1. Rose Kennedy ST3

2.  Definition of learning disabilities  Mental capacity act  Tips for consultations  Resources to use

3.  Defined as “significantly reduced ability to understand new and complex information, to learn new skills (impaired intelligence) and with a reduced ability to cope independently (impaired social functioning)”  Greater health needs but poorer access ◦ Associated co-morbidities – epilepsy, mental illness and behavioural issues  Challenging consultations- often involving carers, MDT members

4.  The act assumes mental capacity, and if deemed to lack capacity we act in the best interests of the patient  To have capacity an individual needs to ◦ Understand the information ◦ Retain the information relevant to the decision ◦ Use or weigh the information ◦ Communicate the decision (by any means)  Capacity is time-specific and decision-specific

5.  Try to build a rapport and keep continuity  Allow time – offer double appointments  Offer first appointment of the day ◦ Less busy waiting area, not having to wait a long time – may become distressed or upset  Annual health check with an individualised “health action plan” (DoH White paper 2001) Health passport  Demonstrate any procedure/examination before doing it

6.  Always address the patient first before discussing with the carer/relative ◦ Important to use the carer’s knowledge ◦ Check for consent to have the carer present (safeguarding)  Use simple language, without medical or abstract words.  Health related books to inform patients about different situations http://www.booksbeyondwords.co.uk/ http://www.booksbeyondwords.co.uk/  Use websites such as http://www.easyhealth.org.uk/ 500 easily accessible health information leafletshttp://www.easyhealth.org.uk/

9.  Challenging consultation  Important to have a plan in your practice  Allow time and be patient  Use online resources to aid the consultation

10.  GMC Learning disabilities http://www.gmc- uk.org/learningdisabilities/302.aspxhttp://www.gmc- uk.org/learningdisabilities/302.aspx  GP online – advance consultations http://www.gponline.com/advanced- consulting-consulting-patients-learning- disabilities/article/1157072 http://www.gponline.com/advanced- consulting-consulting-patients-learning- disabilities/article/1157072