Improving access to Hackney Integrated Learning Disability Service

• Published in: BMJ open quality Vol. 11; no. 3; p. e001728
• Main Authors: Omrani, Osama, Spiers, Jessica, Prior, David, Haberland, Kirsty, Kabir, Anwar, Sinclair, Candace, Woods, Tom, Hall, Ian, Checkley, Laura
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 01.09.2022; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Adult learning; community mental health services; COVID-19; Disability; Feedback; Health services; healthcare quality improvement; Learning disabilities; Likert scale; Mental health; Psychiatrists; Psychologists; Quality improvement; Quality Improvement Report; Quality of care; Social workers; staff development; Therapists; waiting lists; United Kingdom > UK
• ISSN: 2399-6641; 2399-6641
• DOI: 10.1136/bmjoq-2021-001728

AimsImproving access to Hackney Integrated Learning Disability Service (ILDS) using quality improvement (QI) methodology by reducing the time taken to complete eligibility assessment by 50% by April 2021, while improving service user and staff experience.BackgroundReferrals to ILDS require assessment of eligibility. It was noted that there was significant waiting time between referral and eligibility assessment, exacerbated by the COVID-19 pandemic. Quality Network for Community Learning Disability Services guidelines suggest waiting times for those accessing adult learning disability (LD) community services be locally agreed, although there is limited literature on this topic.MethodsAll staff members across the multidisciplinary team were invited to participate in the QI project. We defined outcome measures as days from referral to allocation of eligibility assessment to staff member and to completion of eligibility assessment, comparing referrals received before and after start of the project. The key change ideas tested using Plan-Do-Study-Act cycles were: (1) eligibility screening checklist, (2) eligibility assessments drop-in sessions for staff, (3) formal training for ILDS staff, (4) eligibility screening allocation system, (5) template letters for eligibility decisions, (6) new ILDS referral form, (7) workshops for local general practitioners.ResultsTime taken to eligibility assessment allocation decreased from median of 184 (mean=183.5±109.8) to 13 days (mean=19.9±26.4) (93% reduction). Time to completion of eligibility assessment decreased from a median of 271 (mean=296.0±133.8) to 63 days (mean=75.7±34.8) (77% reduction). We received positive feedback from staff and service users regarding the new eligibility process.ConclusionsWe report waiting times for accessing our community adult LD services and effective strategies for reducing this. We recommend similar services use a QI methodology to reduce waiting times and improve the experience of staff and service users.