Helping patients with specific Helping patients with specific needs and learning difficulties needs and learning difficulties

succeed in the world of succeed in the world of

Radiology.Radiology. By By

Nicola Voos – Health Play Specialist,Nicola Voos – Health Play Specialist,

Therapeutic and Specialised Play servicesTherapeutic and Specialised Play services

Linked to the Radiology Linked to the Radiology

at Royal Manchester Children’s Hospital.at Royal Manchester Children’s Hospital.

NHS Choices 2014NHS Choices 2014 – “ A learning disability affects the way a person learns new things in – “ A learning disability affects the way a person learns new things in any area of life, not just at school. A learning disability affects the way a person any area of life, not just at school. A learning disability affects the way a person understands information and how they communicate. understands information and how they communicate. Around 1.5 million people in the UK have one. This means they can have difficulty: Around 1.5 million people in the UK have one. This means they can have difficulty: understanding, learning new skills, coping independently. It is thought that up to 350,000 understanding, learning new skills, coping independently. It is thought that up to 350,000 people have severe learning disabilities. This figure is increasing”. people have severe learning disabilities. This figure is increasing”.

Foundation for people with learning disabilities 2014Foundation for people with learning disabilities 2014 – “ A learning disability can affect – “ A learning disability can affectsomeone in a wide variety of ways. The terms ‘mild’, ‘severe’ and ‘profound’ learning someone in a wide variety of ways. The terms ‘mild’, ‘severe’ and ‘profound’ learning disabilities are sometimes used.” “Empowering people with learning difficulties – There is no disabilities are sometimes used.” “Empowering people with learning difficulties – There is no reason why people with learning disabilities shouldn’t have access to all the same things thatreason why people with learning disabilities shouldn’t have access to all the same things thateveryone else does in our society”. everyone else does in our society”.

14th July 2014 – Jane Cummings, Chief Nursing Officer for NHS England,said: “ People with learning disabilities, autism or challenging behaviour, oftenhave complex health needs and it is vital that they have health and care support in theirhomes and communities.”

Referral Process Referral Process Health professional sends a referral form or referring letter to the Therapeutic and SpecialisedHealth professional sends a referral form or referring letter to the Therapeutic and Specialised Play Services, or Radiographer refers after receiving a request for a procedure/ investigation.Play Services, or Radiographer refers after receiving a request for a procedure/ investigation.

Health Play Specialist makes contact with the family and carries out a disability assessment. Health Play Specialist makes contact with the family and carries out a disability assessment. The procedure is discussed in detail with the parent or guardian.The procedure is discussed in detail with the parent or guardian.

Arrange work up sessions /Arrange work up sessions / psychological preparation.psychological preparation.

Health Play Specialist devises a plan – where the procedure is going to take place.,Health Play Specialist devises a plan – where the procedure is going to take place.,

things they will and will not tolerate and risk assessments if required etc. things they will and will not tolerate and risk assessments if required etc.

Inform health professional/ clinician and bookingsInform health professional/ clinician and bookings

clerk that assessment is complete and to book scan. clerk that assessment is complete and to book scan.

Patient comes in for the procedure and Health Play Specialists plan is followed by all Patient comes in for the procedure and Health Play Specialists plan is followed by all

Multi-disciplinary Team. Health Play Specialist helps to facilitate the admission/ procedure.Multi-disciplinary Team. Health Play Specialist helps to facilitate the admission/ procedure.

Patient is discharged, Health Play Specialist places all documentation in the patients notes Patient is discharged, Health Play Specialist places all documentation in the patients notes and sends a letter to the referrer informing them that the patient has successfully and sends a letter to the referrer informing them that the patient has successfully

undergone the required procedure. undergone the required procedure.

Referral Audit April 2010 – March 2014Referral Audit April 2010 – March 2014

2010-20112010-2011 2011-20122011-2012 2012-20132012-2013 2013-20142013-2014

Specific needs/ learning Specific needs/ learning difficulties. difficulties. 3434 8282 7171 8181

Fear of needles, Fear of needles, procedures, scans or x-ray.procedures, scans or x-ray. 3939 4444 2626 3737

Previously had scans Previously had scans under sedation or general under sedation or general anaesthetic.anaesthetic.

1616 1313 3232 2222

Total referrals: Total referrals: 8989 139139 129129 140140

Ken Hindel – Superintendent Radiographer

Emma Fieldhouse – Sonographer. Emma Fieldhouse – Sonographer.

Case StudyCase Study

A 13 year old boy with severe learning difficulties and A 13 year old boy with severe learning difficulties and autism is referred to ( myself) Health Play Specialist for autism is referred to ( myself) Health Play Specialist for an ultrasound scan. It has been requested under a an ultrasound scan. It has been requested under a general anaesthetic as he attended his local hospital and general anaesthetic as he attended his local hospital and when asked to lie on the bed he became extremely when asked to lie on the bed he became extremely violent. He began to throw furniture and attempted to violent. He began to throw furniture and attempted to attack staff and mum. When contacting mum she said attack staff and mum. When contacting mum she said she felt that if given time and prepared well he would be she felt that if given time and prepared well he would be able to receive the scan awake without sedation or a able to receive the scan awake without sedation or a general anaesthetic. general anaesthetic.

Importance of preparationImportance of preparation

Importance Distraction/Importance Distraction/Diversional therapies. Diversional therapies.

Distraction is a vital factor in helping all children get through invasive or time Distraction is a vital factor in helping all children get through invasive or time consuming procedures. Getting to know a patients level of development helps you consuming procedures. Getting to know a patients level of development helps you choose which tools to use for distraction. choose which tools to use for distraction.

Remember: children react better to a calm environment. Minimal staff should be Remember: children react better to a calm environment. Minimal staff should be present during invasive procedures. If you appear happy and interactive to children it present during invasive procedures. If you appear happy and interactive to children it makes them relax and they relate to you better.makes them relax and they relate to you better.

Who is responsible for making a patients Who is responsible for making a patients experience in hospital a positive one?experience in hospital a positive one?

We ALL are! We ALL are!