Reasonable adjustment flags to be integrated with patient record systems

NHS Digital is trialling the reasonable adjustment flag on patient records that alerts health and care staff if a patient has a learning disability and has specific requirements for care services.

The reasonable adjustment flag is a national record that indicates whether adjustments are required for a patient who has significant impairments.

This can can include ensuring there is wheelchair access to a hospital or clinic. Alternatively, it can include a patient’s need for a longer appointment or a quiet waiting area, how to communicate with them or who to involve in decisions about their health and care.

In the new trial, staff will be able to access the information through a patient’s record on the Summary Care Record application, a program designed to share key information about patients.

Further ahead, the plan is to integrate the reasonable adjustment flag with clinical systems so staff can see it on-screen as soon as they search for the patient.

The pilots in Gloucestershire and Devon involve various care settings including GP surgeries, hospitals and community services for learning disability. They will look at how care is impacted when that information is readily available to staff from the first point of contact and beyond.

They will run to the end of September, during which time the technology behind the flag will be tested and feedback collected from staff, patients and carers.

NHS Digital will then explore a potential expansion, including widening the geographical area, giving access to more care settings and trialling integration with clinical systems.

A software interface is being developed to facilitate future integration with local health IT systems.

Preventing poor experiences

Susan Hanley, chief executive of Leeds People First and leading learning disability campaigner, said: “1.5 million people in the United Kingdom have a learning disability but it can’t always be seen.

“For me, if the hospital had a system that told them I wanted easy-read information and for the doctor to speak clearly with no jargon, it would be really useful as I don’t always have my health passport on me. Some people don’t want to repeat themselves to everyone they meet so this information on a computer would help.”

Brendan Chivasa, member of the learning disability charity Mencap’s Treat Me Well campaign steering group, explained that people with learning disabilities could have bad experiences if doctors didn’t understand their learning disabilities or failed to make the reasonable adjustments they required.

This is the thinking behind Mencap’s Treat Me Well campaign, which aims to transform the way the NHS treats people with learning disabilities hospitals and prevent them dying earlier.

“Personally, health professionals understand me because I’m able to express myself verbally, but for someone who is non-verbal it’s much more difficult for them to explain their symptoms and emotions,” said Mr Chivasa.

“Therefore, I think the doctors and nurses should have access to more specialist training in this field, on top of this flagging system trial.”

Dr Rob Jeeves, clinical lead for the project at NHS Digital, added: “By helping staff to recognise their patients’ needs earlier, we can help those patients access the best possible care while reducing pressure on the NHS.

“This pilot will explore how flagging vital information can influence the experience of care for people with a learning disability.

“This will help to drive real improvement for a patient group that is disproportionally affected by poor health outcomes. I welcome this step and look forward to the results of the pilot.”

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