Isla McGlade Clinical Academic Learning Disability Nursing Supporting your teenager/adult to stay healthy & examples of adult health checks Isla McGlade Clinical Academic Learning Disability Nursing

Good health The benefits of good health are central to improving quality of life and reducing health inequalities for every person with a Learning Disability The Scottish Government: Equally Well (2008)

Health Need Each person with Down's syndrome is affected differently, but most share a number of physical characteristics and developmental problems

Health Need

Health need/input may include Heart Musculoskeletal Mental well being Vision & Hearing ADHD Thyroid Dental Life circumstances/life events/life time

Provision of health checks can improve health outcome Health checks for adults with a LD accepted as way of identifying unmet health needs that are often unrecognised and lead to stark health inequalities. A structured health check in protected time is known to identify twice as many clinical needs as GP standard care for a whole year. Cooper et al 2014; Lennox et al 2011; Lennox et al 2010; Slowie & Martin 2014

What may be involved in a health check?

C21st Health Check University of Glasgow Health checks are a key element in the improvement in primary health care outcomes found in NHS Greater Glasgow and Clyde between 2007 and 2014

C21st Health Check University of Glasgow Cooper et al 2016

C21st Health Check University of Glasgow Cooper et al 2016

C21st Health Check University of Glasgow Cooper et al 2016

Health Checks for Young Adults with LD at Transition- Inverclyde From August each year person > 16 year leaving school within 1 year. CLDT to provide parents/young person with health check leaflets

Inverclyde HSCP Transition Pilot Project contacts- If you have any questions about this work please contact: Lynne McGrath, Julie Houten and Loranda Guinea Community Learning Disability Team, Cathcart Centre, 128 Cathcart Street, Greenock, PA15 1BQ. Tel:01475 499053

Health Screening clinic for adults with Down’s syndrome

Health Screening clinic for adults with Down’s syndrome Those under the age of 40 will be invited to a review clinic every 3 years Those over the age of 40 will be invited annually For those over 40 there will be an additional assessment carried out every 2 years which means these clinic will last a bit longer (2 – 2.5 hours approximately)

Health Screening clinic f adults with Down’s syndrome contact details Referral coordinator – Community Learning Disability Service Lynebank Hospital Halbeath Road Dunfermline, KY11 4UW Tel: 01383 565230 Email: Fife-UHB.LDReferrals@nhs.net

Current Research Project Reasonable Adjustments to Provide Equitable Assessment, Screening and Treatment of Osteoporosis for People with Learning Disabilities: A Feasibility Study

Background Individuals with Down Syndrome (DS) are a high risk group for developing Osteoporosis – a condition where bones become weak and fragile This can be due to a number of reasons: Taking antiepileptic medication Having musculoskeletal impairments Have related conditions (e.g., cerebral palsy) which can cause mobility problems Experience other health problems that can lead to bone ill-health (e.g., premature ageing)

Background Osteoporosis can lead to fractures - thus important to determine if individuals with DS have this condition or the precursor Osteopenia However, adults with DS experience barriers to accessing osteoporosis services, and we need to assess how we can overcome these barriers

Aim The aim of the study is to work with 30 adults with LDs (this will include individuals with DS) who are at risk of developing Osteoporosis We want to try and make reasonable adjustments to osteoporosis assessment, screening (DXA scan) and treatment processes, to learn how these processes can be tailored more inclusively towards people with LDs

Outcomes of Interest The reasonable adjustments required for adults with LDs to access a scan The proportion of individuals with LDs able to receive a scan The proportion of participants diagnosed with osteopenia and osteoporosis The number of risk factors for osteoporosis each participant has The views and experiences of people with LDs, their carers’, and osteoporosis services health care professionals’ of going through the assessment and screening process

Contact me If you have any questions about this study please contact me: Dr Joanne Cummings Phone: 0141 331 3771 Email: Joanne.Cummings@gcu.ac.uk

The Scottish Learning Disability Observatory https://www.sldo.ac.uk/

Management of long-term conditions and health promotion in primary care for adults with learning disabilities Recommendations “Consider introducing a Directly Enhanced Service for adults with learning disabilities across Scotland including delivery of annual health checks, or other methods within primary care to deliver the same or similar actions and outcomes. Establish routine monitoring of primary care data across Scotland to follow trends in the management of long-term conditions and health promotion for adults with learning disabilities in comparison with the general population, over time, geographically To further improve understanding of factors driving change and improvements” Cooper et al 2016 p 5

Thank you Isla.mcglade@gcu.ac.uk