Learning Disability Today
Supporting professionals working in learning disability and autism services

People with a learning disability to design ‘quality checks’ for NHS services

NHS EnglandPeople with a learning disability are being asked to contribute to new tests that will help improve NHS services ranging from dentistry to acute care, NHS England has announced.

The NHS Quality Checkers programme employs people with a learning disability to inspect local NHS services and provide advice on how they can better meet their needs and those of other patients.

People with a learning disability can face significant barriers to accessing NHS services, whether it’s the use of complicated forms and language, confusing layouts of buildings, or staff who aren’t sure how to interact with them.

This contributes to people with a learning disability being less likely to use services, including programmes like health checks and cancer screening; as a result, they are more likely to experience poor physical health than the rest of the population.

Quality checkers use their experiences to assess the quality of care and support patients receive, giving a view that can be often missing from other forms of inspection.

Evaluation of quality checking programmes currently operating show them to be an effective and efficient use of resources, and are associated with increases in quality and improved outcomes. Building on this success, NHS England is now seeking input on new resources that will help support a national rollout.

Scott Durairaj, NHS England’s experience of care lead for mental health and learning disabilities, said: “The experience that people with learning disabilities have of health services directly impacts on how likely they are to use them, and therefore how healthy they’re likely to be.

“NHS Quality Checkers… have made a real difference to local services where they have been used; now we want to take it to the next level and make a significant contribution to improving health outcomes for this group of patients across England.

“It is important to gain the backing from commissioners to implement this across the country and help to build momentum.”

Quality Checker inspections can be organised at any time by services such as GP and dental practices, where there are currently groups set up to perform them. Quality checkers with a learning disability carry out the evaluation, including talking to other service users about their experiences, and judging services against criteria they consider to be important.

Feedback from current Quality Checkers has also demonstrated the positive impact this work has on the individuals involved, as well on improving attitudes towards those with a learning disability and/or autism.

Suzie Fothergill, Skills for People, Newcastle upon Tyne, and chairperson, Association of Quality Checkers, said: “I have been employed as a Quality Checker for many years now, and trained a lot of people with learning disabilities to do the same. I am so pleased that health services across the country will be able to have NHS Quality Checkers. Our work inspires health professionals to makes services better, so that people with learning disabilities can have better lives where they are healthy, happy and safe.

“As a person with a learning disability, I am happy that I have had the chance to improve the way health services support people with learning disabilities.”

Gavin Barr, a quality checker at Sunderland People First, added: “It is so important that people with learning disabilities are involved in quality checking health services. We are able to use our own experiences of what it means to have the right support.

“I really enjoy listening to patients and families and finding out what they think about services. It’s important to be able to bring our findings together and share these with health professionals in our training sessions. I like working as part of a team and hearing how our quality checks have made a difference. I think NHS Quality Checkers can make a big difference to the health of people with learning disabilities across the country.”

As set out in Building the Right Support, the national plan to transform services for people with a learning disability over the next 3 years, NHS England is now seeking to make it easier for groups to set up to offer Quality Checks, and improve consistency across the country, by establishing a national programme to support these local quality checks.

To support the rollout, and in partnership with the Centre of Disability Studies at the University of Leeds and CHANGE – a disabled person’s organisation focusing on the equality and inclusion for people with learning disabilities – NHS England is asking people with a learning disability, their loved ones and carers, and local and national groups representing them, to help develop new resources.

Dr Paul Lelliott, deputy chief inspector of hospitals (lead for mental health) at the Care Quality Commission (CQC), said: “The CQC is pleased to see NHS England supporting using the knowledge and expertise of people who use services in assessing and improving quality of services.

“The voices of people, who use services, including the voices of people with a learning disability, are a vital source of information for providers and commissioners on the quality of care being provided. For CQC, they help inform when, where and what we inspect and our judgements and ratings of services.

“We will be actively working with NHS England once the trials are complete to examine ways that the results can be utilised by CQC, ensuring that we have a single shared view of quality and do not duplicate efforts, with the ultimate aim of improving quality of healthcare across England for people with a learning disability.”

The resources will include training kits for new Quality Checkers, as well as template assessments which will produce national standards to be measured and benchmarked, while allowing for different local circumstances and needs to be taken into account.

The programme aims to develop tools that can be used by Quality Checkers in 7 different service areas: emergency departments, community services, acute hospitals, primary Care (GPs), dentistry, mental health services and learning disability services.

Following the establishment of a national framework and an increase in the number of local Quality Checker services available, NHS England will then look to work with local clinical commissioning groups and NHS providers (hospitals, clinics etc) to encourage take-up of these services.

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