Organisation develops a video book of short films to show the process of health appointments and reduce anxiety in learning disability patients, increasing attendance at appointments

* Please provide a brief outline of your work. 

Data from Essex CCG’s and health services identified a worrying number of people with learning disabilities and/or Autism who ‘Did Not Attend’ (DNA) health appointments on a regular basis. A significant number of DNA’s are due to the adult being afraid to attend.

After consultation with health colleagues and working with Essex County Council’s Access to Health Champions who are people with a Learning Disability, we developed a video book of short films about the real experience of having a blood test, emergency ambulance attendance, MRI scans, A&E and the dentist to prepare people prior to their appointments.

 * Please describe the actions you took to achieve your result.

 We engaged the Health Access Champions who are all people with a learning disability and work for Essex County Council on a number of health related projects. They acted the part of the patient in the films which was important for authenticity and allowed the viewer to relate to the scenario.

They also provided valuable guidance throughout the project and narrated the films. We enlisted the support of dentists, LD liaison nurses, radiographers, East of England Ambulance Services and Colchester General Hospital who granted permission for us to film in the hospital.

Media students from the Colchester Institute, some of which have a Learning Disability and/or Autism provided the filming and editing. Many of the contributors arranged for the filming to take place onsite outside of their normal working hours and willingly volunteered their time.

We engaged with care providers of services for people with a learning disability or Autism to gather initial data of the issues and sought their feedback. The films are individually available on You Tube but we wanted a different media that would allow people to view them whenever they wanted and took into account those people who didn’t like looking at big screens.

Film brochures were commissioned containing the five films, are rechargeable and completely portable being A5 size.

 They automatically play the films on opening and can be repeated time and time again.

The films include:

• Dentist: https://www.youtube.com/watch?v=clmkwuGW6jE

• MRI Scan: https://www.youtube.com/watch?v=ZOt8tDfvoE4

• Blood Test: https://www.youtube.com/watch?v=Iyp_myNGWhw

• Accident and Emergency: https://www.youtube.com/watch?v=tjey-B-Um9Y

• Ambulance: https://www.youtube.com/watch?v=1qV2GajM12U

The value of the project is in cost avoidance of missed appointments, Mid Essex CCG tariff of costs identifies initial outpatient appointments as costing between £115 and £283. NHS England puts the annual national cost of missed appointments at £750 million.

NHS England data also identifies that:

• People labelled ‘learning disabled’ die 13-25 yrs earlier than people who aren’t considered ‘learning disabled’.

• Have less equitable access to health services, particularly primary care and preventative services.

• Have poorer experience of healthcare because of lack of ‘reasonable adjustments’

• Are subject to ‘Diagnostic overshadowing’ – physical health not investigated/understood because of learning disability

• Experience variation in delivery of Care Pathways that address top causes of death. The value of the project is also and more importantly to the individual with a Learning Disability and/or Autism who is now able to access health services they need without severely distressing them or in many cases not accessing at all.

 * Please list the most significant results

• Books in CHUFT A&E and children’s ward.

• HFPT: report increased attendance at appointments.

• Livability used video book in Newcastle Home for adult needing urgent hospital appointment. Using films regularly to discuss appointment he attended and got treatment.

• Actor in dentist film recognised by someone who offered thanks because he got his adult son with Autism to attend dentist when previously refused.

• Inclusive Support: individual urgently needed blood test but was refusing. Previously caused damage to environment while having blood tests and not been attempted for 10 years. Manager tried films and adult walked into hospital for blood test without incident.

 * Describe how your project has spread to other teams, departments or organisations

 The films are on You Tube and available to anyone. Health colleagues and service providers have been utilising the film brochures and many individuals living at home have been given copies. Livability has used this format successfully with a person they support in Newcastle. Mencap have promoted use of the films during their health campaign.

GP’s using them with their patients NE Essex ambulance services have copies to use We are looking at other topics to include in the suite of films to support people with a Learning Disability and exploring the use for people living with Dementia.