1. Different but Equal Jainab Desai Hospital Learning Disability Liaison Nurse Royal Bolton Hospital

2. Jainab Desai Royal Bolton Hospital

3. Death by Indifference

4. MartinEmma

5. Health Care for All Sir Jonathan Michaels

6. Reasonable Adjustments Appointment times Minimise waiting times Staggered admission times Introduction to hospital staff Flexibility to hospital rules Flexible visiting times Flexible doctor’s appointments

7. Keeping Me safe

8. Case Study Joshua 21 years old & 3st 9lb Cerebral palsy which affects all 4 limbs Unable to move arms or legs No speech Requires constant supervision

9. Hospital Experience Admission via GP Unable to take blood and to be given fluid Blood results showed infection Oral antibiotics via gastrostomy tube Several episodes of vomiting Transferred to children’s ward – approximately 18 hours in hospital by this time Familiar staff looking after Joshua – X-ray showed fracture

10. As a result… Very unhappy experience for Joshua and his family Worried about future admissions Lack of confidence in Royal Bolton Hospital Inadequate access to health care

11. What happened next? To raise awareness Acknowledging Joshua unable to access health care at Royal Bolton Hospital Commitment from Royal Bolton Hospital to improve and implement reasonable adjustments

12. Communication

13. Pathway Prevention Equipment Carers Needs Initial contact

14. PATHWAY

15. The Challenge Continues…