Learning disability and autism awareness

Learning disability and autism awareness

Learning disabilities often affect the ability to understand new or complex information and to cope independently. Autism is a neurodevelopmental condition affecting communication, social interaction and behaviour. Some people with a learning disability are also autistic.

People with a learning disability and autistic people are known to experience health inequality, poor experience with healthcare services and inappropriate prescribing, and some studies have shown increased likelihood of early death at up to 20 years younger than the general population. Many of these early deaths are thought to be largely preventable.

This pharmacy guide will cover a range of practical issues to raise awareness about the needs of people with a learning disability and autistic people, as well as highlighting resources to enable all pharmacy teams to improve, and prioritise, their service for these groups of people.

This information should be applicable to a range of pharmacy professionals based on their level of understanding, competence and experience in the field of learning disability. It covers issues related to medicine supply, and management, as well as more specialised services looking at delivering structured medication reviews and deprescribing work linked to the STOMP and STAMP (Over-prescribing) agenda. There is something applicable to all sectors of pharmacy practice.

The resources focus on quality-of-life improvement and the reduction in inequality through good medicine management and optimisation. All pharmacy practitioners can utilise the resources to improve their practice and services to people with a learning disability, autistic people, their families and carers.

Learning disability and autism awareness

These will allow pharmacy teams to develop good standards of communication and accessible care to improve their practice.

An understanding and awareness of the particular challenges and issues related to people with a learning disability and autistic people will be key to developing all pharmacy related services and improving health and wellbeing.

General awareness

Training
  • Learning Disability Hub Centre for Postgraduate Pharmacy Education (CPPE) Learning disabilities: CPPE is free to access for all pharmacy professionals and can be used as part of revalidation. It demonstrates you are improving your knowledge and skills to remain on the pharmacy register. It will help you to learn about what it means to be a person with a learning disability and adapt your communication style. You will be aware of the range of accessible resources and how they can be used in practice. It will help you to understand your role in promoting physical, mental and behavioural wellbeing in people with a learning disability as well as to understand how to adapt your practice to ensure excellent medicines optimisation in people with a learning disability
  • The Oliver McGowan Mandatory Training on Learning Disability and Autism — e-learning for healthcare enables you to have the right skills and knowledge to provide safe, compassionate and informed care to autistic people and people with a learning disability. It will support you in your interactions with people and their families. (Access limited to NHS health or care organisation (registration required).

Specific pathways, programmes of work and resources
Mental capacity

This section will help you if you are involved with undertaking mental capacity assessment, in asking whether a person needs a mental capacity assessment, and in asking about and referring to best interest decisions.

Reasonable adjustment digital flag

This section will ensure pharmacists know their responsibilities within the digital flag, that they know how to use it and to ensure they are making reasonable adjustments whenever needed. You can also check if your workplace is meeting the criteria in the checklist.

Specialist pharmacy services

Health and care passports

This section provides an overview of the passport, supporting pharmacists to ask the person if they have one and if they would be okay to show it to the pharmacist, and also providing information on how to get one.

  • NHS England Health and care passports is designed to be a quick and easy way for a person to give health and social care professionals more information about their needs, choices, communication and reasonable adjustments.

LeDeR

This section will help pharmacists understand the health inequalities people with a learning disability and autistic people face and the impact of these.  

NHS Futures (free but requires registration)


Accessible information for patients, families and carers

Includes accessible information about medication, practical tips and hints, getting advice from pharmacists in different settings, how to safely use medication and language specific resources for particular communities.

Resources for pharmacy teams to use to inform accessible pharmacy services

And resources that you can share with people and help you to ensure that people have information in accessible formats. It also includes discussion cards to make sure the person feels included in making decisions about their treatment, including medication 

Adapted information for pharmacy teams to access and share with patients

This section supports you in educating customers and patients about their medication in an accessible format. It contains information about language specific leaflets for particular nationalities and ethnic communities and ensures the person and their care team are educated and informed so they can be fully included in joint decision-making. 


Medication reviews

This section includes a Structured Medication Review tool kit, resources to be used before, during and after medication reviews.

Adapted resources to give to patients, families and care providers ​​

CoSMR resources

Co-SMR is a collaborative project that worked with healthcare professionals across the country, and people with Learning Disability, families and carers to co-produce tools and resources to use in practice for reviewing Psychotropic medication in practice. For more information about Co-SMR, please look at the NHS Futures STOMP STAMP platform, and the Summary document.

Information for patients, families and carers:

Preparing for structured medication reviews​​:

NHS Futures resource bank:

  • This workspace is free to access with a suitable email via NHS Futures.

Medication information

This section helps you to keep updated with all agents and understand their usefulness in treatment, understanding side effect profiles and what to look for and discuss in medication reviews.

  • BNFC​: The British National Formulary for Children — no specific page on psychosis and related disorders information.
  • BNF​: The British National Formulary information on benefits, side effects and monitoring requirements for first- and second-generation antipsychotics​.

Impact of effective structured medication reviews

NHS Futures (free, but requires registration)
  • STOMP and STAMP — Futures highlights and develops good practice relating to the most appropriate use of medication in people with a learning disability and autistic people, including links to training webinars, resources, reports and access to a community of practice to ask questions and share good practice.
  • Community of Practice Pilot Report outlines key recommendations in relation to the role local health systems and all pharmacy teams in the use of medication reviews to reduce over-medication of people with a learning disability.


STOMP and STAMP

This section includes standards, survey and resources linked to safe prescribing and deprescribing practice.

General information​

Guidance​
  • NICE NG11​ and Quality Standard 101​ are NICE Guidelines relating to challenging behaviour and learning disabilities and associated standards, highlighting the pathway for prevention and interventions for behaviour that challenges. This includes psychological and environmental interventions as well as medication​.
  • Stopping antidepressants is a Royal College of Psychiatry guide to stopping antidepressants including practical advice, schedules and safe practice.
  • GP prescribing leaflet outlines the role GPs and those working in GP practices have in prescribing, reviewing and deprescribing psychotropic mediation for people with a learning disability.

Resources to use by family and/or support staff
  • Preparing to visit a doctor to talk about medication​ is designed for a support worker who is accompanying a person with​ a learning disability, autism or both to a GP or consultant appointment.
  • Medication Pathway​ is from the Challenging Behaviour Foundation (CBF) and is for families who have loved ones with more severe learning disability and whose behaviour can be thought to be challenging. It includes information on how to be included in decision-making and challenge long-standing medication no longer thought to be beneficial or is causing significant side effects.
  • STOMP STAMP family guide​ is a co-produced resource to help family carers to understand more about medication and suggests questions to ask clinicians, especially in relation to children and young people.​

Resources for patients​

Training​
  • Link to Mind Ed training has 10 modules within the Mind ED training relating to psychotropic medication and STOMP STAMP, including awareness raising, impact of psychotropic prescribing, safely prescribing and deprescribing and service development.

People’s experiences ​
  • Richards story part 2​ is a film about the challenges a person and their family experienced — the importance of nonmedical strategies, regular reviews and co-production​.
  • Shane’s Story shows the use of non-medication strategies to safely deprescribe psychotropic medication
  • Debbie and Lucy’s Story shows how using non-medication strategies to prevent the prescribing of psychotropic medication for behaviour that challenges.
  • Ethan’s Story shows how STOMP can be used to improve all aspects of health through quality medication optimisation.
  • Collaboration in Sunderland explains how working in true collaboration leads to more successful outcomes related to medicines.

NHS Futures (free but requires registration)​
  • STOMP and STAMP — Futures​ is dedicated to highlighting and developing good practice relating to the most appropriate use of medication in people with a learning disability and autistic people — includes links to training webinars, resources, reports and access to a community of practice to ask questions and share good practice.