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Why diagnostic overshadowing could be costing lives

Making assumptions about people with learning disabilities harms patient outcomes, congress told

Making assumptions about people with learning disabilities harms patient outcomes, congress told

A learning disability nurse who tried to get a sick patient to an emergency department was refused assistance by a paramedic who insisted the woman should be taken to a secure unit. 


Hamish Kemp.
Picture: John Houlihan

Catriona McIntosh told RCN congress that diagnostic overshadowing in learning disability – where health staff make assumptions about people instead of trying to find out what was wrong with them – is costing lives. 

‘The police were in attendance and they showed more compassion than the paramedic. In the end we had to get the air ambulance,’ said Ms McIntosh, who is based in Derbyshire.

When the patient arrived at hospital she was dangerously dehydrated, in kidney failure and had sepsis, the congress audience in Belfast was told.

Ms McIntosh said: ‘She was in theatre that day. If she had gone to the secure unit she would have died.’

Behavioural dismissal

Manchester clinical lead nurse Hamish Kemp, said too many health professionals dismissed health concerns and sent people home saying ‘it’s only a behaviour’ or ‘what do you expect? He has learning disability.’


Jim Blair.
Picture: John Houlihan

He quoted cases including a person with learning disabilities who was turned away from hospital, but staff later discovered the individual had a collapsed spine. Another man turned out to have had a cerebral brain haemorrhage. Both patients died shortly afterwards. 

‘This is what I’ve seen in my 30 years of nursing and I’m disgusted,’ Mr Kemp said.

Learning disability consultant nurse Jim Blair urged all healthcare staff to act on every single behaviour change in their clients.

‘Too many staff say, "there’s no point in doing tests on that type of person – they won’t comply with treatment", but how do you know they won't?’


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