1. Helen Sullivan Knowledge and Information Manager Mandy Jenkins Partners in Healthcare Coordinator Welsh Ambulance Service Beginners Guide to the Health Service.

2. Learning programme The ‘Beginners Guide to the Health Service’ is an interactive learning programme, designed for people with a learning disability. It is the first of its kind in the UK and helps to show the learner: When a situation is an emergency How to ring 999 What other services are available when it’s not an emergency Information about the ambulance service

3. Why do people ring 999?

4. What's wrong with me? Who should I call? Where should I go? Is it an emergency? I’m not sure how to ring for an ambulance Will I get into trouble for ringing 999? Is anywhere open? I don’t want to bother anyone Who can help me?

5. Which service should I use?

7. Let’s check our answers The Choose Well quizzes can be found on the NHS Direct Wales website at www.nhsdirect.wales.nhs.uk/choosewell/ www.nhsdirect.wales.nhs.uk/choosewell/

8. What does the data tell us? What percentage of people with a learning disability are admitted to hospital in the UK each year? Can you think of any reasons why people with learning disabilities are more likely to need to access healthcare? How many people with learning disabilities are registered with local authorities in Wales? Do you think the numbers of people with learning disabilities will increase or decrease? Why do you think this is?

9. The data tells us that... Approximately 26 per cent of people with learning disabilities are admitted to hospital in the UK each year. People with learning disabilities are more likely to need to access healthcare services as they have higher levels of ill health and much higher rates of premature death than the population as a whole. People with learning disabilities have higher rates of obesity, coronary heart disease, respiratory disease, dementia and epilepsy. There were 15,029 people in Wales registered with the Local Authority as having a learning disability March 2013 with 86% living in community placements. People with learning disabilities represent a growing proportion of the population, with numbers expected to rise by around one per cent per annum over the next ten years.

10. Strategic Drivers Working Together for Success – Five year strategy Equality Act (2010) Choose Well campaign - Welsh Government Death by Indifference (2007) - Mencap Death by Indifference: 74 deaths and counting (2012) – Mencap Together for Health (2011) Engagement with people with learning disabilities Patient experience

11. Putting the citizen at the heart of service delivery Citizen Know the needs of service users Involvement from the beginning Listen Focus groups Partnership working Joint Ownership Involve others with expertise Leadership Clear aims Innovation Always remember – one size doesn’t fit all

12. Working together Over 5,000 What happens when you call 999 booklets have been distributed across Wales, including People First groups, Health and Social Care Facilitators and other NHS and third sector organisations. “This booklet gives very straightforward information and is a real gem” Rachel Evans, Senior Project Coordinator Help4Carers Project “This leaflet is the first one developed with the Ambulance Service specifically for people with learning disabilities and it has been a very positive partnership. We look forward to working together in the future” Lynn Coleman, Project Coordinator Swansea People First

13. An interactive learning programme Total communication Variety of formats Interactive, to engage learner Choice of learning styles Opportunity to discuss real life experiences Can be accessed at any time Cost effective Information for carers and others who support people with learning disabilities Can be adapted for other audiences

14. Testing the concept Community Voices ‘Keeping Safe’ event in Cardiff Our first event Well attended by people with learning disabilities and their carers The activities showed them how to use emergency services We involved the Community Voices group in planning the event We used role play and audience participation “….. some very inventive people” Welsh Assembly Member Vaughan Gethin “Fun accessible workshop...the feedback from the members and other attendees was really good” Shahid Afsar member Community Voices Karen Jeffries Coordinator Community Voices

15. Workshops and focus groups “ Thank you again for a valuable class. It was a great session. We’d love you to visit again. The students really enjoyed your visit and it was fun as well as informative. I would love to write a short article for your newsletter outlining how the students enjoy and benefit from your talks” Maria Carroll, Tutor Gartholwg Life Long Learning Centre The session was very informative and delivered in the right way for this particular group. Particularly pleased that the pictures were clear and suitable’. Lynn Coleman, Project Coordinator Swansea People First We trialled the learning programme by holding focus groups and workshops across Wales We have seen approximately 150 people with learning disabilities and the sessions have been with mixed ability groups

16. Learning Disabilities Zone

17. Benefits and impact Benefits of the programme Variety of formats Uses a selection of learning styles Easy to use Clear messages Bilingual Information for carers and support workers All Wales Benefits to patients Ability to make informed choices regarding one’s own healthcare Increased confidence in using the service that will best meet their healthcare needs Improved patient experience Benefits to the Welsh Ambulance Service The public will use Trust and other NHS services more appropriately Increased availability of staff and emergency vehicles, to attend emergency calls Greater staff understanding of the experience of those who use our services

18. What did we learn? We now have a better understanding of what it’s like to use our services if you have a learning disability To remember that everyone has the right to the same level of services as everyone else Not to make assumptions One size doesn’t fit all Listen Expect the unexpected “This is an excellent piece of work. It is a very well presented pack which has been carefully thought through. The use of simple vocabulary, short sentence length and additional symbol prompts is excellent” Nigel Miller FRCSLT Therapies Lead (Learning Disabilities) Hywel Dda Health Board

19. Sharing the learning Train the trainer Role out across LD organisations Share with other NHS organisations (e.g. Health Boards, Ambulance Trusts) ESOL courses Children and young people People with sensory loss - audio and BSL Community Champion

20. Darren – our community champion You can see Darren’s welcome message on the Learning Disabilities Zone at : www.ambulance.wales.nhs.uk/About Us/Learning Disabilities Zone www.ambulance.wales.nhs.uk/About Us/Learning Disabilities Zone

21. Thank you. Any questions?

22. Thank you For more information, please contact: Helen Sullivan 01792 776252 ext 45401 Email: helen.sullivan@wales.nhs.ukhelen.sullivan@wales.nhs.uk Mandy Jenkins 01792 776252 ext 45400 Email: mandy.jenkins@wales.nhs.ukmandy.jenkins@wales.nhs.uk