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Specialist nursing input improves hospital care for children with learning disabilities

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Study shows wide discrepancies between hospital care for children and young people with and without learning disabilities

Challenges persist in ensuring consistent approaches which fully respect people’s rights and which ensure full inclusion and engagement of people and families. 


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This paper reported on the organisational context of hospital care and staff perceptions of their ability to recognise and meet the needs of children and young people (CYP) with learning disabilities. The research team conducted 65 semi-structured interviews and more than 2,200 online surveys with staff working in 15 children’s hospitals and nine non-children’s hospitals in England.

Considerable variations in support mechanisms were found. Across the hospitals considered, inconsistencies were noted with policy and care pathway provision for CYP with learning disabilities, and the use of electronic ‘flagging systems’ and reasonable adjustments such as hospital passports.

Staff feedback

There was uncertainty and discrepancies about adjustments made to elicit feedback from CYP with learning disabilities. Staff also felt that CYP with learning disabilities were significantly less involved in their care than those without learning disabilities. Similarly, staff from children’s hospitals felt parents were significantly less involved. Staff reported feeling less confident in ‘managing challenging behaviour’ and ‘always delivering safe care’ to CYP with learning disabilities, compared to those without.

Some form of learning disability nursing provision was available in eight children’s hospitals and one of the non-children’s hospitals. The data appears to show a correlation between hospitals with some form of learning disability nursing input and an increased likelihood of them having a more cohesive approach to recognising and meeting people’s needs.

Oulton K, Gibson F, Carr L et al (2018) Mapping staff perspectives towards the delivery of hospital care for children and young people with and without learning disabilities in England: a mixed methods national study. BMC Health Services Research. 18, 203.


Dave Atkinson is an independent nurse consultant

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