This year’s SLDNN17 Annual Conference focused on the theme of ‘Learning Disability Nursing in the 21st century’ which demonstrated both the excellence and value of current learning disability nursing across Scotland.
Steve Wright, Team Lead from Ayrshire and Arran and Chairman of the SLDNN steering group welcomed everyone and thanked the funders, helpers and conference sub group for organising the day. Steve introduced Professor Michael Brown our Chair for the day.
Michael holds a joint clinical academic appointment with NHS Lothian as a Nurse Consultant and is Professor in Health and Social Care Research at Edinburgh Napier University. He is editor of Learning Disability Practice and Associate Editor of the Journal of Policy and Practice in Intellectual Disabilities. Michael is also chair of the International Associate of the Scientific Study of Intellectual Disabilities (IASSID) Policy and Practice Special Interest Research Group. He was made a Fellow of the Royal College of Nursing in June 2015 in recognition of his contributions to the art and science of nursing.
Professor Michael Brown chaired the day, he introduced the speakers and expressed thanks to the steering group for organising the conference and their continued commitment to the SLDNN. He reminisced about his involvement along with the early founders and of the values in bringing all areas of Scotland’s Learning Disability (LD) Nurses together.
The following shows each conference summary and highlights of the presentations for each of the speakers through the day.
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| Professor Michael Brown |
The following shows each conference summary and highlights of the presentations for each of the speakers through the day.
Angela Henderson: Learning Disabilities Evidence - The Scottish Learning Disabilities Observatory 2 years on
Angela is the Deputy Director of the (SLDO), it was set up in 2015 and is funded by the government. Angela is involved in a number of projects at the SLDO that draw on routinely collected health data to generate evidence about the health and health care of people with a Learning Disability. The SLDO provide relevant and accessible health intelligence to support more evidence informed policy making and health care policy. One aim to, robustly underpin health improvement to address health inequalities. The SLDO is able to collect data from different sectors and data sets and analyse and present this data. They carry out systematic reviews to identify gaps.
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| Angela Henderson |
Some of the points Angela presented:
- No gradient was seen in multi-morbidities due to neighbourhood deprevation – this highlights the need for earliers intervention across the board
- Psychotropic prescribing – over use – stats show that 20% of people with LD are prescribed psychotropic meds but only 6% due to psychosis
- To gather accurate information regarding the numbers of people with a learning disability who are either placed out of area or are subject to delayed discharge
- Explore the support needs of those concerned
- To take a national strategic approach
To identify local sustainable alternatives She highlighted the following statistics:
- 242 people with a learning disability are living in hospital
- 49 of whom are delayed discharge
- 180 people living in assessment and treatment units
- 58 of whom are delayed discharge
- 1055 people with a learning disability living out of area - although it must be noted that some of these people may be out of area through choice.
For more stats, information check out the website: www.sldo.ac.uk They also have a Newsletter.
Dr Anne MacDonald: Supporting People with Learning Disabilities and Complex Needs - Minimising out-of-area placements and delayed discharge
Dr Anne MacDonald is Head of Complex Needs at The Richmond Fellowship Scotland and is also seconded part-time to the Scottish Government via “The keys to life Development Fund”, where she leads a project in relation to out-of-area placements and delayed discharge from hospital for people with Learning disabilities and complex needs.
The project aims to collect data from across Scotland regarding these types of placements and then provide recommendations to the Scottish Government, in relation to the development of high quality, local, sustainable and community-based alternatives. Part of this role is to take a national approach to scope the use of Positive Behaviour Support across Scotland and to make recommendations for its future implementation and development.
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| Dr Anne MacDonald |
For her presentation to conference Dr Anne MacDonald outlined the aims of the project:
Possible reasons for delayed discharge include lack of funding to provide necessary level of support and difficulties identifying suitable accommodation to meet specific needs. She also highlighted the lack of suitable social care providers, the skills gap within the sector and the limited use of positive behaviour support.
Whilst the project is still on going and formal recommendations far from complete she did share some ideas so far: the hope that there would be creative approaches to commissioning, developing new models of support with more use of PCP and the involvement of families; that there should be detailed guidance for those commissioning complex needs services; that there should be specific requirements for those providers delivering complex needs services and the skilling up of the workforce.
It is hoped that the project report will be completed by March 2018. We look forward to reading the findings and recommendation in full.
Heather Duff: Overview of HEF training, implementation and evaluation
Heather trained as a Learning Disability nurse and has worked across NHS Lothian and NHS Fife in in-patient services. In 2014, Heather moved onto the role of Project Manager Health Equalities Framework (HEF) for the Learning Disability Managed Care Network across South East Scotland. This has resulted in the HEF being rolled out across the four boards in South East Scotland – NHS Borders, NHS Lothian, NHS Fife and NHS Forth Valley.
At the conference, Heather gave an overview of the work the HEF has been doing. This mainly focused on an online survey of nurses working in practice who have been using the HEF and the impact they have seen while using it. The feedback given was that the HEF is easy to use, it promotes collaborative working, is patient centred and is a good evidence base for Learning Disability nursing. There had also been data collected on patients involved in the HEF which asked 29 questions around issues such and capacity, diet, finance etc and looked at five different determinants of health. These are social, communication, genetic/biological, personal lifestyle and service quality. There was a significant reduction in health inequalities noted across each of the determinants which goes to show the importance of the work that Learning Disability nurses do.
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| Heather Duff |
At the conference, Heather gave an overview of the work the HEF has been doing. This mainly focused on an online survey of nurses working in practice who have been using the HEF and the impact they have seen while using it. The feedback given was that the HEF is easy to use, it promotes collaborative working, is patient centred and is a good evidence base for Learning Disability nursing. There had also been data collected on patients involved in the HEF which asked 29 questions around issues such and capacity, diet, finance etc and looked at five different determinants of health. These are social, communication, genetic/biological, personal lifestyle and service quality. There was a significant reduction in health inequalities noted across each of the determinants which goes to show the importance of the work that Learning Disability nurses do.
Key message, always enthusiastic Heather says, “Learning Disability nurses rock!”
Dominic Jarrett: Parents with Learning Disabilities
Research was carried out by Dominic Jarrett, Sharon McGregor, and Ailsa Stewart. Research was carried out in 2 projects spanning a 16-year difference to identify key themes and issues in providing support to a parent with a learning disability. How professionals are involved and what the impact that little or no support can have. It also looked at how to encourage parents to engage with services, and evaluated the outcomes based on this.
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| Dominic Jarrett |
Dominic’s presentation focused on his findings from his research on Parents with Learning Disabilities. He discussed the long-term outcomes of a parenting support project. The initial “Parenting Project” was carried out 16 years ago. Involved in research were 7 parents, initially 12, but 5 left due to a variety of reasons. Of the 7 parents involved 3 were involved in the original project. Not all parents had a learning disability, but some parents were included in vulnerable groups, and therefore included in the research.11 practitioners were involved including: CLDMHT, GP, Deputy Head, CLDN, Paediatric Nurse, Social Worker, and respite care staff.
Feedback was received from parents, children and other professionals involved. Research identified there are significant issues in supporting parents with a learning disability. It is hoped that there can be support at home offered with practical and flexible interventions, however the risk of removal of children from the family home is exceptionally high. Of the families involved only 1 in 5 children remained in the family home. Although all parents are still involved in their children’s lives.
Research has highlighted that working with parents with a learning disability, has its complexities, however good relationships between parents and support workers, alongside effective communication is more likely to achieve a positive outcome.
Both research projects highlighted the need for good communication and good relationships between families and professionals. The quality of support from the support workers in the original research project, had a direct impact on families completing the project or withdrawing. Some parents, have difficult relationships with professionals. But using the Good Practice Guidance – how to communicate with a parent with a learning disability, may be able to improve relationships.
Parents who have completed the research have stated this was due to good communication – being listened to and respected. Time after time the feedback received was focused on good relationships.
Two key statements from the presentation were: The research has identified the “Benefits of recognising needs of the parent and establishing a relationship on the basis of that” and this research has identified the need for professionals to embrace complexity – “not everything can or needs to be reduced to a simple pathway.”
Ian Stables and Mark Gallagher: Preparing Students within Scottish Learning Disability Nurse Education
Ian Stables: Lecturer from Edinburgh Napier University
Ian explained how both Universities had been working with NHS Education for Scotland (NES) to roll out training to all Schools of Nursing to educate them to be able to communicate and work better with people with Learning Disabilities. The course also highlights the significant differences our client group have and gives a greater understanding of people with LD’s health needs, which will improve patient’s treatment in hospital and tackling health inequalities. Ian also informed us of the Learning Bytes educational resources units.
Napier was of course congratulated for getting the fantastic Student Nursing Times Award a for winner of the Nurse Educatiion Provider of the Year (pre-registration) – Learning Disability Nursing Programme – Proud!
Mark Gallagher Lecturer from Glasgow Caledonian University
Mark Gallagher spoke passionately about educating Learning Disability Nursing students and about the Nursing Programme. He talked about how Strengthening the Commitment report has fed into and informed the way students are educated which in turn will impact positively on this client group. GCU have Inter professional Modules, working alongside Physiotherapists for example encourages good work practice and communication between different professionals.
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| Professor Michael Brown, Mark Gallagher and Ian Stables |
SLDNN Student Sub Group: 21st Century Journey to Integration: The Student Perspective
Presented by Danielle Donaghy (3rd year GCU), Ruth Hirst (2nd year ENU), Emma Fordie (2nd year ENU) and Zoe Wood (1st year ENU)
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| Ruth Hirst, Danielle Donaghy, Emma Fordie and Zoe Wood |
The students gave some history and background leading up to Health and Social Care integration. Since its launch in April 2016, integration is still very much in the initial stages and differs across Scotland. However, to support our client group Learning Disability Nurses are used to and have been working Person Centred and are already working in multi disaplinary teams and across interagency teams and services. When out in practical placements students felt there was apprehension, unclear future plans and mixed opinions about Health and Social Care integration amongst teams. They decided to ask fellow students and the audience their views on integration. They put out a survey monkey to both Universities, they fed back the results.
Question for Students: What 3 words would you use to describe your feelings about becoming a Learning Disability Nurse in the future? We generated the words the students used and displayed them in this word wall, the bigger the words the more the word was used.
We asked the audience of Learning Disability Nurses what their 3 words would be, their responses were displayed on a live text wall. We generated the responses in this word cloud.
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| Word cloud shows responses from audience via live text wall |
Being the biggest Health reform since the NHS began the future will bring uncertainty and major changes. The students expressed their gratitude to the LD Nurses who have built resilience, protected the LD Nurse role and continually show commitment to the care, health and rights of people with LD.
The students brought a wooden baton that was given to them at this years Student LD conference Positive Choices. They pledged to take it forward with Strength and Excitement into the future.
Susan Gimson: Mentally Healthly Workplaces - A Positive Outlook
Susan Gimson works as a Health & Work Specialist within the Health and Work Directorate at Health Scotland, where she leads on health and wellbeing.
The directorate contributes to the delivery of NHS Health Scotland’s strategy, “A Fairer Healthier Scotland” by leading work with industry, employers and their stakeholders to achieve better and more equitable health outcomes. The Directorate also leads on other health and work-related policy ideas including Good Work, Income and Welfare.
Susan has worked for 15 years within Health Scotland’s “Healthy Working Lives” and previous “Safe & Healthy Working “programmes and has wide experience of both occupational health and health and safety topics.
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| Susan Gimson |
Susan has worked for 15 years within Health Scotland’s “Healthy Working Lives” and previous “Safe & Healthy Working “programmes and has wide experience of both occupational health and health and safety topics.
For her presentation to conference Susan aimed to give delegates a broad understanding of mental health matters in the workplace, by highlighting things that can contribute to stress in the workplace and issues of self-resilience. She began by introducing “Mentally Healthy Workplaces.”
Employers should expect that at any one time nearly 1 in 6 of their workforce is affected by a mental health problem. A study carried out by the University of Strathclyde on behalf of the Scottish Trades Union Congress (STUC) reported that on average employees take 21 days for each period of absence related to mental health. Mental health problems cost Scottish employers over £2billion a year.
Stress, depression and anxiety are reported as the most common reasons for staff absence – however, a lot of the mental health absence that is work related could have been prevented. Evidence shows that there are a number of simple, cost effective ways to support employee mental health, it makes good business sense to promote positive mental health in the workplace.
Susan ended her presentation by introducing us to the Water Bear and Resilience, a topic which resonates strongly with us as Nurses.
For further information and details of training options available many of which are free go to http://www.healthyworkinglives.com and https://elearning.healthscotland.com/
Professor Michael Brown: Reflecting on the Journey so far
Professor Michael Brown then presented his journey and story to where he is now. Michael has had extensive experience and a very long list of qualifications, too long to mention. He was almost in disbelief as to how he got to where he is today but it was very apparent that this achieved by absolute commitment and hard work.
Unsung Hero Award
Congratulations to Dave Holloway who received the SLDNN17 Unsung Hero Award! He was described as an unassuming individual and a fantastic role model. He is an approachable leader and clients are always priority. He has been involved in service improvement in rural locations and shows dedication to clients. Well deserved Dave!
For those unable to attend, we hope this blog has given you an outline of the day and the hashtag #SLDNN17 was informative in providing updates on the day. There were 333 #SLDNN17 tweets thought the duration of the conference and tweets were viewed 5,500 times reaching as far as the UK, US, Ireland, Spain, Tanzania, Australia and Latvia.
The feedback received from conference evaluations as well as reactions on the day were very positive. The conference was certainly inspiring and gave those in attendance a chance to network throughout the day and reflect and refocus on the commitment and values we hold in our roles.
