According to Public Health England, up to 35,000 people living with a learning disability, autism or both, are being prescribed medication which they do not need, and which could cause them harm.
“STOMP encourages healthcare providers to explore alternatives to medication.”
Currently, many people living with one or both of these diagnoses, and who present with behaviours of concern, are being prescribed an anti-psychotic medication. These types of medications have an important role to play when prescribed effectively.
It is recognised, however, that such medications have tended to be over-used in certain circumstances. They have a sedative effect, meaning that while the medicine may be effective in reducing the behaviours of concern, in some cases this is likely only because the person feels too sleepy and unfocussed to summon up the energy to challenge. We also know that medication of this type can cause some nasty side effects, and that long-term use can be harmful.
In short, the use of anti-psychotic medication when inappropriately prescribed simply masks the underlying cause of the challenging behaviour and could potentially cause more harm than good.
This is why NHS England has launched the ‘Stopping over medication of people with a Learning Disability, Autism or both’ (STOMP) campaign, and why my organisation, accomplish is proud to be one of only three independent healthcare providers to have both signed up to the pledge and to be actively working with NHS England on the initiative.
STOMP aims to encourage healthcare providers to explore alternatives to medication, ensure people are as fully involved in decisions about their care as they can be, and to train staff about the potentially harmful effects of over-medicating.
As the dedicated STOMP manager at accomplish, it has been my job to design and put in place a plan to facilitate our staff and support centres across the UK to comply with the pledge.
One of the first steps we have taken is to make sure all our support staff, not just doctors and nurses, get the training they need to explore alternatives to medication, the correct principles of care and the correct use of anti-psychotic medications. This is something we had already focussed on as an organisation and we are working hard to make this training even better with regular sessions for all staff levels.
We have also developed a ‘STOMP pack’ which includes a checklist and practical guidance for our staff to help them put the training they receive into practice. To make sure the pack is effective we trialled it at Lakeside, our inpatient service in Bedfordshire. The team at Lakeside, led by Deputy Hospital Director Victoria Hulstrom, are part of the STOMP working group and so are perfectly placed to understand the goals of STOMP and help create best practice which can be shared across the organisation.
We have already seen some great results from the pilot and are now ready to rollout the pack to our services across the country. Furthermore, we are in discussions about how best to distribute similar packs to other healthcare providers in an effort to help them move away from over-medicating.
Finally, one of the most important considerations we should always keep in mind is to listen to the people we support. STOMP is a campaign which has their well-being at its heart and they should be as fully involved with their care as they want, and are able, to be. This means having conversations with people about the steps we are taking to fulfil the STOMP pledge; ensuring information about the scheme is available in easy-to-read formats for them, their families and carers; and having regular feedback sessions to see what we are doing right and where we can do better.
Ultimately, this is a scheme which I am hugely excited about. By making sure we address the root causes of challenging behaviour and reducing the amount of anti-psychotic medication being unnecessarily prescribed, we can make a real difference to the lives of people with Learning Disabilities, Autism, or both.
Sue Hullin is Quality and Service Director at accomplish, a specialist provider of support for people with Learning Disabilities, Autism, Mental Health Needs and Acquired Brain Injuries.
