surgical lists, minimise cancellation rates due to unavailability of packages of care for patients with LD at the time of their attendance)

This project will bring positive impact to the LD population’s health outcomes, by enabling them to access the care they need and improve quality of life by reducing the need for admissions.

How will the project be delivered?

Identify rationale for differential access

• Engage with patients with LD, LD support team and service lines to identify reasons for delays.
• Scoping review to understand the barriers of access to care
• Subgroup analysis – Index of Multiple Deprivation

Reducing Delays

• Implement an operational approach to improving equality for the LD patients (e.g. integrate existing priority coding or creating bespoke lists)

Waiting Well Initiative – intervene earlier and provide care at the earliest opportunity.

• Working with LiveWell South-West, LD team and Integrated Care Board to support LD patients to wait well: understanding how to manage exacerbation of their chronic conditions and reduce frequency in admission to emergency care (e.g. identification of options for early identification and intervention for people whose needs may be escalating).
• Create a role to support the LD population – part of the “waiting well” initiative.

Re-evaluation throughout to improve our services for patients with LD and sharing of good practice.

How is your project going to share learning?

Most importantly, this project will be shared with the patients with LD, their families, and carers through accessible means. Additionally, the result of this project will be shared internally via our weekly bulletin and through our social media channels. It will also be formally written up and aim to be published in an academic journal to help shared learning across UK or even globally. The progress of this project will also be shared with the Q community through updates on the Q website and results can be shared via presentations at Q events.