The development of a care package for clients with a learning disability accessing contraception and reproductive health services

The development of a care package for clients with a learning disability

accessing contraception and reproductive health services

E. Maudsley (1), S. Kinvig (1), A. Gunstone (1), M. Atkins (2)

Abacus Clinics for Contraception and Reproductive Health Liverpool, UK

(1); Learning Disabilities Directorate, Liverpool, UK (2)

Introduction: Clinical staff had reported concerns when dealing with

clients with a learning disability (LD). The identified issues related to the

client’s capacity to consent to contraception, breast and cervical screening

and the ability to obtain an accurate history from the client/carer. When a

history and/or consent were not obtained, the consultation could go no further

and clinical staff believed the health care needs of these clients were not

being met.

Aims & Method: The goal was to develop a care package appropriate

to the diverse needs of these clients, ensuring that they were provided with the

same rights of access as all other service users. From February 2003,

multi-disciplinary meetings were held to identify options for the new care

package. Several issues were raised including, barriers to access, communication,

provision of an adequate support network and promotion of the new development to

all clinicians throughout the city. Five areas were developed.

Results: 1. Referral/assessment forms were designed to ensure an

appropriate medical, social and sexual history could be obtained with particular

emphasis on assessing client communication methods. 2. An aid to assessment of

the client’s competency to consent and in particular, identify whether

preparatory work/education would be beneficial. If the latter was requested, the

option of providing this service at home would be feasible via referral to the

Domiciliary team. If consent and preparatory work were both declined an option

would be given for follow up at a later date. 3. A guide for good practice in

assessing the client’s capacity to consent was developed and was included in

the package for reference purposes. 4. Several information booklets were

obtained for inclusion in the LD package: these booklets were specifically

developed for women with LD’s by People First (Liverpool), who themselves have

LD’s. 5. Instructions for the new proposal were drafted to aid clinicians in

the use of the new package. 6. The final LD package was agreed in November 2003

and is now being piloted for a 12-month trail period, from January 2004.

Conclusion: Multidisciplinary working has led to a package which

enables staff to feel more confident in carrying out consultations with clients

with LD’s and these client’s are more confident to access health services.

Scroll to Top