1. Discharge Pathway Preparation for admission Hospital ward to make contact with the person as far in advance as possible so that arrangements can be made Person is assessed by pre-admission services Discuss issues of consent; does the person have the capacity to consent to this treatment; is it likely that a best interests meeting will need to be arranged Identify if the person has a patient passport, if not complete with the person or give carer details and suggest to bring passport when person is to be admitted Arrange visit to ward [if required] This will help to reduce anxiety for both the person with a learning disability and or family/carers and enable questions to be asked prior to admission Try to identify a named contact for the carers if possible Consider contacting the CTLD/Health Facilitator/Acute liaison nurse for support Extra support during admission; think if this will be likely Consent to treatment Does the person have the capacity to consent? Can the decision wait until the person has the capacity If not, a best interests meeting must be called by the decision maker Who is the decision maker; the doctor is the decision maker with regards to medical treatment Evidence of the decision must be recorded on the decision record (DOH form) See decision making and best interest pathways for further details Admission into Hospital For people with learning Disabilities – begin discharge plan Emergency Admission Admission to the ward Share the patient passport with the ward staff to ensure that they are aware of the persons additional needs ie medication /epilepsy/eating and drinking etc Fast-tracking through A&E A person may be fast-tracked if deemed appropriate by the admitting doctor/triage nurse Family/Carers to make contact with A&E To inform of a persons needs Take the patient passport with you; ensure that up to date medication is clearly identified within patient passport/bring copy of medication/mar chart Admission to ward Share/complete patient passport with ward staff Ensure that up to date medication is clearly identified within patient passport/bring copy of medication/mar chart Complete Care Plan The patient passport with assist in the development of the persons care plan; this will ensure that the persons everyday needs are addressed and met ie times of medication, eating and drinking, pain management ; this will help to reduce diagnostic overshadowing Carer support Ward staff should discuss with carers/others to identify the level of support needed to care for the person in hospital This may mean seeking extra support and funding will need to be agreed by the Modern Matron Triage Ensure nurse is aware of the persons additional needs and share or complete patient passport with carers Waiting time Consider if access to a quiet area may be of benefit to the person to minimise distress for the person Planned Admission Pathway based upon Department of Health (2003) Discharge from Hospital; pathway, process and practice, London, Department of Health Appendix 5.7 Guidelines for the acute sector when caring for someone with a learning disability – Allyson Kent (2008) Discharge Planning Meeting Discharge Plan will begin at point of admission with an estimation of date of discharge (EDD) As soon as discharge is considered, contact the people who know the person best ie family/carers/professionals involved with the person and the discharge planning team Ensure that all aspects of the persons care is discussed and action plan agreed to meet the needs of the person at discharge. This should be documented as part of the discharge plan If a persons care needs have changed, ensure that a section 2 is completed Ensure that all actions are completed /equipment needed obtained prior to discharge Ensure Immediate discharge letter (IDL) is completed with full details of current medications/health conditions is completed. This IDL will be faxed to the GP at discharge Ensure that the person/family carer/professional carers are aware of the medication changes or new medication regime is clearly understood and checked at point of discharge (This will contain either 14 or 28 days of medication, enough medication until their next prescription