Evaluating Policy and Practice in Healthcare

Evaluation Policy and Practice in Healthcare

The government of the United Kingdom has created different health systems that share the same objectives. Significantly, devolution has had remarkable impact in the history of the National Health Service. Since then, England has given priority to market-based reforms and has concentrated on improvements such as cutting waiting times and offering patients more choice. Majority of people with learning disabilities need continued support that creates the need for the government to increase the number of primary care givers particularly those looking after individuals with severe health problems. The level of support depends on the level of the person’s disability. It, therefore, requires the health care professionals to collect as much information as possible from the patients, families, and friends in order to improve every aspect of the services provided. In the following work, a few studies are used to demonstrate how the National Health Service (NHS) in the UK has formulated and evaluated policies to improve health services for people with learning disabilities.

The Discussion of the Studies

The report Health Care Provision and People with Learning Disabilities: A Guide for Health Professionals by Corbett written in 2006 shows that people with learning disabilities face various limitations in accessing quality health services. On this basis, the UK government and stakeholders are partnering to improve the provision of services for this group (Corbett 2006, p.5). Consequently, people under consideration will have the increased opportunity to participate in the life of the society and contribute skills into it. Most of them will gain meaningful employment that will give them a real sense of self-worth. There are examples of such people working in administrative and clerical posts, and different retail businesses (Corbett 2006, p.5). In addition, there are also several people with learning disabilities who are linked to sports. Some have excelled in their chosen fields and shown great results in competitions like the Special Olympics. These opportunities offer great reward for those involved, and it is important for the U.K government to increase them (Corbett 2006, p.6).

Moreover, it should be highlighted that these individuals do not have access to the full range of health care provision to which they are entitled. Furthermore, in essence, many of them live in the community with little or no support from family and friends. Further analysis of the study by Corbett (2006, p.6) shows that there are many persons within this group who lack the literacy skills required to understand what constitutes good health. As a result, they face a variety of challenges that deteriorate their health. To deal with this issue, the government has increased the number of primary care teams to create a point of contact for people with learning disabilities who have not yet been identified. In this way, the authorities will ensure the improved access to the NHS is available to this group when needed (Corbett 2006 p.6).

The study Bereavement, Loss and Learning Disabilities: A Guide for Professionals and Carers by Grey shows that since the 1990s, there has been some positive legislation in the U.K. that has improved the lives of people with learning disabilities, and the way they can gain support to live more independently (Grey 2010, p.10). On a large scale, services such as NHS, education, and other social ones have become better in a significant manner. Moreover, the advocacy services have taken a responsibility for enabling people with learning disabilities to take on greater roles in their own lives (Grey 2010, p.11).

In the UK, the Valuing People White Paper has been an important tool to changing the way that people in this group can access health services. It has improved the culture of seeking help when necessary as well as set an expectation that the right care will be provided (Grey 2010, p.11). The research mentions that the mentioned initiative aimed at reducing health inequalities. It provided a framework for services for people with learning disabilities and outlined how their lives could be improved through clear thinking about their rights and responsibilities and a change in policy making (Mitchell 2006, p. 13).

The Mental Capacity Act 2005 is also referred to in the study. It states that there are cases when individuals are not able to make decisions on their own. Therefore, in such situations, decisions may need to be taken in the best interests of those concerned (Firth, Berry & Irvine 2010, p.53). Such situations usually occur following a bereavement or crisis. It is also considered necessary to assess the capacity of that person to make decisions that will ultimately ensure their safety in the future. In addition, The Mental Health Act 2007 addressed how people who were under extreme stress or vulnerability could be cared for safely under specific terms and conditions (Mitchell 2006, p. 13).

In addition, a similar reportLearning Disabilities: Toward Inclusion by Gates, shows that the UK has introduced National Service Frameworks (NSF) to ensure national health care standards. This means that all people including these with learning disabilities should receive the same level of care outlined for specific conditions (Gates 2010, p.286). More importantly, people with learning disabilities are included into the category of those with long-term conditions. The NSF works in partnership with practices of ethos; this means that the services should be accessible and communication should be strong between the different agencies involved in care giving (Grey 2010, p. 12). For instance, when dealing with individuals with learning disabilities, all the services should work together for the benefit of the client particularly in cases such as bereavement. The NSF have made significant progress in enabling individuals in this group to have real choices that affect their lives (Johnson & Traustadóttir 2005, p.117).

The Needed Improvements

In 1998, the NHS made improvements recommending the learning disability nurses to be available to offer education, advice, and support as required round the clock. In some hospitals, it has been achieved by the establishment of a Liaison Nurse Specialist Service (Atkinson et al. 2014, p. 182). This act has helped to set the aims and objectives to ensure a measurable improvement in services offered to people with learning disabilities.

One of the possible outcomes of this initiative is that arrangements will be able to be made to access expert advice and support through the existing learning disability manager on-call system (O'Hara, McCarthy & Bouras 2010, p.6). The project could be implemented in the form of weekly visits to facilitate both a support system for staff and a mechanism for the referral of patients identified as requiring follow-ups.

Furthermore, to improve communication with patients with learning disability, nurses need to improve their verbal communication skills (Taylor & Rhodes 2006, p. 49). Remarkably, these cases require the nurses to use non-verbal tools like sign language and pictures. In this way, it becomes easier to recognize various mental needs and signs of challenging behaviour (Taylor & Rhodes 2006, p. 49).

Problems People with Learning Disabilities Face while Accessing Services

As more people with learning inabilities live to older age, they experience age-related health conditions. Usually, these individuals tend to experience these disorders at an earlier age than those without disabilities (Hall & Scragg 2012, p. 104). Presumably, they have limited access to opportunities that can help in improving their health thereby reducing their lifespan. As a consequence, they face conditions such as mobility and cardiac problems and those associated with impaired sight and hearing (Hall & Scragg 2012, p 105). In addition, there is a lack of professionals’ awareness that the elderly with learning disabilities can experience pain as a result of conditions such as dementia. These individuals are also susceptible to syndrome-specific conditions meaning that particular forms of learning disability can result in a greater risk of associated conditions (Tyson & Kitson 2010, p. 312). Commonly, this is seen in the relationship between Down’s syndrome and congenital heart attacks. Moreover, other conditions such as epilepsy and cerebral palsy are closely associated with learning disability as well (Hall & Scragg 2012, p.105).

Alongside the physical conditions, there is a relatively high prevalence of mental health problems among people with learning disabilities. Unfortunately, conditions such as anxiety often remain undiagnosed or poorly managed due to the lack of knowledge (Woods & Thomas 2003, p.51). In other words, in spite of a high number of cases of mental problems, relatively few persons apply for psychiatric services. Additionally, mental conditions such as dementia cause the impairment of higher mental functioning including loss of memory, social skills, and emotional control (Walmsley & Johnson 2003, p. 44).

Furthermore, in an effort to access social services, people with learning disabilities face a common problem of discrimination. In most cases, issues of discrimination are influenced by factors such as the inability to understand the information that is relevant to the decision, retaining that information, and communicating decisions whether by talking or using sign language (Peate & Fearns 2006, p.156). Therefore, it becomes hard to make the appropriate conclusion regarding a particular individual (Hardie & Tilly 2012, p. 109). Moreover, some specialists and staff ignore the need to use visual aids or translation for non-English speakers. This makes it easier for the patient to forget the information that would facilitate making informed decisions (Tilly 2011, p. 6).

Recommendations for Improvements

Many policy reports and recommendations have been made on how to improve services for people living with disabilities. However, some of them have made little or no impact, and therefore, they should be changed (Clark & Griffiths 2008, p. 68). For example, in the UK, the government expects to use professionals in health care as the link to helping people facing learning disabilities. Unfortunately, some of these specialists have a negative attitude that there is nothing much that can be done to solve problems associated with learning disabilities (Clark & Griffiths 2008, p. 68). Moreover, there is a lack of understanding among the health care staff that creates disparities. In this case, it is crucial to periodically conduct training to improve the understanding of the conditions facing people with learning disabilities (Hannon & Clift 2010, p. 220).

All people with learning disability must have the right to access all mainstream health care services. Moreover, the government and community have the responsibility to make sure that these individuals have additional support to be provided with the services that are specifically designed to meet their individual needs (Hannon & Clift 2010, p. 220). This involves an action plan such as registering them with a government agency with details showing the required interventions for each person in this group. In addition, the appointment of health facilitators is important to support patients with learning disabilities to cater for their health care needs (Hannon & Clift 2010, p. 220). The National Service Framework should be applied equally to such individuals and ensure that a clear guidance on consent issues is available and accessible (Atherton & Crickmore 2011, p.46).

The government should also develop an approach for dealing with institutional discrimination. Most reports show that people with learning disabilities are more likely to face barriers, abuse and neglect when accessing services compared to other members of the population (Rennie 2007, p.35). As a result, individuals in this group are more likely to develop other illnesses and severe health conditions that cause their premature deaths (Hannon & Clift 2010, p. 220). These acts contradict the provisions of the Disability Discrimination Act. These actions require the intervention by the government to ensure that people with learning disabilities are treated as equal citizens and get equal access to all health-related services. For example, the UK government should develop an approach that will ensure that the stakeholders in health sector develop and extend their efforts to monitor the standard of health services provided for people with learning disabilities (Hannon & Clift 2010, p.221). Similarly, the NHS bodies should involve and consult patients, families, and the public in the process of making health care decisions (Hannon & Clift 2010, p 222). Furthermore, it is recommended to create projects aiming at developing and improving services for specific individuals. It is also advisable to provide arrangements that will facilitate advocacy for all those who need it (Hannon & Clift 2010, p 222).

In conclusion, there are many reports that present evidence that people with learning disabilities face problems in accessing healthcare. These are issues such as lack of intellectual ability to make informed decisions, the ignorance of caregivers, discrimination, and the risk of developing other associated illnesses. Following these challenges, the NHS in the UK has formulated policies to improve the access to quality healthcare for this group of people. The UK government has increased the number of primary care givers, advocacy services, and mechanisms to identify patients that require follow-ups. However, it is recommended that the government develops additional support to ensure that people with learning disabilities have access to quality care that meets their needs. The process of policy formulation should involve patients, families, and friends for effective implementation.

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