Dolores Romero de Ávila Hidalgo

Coded extract table excerpt- clinicians phase one

Participant /Domain

Extract Coded for

Amy PWP Eligibility, Access

P:…thi ki g i te s of e pe ie e, the e s ou k o , f o s ee i g, it s defi itel ot so ethi g ou d, I d e lude at s ee i g a d the t iage people, e see people at step t o, I su e I e see people ho ha e the go e o to step th ee

 We are doing well: Inclusive of PwLD

Eligibility, Access

P: … ell, I suppose e ause the e a e people, it does t ea its representative, I certainly think that there could be more that could

e do e. I ot su e hat…the atio al p opo tio is of people with LD ut, I ha e t o e a oss loads of people, i this se i e, but I have come across people

 We are doing well: but could do better

 Need to increase access for people with learning disabilities generally

Eligibility, Access

P:…I suppose just u e s, a d ki da I su e e o e o to it, ut a ie s at ea lie stages, so… eah, at the ki da late stages, he the get to see so e od I thi k it s fi e. I thi k it s o e about getting people in

 Need to increase access for people with learning disabilities generally

 Need for pre-access reasonable adjustments, communication and fairness

Eligibility, Access

P:…ki da, i easi g a a e ess of ou ki da se i e a d the fa t that we do work with people, you know, all different kinds of people. Maybe kinda targeting areas where people with learning disa ilities ight e, I do t k o hat that ight e, e , I suppose kinda thinking about the distinguishing between a more specialist service and our service and whether other kinda professionals know that we do have the scope to work with people…so the do t ha e to go to a spe ialised se i e, so a e the e s i easi g a a e ess a o gst othe p ofessio als as ell.

 Need to advertise that we can and do work with PwLD  Joint working: Sharing expertise -consultations/ liaisons  Need to develop referral pathways between services

Safeguarding P: I have never raised a safeguarding issue with a vulnerable adult here, but I know that if that were to arise, I would feel comfortable, um, raising it and I would feel supported in the decision of what to do and I feel that people have, people working here have a lot of knowledge in terms of what to do in those kinds of situations, so that s, that would be, yeah, green

 We are doing well: Supportive/ sharing skills  We are doing well: Safeguarding

Safeguarding P: ay e ha i g…. e ha e a flo hart for hildre , do e ha e a flow chat for adults? More simple kinda, erm just visual, what to do, very simplistic, that you can kinda follow it and then know exactly what to do and take things a bit more in depth, umm, , there are all sort of thi gs that a o e up…

 We are doing well: Supportive/ sharing skills  Clinician desire for simplicity /convenience

 Clinician anxiety/uncertainty: Unsure of what protocols to follow  Clinician anxiety/ uncertainty- feeling unskilled/ ill equipped to

work with PwLD

 Training: To be practical- oad, asi ho to  Clinician anxiety/uncertainty: Need for training/ clarity Assessment P: ofte e do t ha e people ho do t ha e a diag osis, a d the

sometimes it can be quite tricky to assess if you get a referral and it does t ha e a diag osis or a y ki d of i di atio o it, so eti es it can be quite difficult to assess a d k o hat e re ea t to e assessi g a d I ha e t had a y trai i g i sort of LD, oh, actually, I think I probably have (laughs) I remember that now very vividly (jokingly), but I mean in terms of assessing it, what sort of questions to ask and how to assess it thoroughly, erm, when working with it and what sort of level to be working with it, that sort of thing, er, so the clinician working with the patient, what they would need to know at assessment, erm, so I think they could be improvements there, ut hether there s so ethi g, I thi k the e s just a diffi ult in there being a lack of diagnosis generally,

 UNCE‘TAINTY fo la it o the LD la el a d LD diag osis  Need for pre-access reasonable adjustments, communication and

fairness

 Clinician anxiety/uncertainty: Need for training/ clarity  Need for training: to be practical- oad, asi ho to

Equalities P: the e s, ou k o it defi itel so ethi g e o k ith a d e a e uite fle i le, u … a I just see… look over answers again) so it thi k it s e , i te s of o ki g ith people, although I thi k it s eall positi e i this se i e, I thi k, u , oh, a e that s o e kinda me. So, we could have more specific materials available, I know the a e a aila le, ut ho eadil used the a e…I suppose I thi ki g a out people that do t ha e a spe ifi diag osis, ou so eti es do t a t to….ju p to o lusio s ith the

 We are doing well: Making adaptations

 Need for greater internal dissemination of knowledge on LD/ Awareness raising within the team on LD matters

 Reasonable Adjustments: Need for (more) easy read materials  Clinician anxiety/uncertainty: Fear of offending

Equalities P: It s a lot o e diffi ult he so eo e does t ha e a diag osis, and you have to adjust your sessions, but not in an explicit way

he e ou ag ee togethe , does that ake se se? So ou e ki d of o ki g ith so e od , a d ou e a e got so e ki d of queries along the way, so your session ns kinda have to be adjusted, but not to the extent of using specific materials and that kind of thing.

 Desi e fo la it o the LD la el a d LD diag osis  Need for clarity on reasonable adjustments

 Clinician anxiety/ uncertainty- feeling unskilled/ ill equipped to work with PwLD

Equalities P: ut I do thi k it s defi itel a good se i e fo ha i g those adjustments available, um and the N to work with people, erm, yeah, creatively.

 We are doing well: Making adaptations

Equalities P: so getting training, knowing what materials are available and how to work with them. So, I think I might be a bit kind of hesitant with some of the materials, purely because I have never worked with the efo e a d I do t k o hi h is the est, kind of way and how and all of that to work with it, and so again, that ties in with some of the training. Errm. But I do think it is a good, flexible service.

 Need for training on LD centric materials

 Need for training to be practical- oad, asi ho to  Clinician anxiety/ uncertainty- feeling unskilled/ ill equipped to

work with PwLD

 Clinician anxiety/uncertainty: Need for training/ clarity  We are doing well: Making adaptations

Staff Attitudes

P: it seems like people have a really positive attitude here. Umm, ki d of, it s uite ha d to e plai , like eall ope to a epti g people and being very, erm, you know, a good sense of equality. If

ou assess people, it s ot ki d of, the e s o stig a, a d e e, it see s like e e happ to o k ith people, all different kinds of people… so people o k ith people ith LD a d see happ a d

o fide t to do so. I e tai l thi k that that s a eall good a ea

 We are doing well: positive staff attitude to working with PwLD  We are doing well: Inclusive of PwLD

Staff Attitudes

P: I think if there were more people referred and we worked with more people, then, that kind of ties back to what we were saying at the beginning about improving access, so by seeing more people,

e d all ki d of…

I: Feel a bit more experienced?

P: Yeah, eah… I thi k getti g o e people i , o e people would feel more confident and it would improve even further

 Need for exposure to people with learning disabilities to increase clinician confidence working with them

 Need to increase access for people with learning disabilities generally

 Clinician anxiety/ uncertainty- feeling unskilled/ ill equipped to work with PwLD

Accessible Information

P: The p o le is that I ha e t o ked spe ifi all ith all the hole a ge of ate ials so I do t k o . So it ould e o e a ki d of a uestio a k, tha a defi ite, pu el e ause I ha e t worked with all the materials myself. Erm, but, as far as I am aware, there is a lot of materials, umm, people kinda are flexible to adapt the sessions and um, you know , adapt language and

communication styles based on who they are working with. But then, I can only speak for myself, so, but as far as in know, it is really positive.

 Clinician anxiety/ uncertainty- feeling unskilled/ ill equipped to work with PwLD

 Need for greater internal dissemination of knowledge on LD/ Awareness raising within the team on LD matters

 Unsure of answer

 We are doing well: Making adaptations

 We are doing well: Aware of individual differences  We are doing well: probably

Accessible Information

P: if all supervisors and triage supervisors were really really familiar with all the materials and things like that, to then work, perhaps, you know, if I were seeing somebody, um, taking it to supervision and using that supervision time to think about things, so if my supervisor had a lot of knowledge and experience of everything that was available, that would be really helpful I think.

 Need for training: for specialists and supervisors  Need for training: on LD centric materials

 Need for greater internal dissemination of knowledge on LD/ Awareness raising within the team on LD matters